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Sample records for health outcomes monitoring

  1. Remote health monitoring: predicting outcome success based on contextual features for cardiovascular disease.

    PubMed

    Alshurafa, Nabil; Eastwood, Jo-Ann; Pourhomayoun, Mohammad; Liu, Jason J; Sarrafzadeh, Majid

    2014-01-01

    Current studies have produced a plethora of remote health monitoring (RHM) systems designed to enhance the care of patients with chronic diseases. Many RHM systems are designed to improve patient risk factors for cardiovascular disease, including physiological parameters such as body mass index (BMI) and waist circumference, and lipid profiles such as low density lipoprotein (LDL) and high density lipoprotein (HDL). There are several patient characteristics that could be determining factors for a patient's RHM outcome success, but these characteristics have been largely unidentified. In this paper, we analyze results from an RHM system deployed in a six month Women's Heart Health study of 90 patients, and apply advanced feature selection and machine learning algorithms to identify patients' key baseline contextual features and build effective prediction models that help determine RHM outcome success. We introduce Wanda-CVD, a smartphone-based RHM system designed to help participants with cardiovascular disease risk factors by motivating participants through wireless coaching using feedback and prompts as social support. We analyze key contextual features that secure positive patient outcomes in both physiological parameters and lipid profiles. Results from the Women's Heart Health study show that health threat of heart disease, quality of life, family history, stress factors, social support, and anxiety at baseline all help predict patient RHM outcome success. PMID:25570321

  2. Routine outcomes monitoring to support improving care for schizophrenia: report from the VA Mental Health QUERI.

    PubMed

    Young, Alexander S; Niv, Noosha; Chinman, Matthew; Dixon, Lisa; Eisen, Susan V; Fischer, Ellen P; Smith, Jeffrey; Valenstein, Marcia; Marder, Stephen R; Owen, Richard R

    2011-04-01

    In schizophrenia, treatments that improve outcomes have not been reliably disseminated. A major barrier to improving care has been a lack of routinely collected outcomes data that identify patients who are failing to improve or not receiving effective treatments. To support high quality care, the VA Mental Health QUERI used literature review, expert interviews, and a national panel process to increase consensus regarding outcomes monitoring instruments and strategies that support quality improvement. There was very good consensus in the domains of psychotic symptoms, side-effects, drugs and alcohol, depression, caregivers, vocational functioning, and community tenure. There are validated instruments and assessment strategies that are feasible for quality improvement in routine practice. PMID:20658320

  3. The Promise of mHealth: Daily Activity Monitoring and Outcome Assessments by Wearable Sensors

    PubMed Central

    Dobkin, Bruce H.; Dorsch, Andrew

    2014-01-01

    Mobile health tools that enable clinicians and researchers to monitor the type, quantity, and quality of everyday activities of patients and trial participants have long been needed to improve daily care, design more clinically meaningful randomized trials of interventions, and establish cost-effective, evidence-based practices. Inexpensive, unobtrusive wireless sensors, including accelerometers, gyroscopes, and pressure-sensitive textiles, combined with Internet-based communications and machine-learning algorithms trained to recognize upper- and lower-extremity movements, have begun to fulfill this need. Continuous data from ankle triaxial accelerometers, for example, can be transmitted from the home and community via WiFi or a smartphone to a remote data analysis server. Reports can include the walking speed and duration of every bout of ambulation, spatiotemporal symmetries between the legs, and the type, duration, and energy used during exercise. For daily care, this readily accessible flow of real-world information allows clinicians to monitor the amount and quality of exercise for risk factor management and compliance in the practice of skills. Feedback may motivate better self-management as well as serve home-based rehabilitation efforts. Monitoring patients with chronic diseases and after hospitalization or the start of new medications for a decline in daily activity may help detect medical complications before rehospitalization becomes necessary. For clinical trials, repeated laboratory-quality assessments of key activities in the community, rather than by clinic testing, self-report, and ordinal scales, may reduce the cost and burden of travel, improve recruitment and retention, and capture more reliable, valid, and responsive ratio-scaled outcome measures that are not mere surrogates for changes in daily impairment, disability, and functioning. PMID:21989632

  4. The promise of mHealth: daily activity monitoring and outcome assessments by wearable sensors.

    PubMed

    Dobkin, Bruce H; Dorsch, Andrew

    2011-01-01

    Mobile health tools that enable clinicians and researchers to monitor the type, quantity, and quality of everyday activities of patients and trial participants have long been needed to improve daily care, design more clinically meaningful randomized trials of interventions, and establish cost-effective, evidence-based practices. Inexpensive, unobtrusive wireless sensors, including accelerometers, gyroscopes, and pressure-sensitive textiles, combined with Internet-based communications and machine-learning algorithms trained to recognize upper- and lower-extremity movements, have begun to fulfill this need. Continuous data from ankle triaxial accelerometers, for example, can be transmitted from the home and community via WiFi or a smartphone to a remote data analysis server. Reports can include the walking speed and duration of every bout of ambulation, spatiotemporal symmetries between the legs, and the type, duration, and energy used during exercise. For daily care, this readily accessible flow of real-world information allows clinicians to monitor the amount and quality of exercise for risk factor management and compliance in the practice of skills. Feedback may motivate better self-management as well as serve home-based rehabilitation efforts. Monitoring patients with chronic diseases and after hospitalization or the start of new medications for a decline in daily activity may help detect medical complications before rehospitalization becomes necessary. For clinical trials, repeated laboratory-quality assessments of key activities in the community, rather than by clinic testing, self-report, and ordinal scales, may reduce the cost and burden of travel, improve recruitment and retention, and capture more reliable, valid, and responsive ratio-scaled outcome measures that are not mere surrogates for changes in daily impairment, disability, and functioning. PMID:21989632

  5. A Wireless Health Outcomes Monitoring System (WHOMS): development and field testing with cancer patients using mobile phones

    PubMed Central

    Bielli, Emilia; Carminati, Fabio; La Capra, Stella; Lina, Micaela; Brunelli, Cinzia; Tamburini, Marcello

    2004-01-01

    Background Health-Related Quality of Life assessment is widely used in clinical research, but rarely in clinical practice. Barriers including practical difficulties administering printed questionnaires have limited their use. Telehealth technology could reduce these barriers and encourage better doctor-patient interaction regarding patient symptoms and quality-of-life monitoring. The aim of this study was to develop a new system for transmitting patients' self-reported outcomes using mobile phones or the internet, and to test whether patients can and will use the system via a mobile phone. Methods We have developed a prototype of a Wireless Health Outcomes Monitoring System, which allows structured questionnaires to be sent to the patient by their medical management team. The patients' answers are directly sent to an authorised website immediately accessible by the medical team, and are displayed in a graphic format that highlights the patient's state of health. In the present study, 97 cancer inpatients were asked to complete a ten-item questionnaire. The questionnaire was delivered by display on a mobile phone, and was answered by the patients using the mobile phone keypad. Results Of the 97 patients, 56 (58%) attempted the questionnaire, and all of these 56 completed it. Only 6% of the total number of questions were left unanswered by patients. Forty-one (42%) patients refused to participate, mostly due to their lack of familiarity with mobile phone use. Compared with those who completed the questionnaire, patients who refused to participate were older, had fewer years of education and were less familiar with new communications technology (mobile phone calls, mobile phone SMS, internet, email). Conclusion More than half of the patients self-completed the questionnaire using the mobile phone. This proportion may increase with the use of multichannel communications which can be incorporated into the system. The proportion may also increase if the patient's partner

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

    PubMed Central

    2012-01-01

    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 clinical practice and

  7. Health Literacy and Health Outcomes

    MedlinePlus

    ... When compared to those with adequate health literacy skills, studies have shown that patients with limited health literacy ... literacy skills. 12 Back to Top Health status Studies demonstrate that persons with limited health literacy skills are significantly more likely than persons with adequate ...

  8. Health Literacy and Health Outcomes

    MedlinePlus

    ... and Health Promotion relied extensively on both the Institute of Medicine (2004) and the Agency for Healthcare Research and Quality (2004) reports, which include comprehensive reviews of the literature on health literacy and ...

  9. MEDICARE HEALTH OUTCOMES SURVEY (HOS)

    EPA Science Inventory

    The Medicare Health Outcomes Survey (HOS) is the first Medicare managed care outcomes measure. CMS, in collaboration with NCQA, launched the Medicare HOS in the 1998 Health Plan Employer Data and Information Set (HEDIS?). The measure includes the most recent advances in summarizi...

  10. Outcomes management in women's health.

    PubMed

    Houston, S; Fleschler, R

    1997-01-01

    Outcomes management uses a quality and research approach to reducing costs in health care. Populations may be targeted for high volumes or their potential for cost savings. Outcomes are identified and measured through data collection and analysis. System and care processes that drive these outcomes are analyzed. Tenets related to outcomes management include questioning practice, administrative and physician involvement; recognizing that change is necessary; accepting uncontrollable factors; and valuing the outcomes management process. Resources necessary for managing outcomes include the use of collaborative practice teams, outcomes assessment, information systems, and educational support services. The women's health population can benefit from an outcomes management effort by improving and standardizing care for mothers and infants across the continuum. There is the opportunity to affect the wellness of this population even before the pregnancy occurs. PMID:9170599

  11. Integrated structural health monitoring.

    SciTech Connect

    Farrar, C. R.

    2001-01-01

    Structural health monitoring is the implementation of a damage detection strategy for aerospace, civil and mechanical engineering infrastructure. Typical damage experienced by this infrastructure might be the development of fatigue cracks, degradation of structural connections, or bearing wear in rotating machinery. The goal of the research effort reported herein is to develop a robust and cost-effective structural health monitoring solution by integrating and extending technologies from various engineering and information technology disciplines. It is the authors opinion that all structural health monitoring systems must be application specific. Therefore, a specific application, monitoring welded moment resisting steel frame connections in structures subjected to seismic excitation, is described along with the motivation for choosing this application. The structural health monitoring solution for this application will integrate structural dynamics, wireless data acquisition, local actuation, micro-electromechanical systems (MEMS) technology, and statistical pattern recognition algorithms. The proposed system is based on an assessment of the deficiencies associated with many current structural health monitoring technologies including past efforts by the authors. This paper provides an example of the integrated approach to structural health monitoring being undertaken at Los Alamos National Laboratory and summarizes progress to date on various aspects of the technology development.

  12. Integrated structural health monitoring

    NASA Astrophysics Data System (ADS)

    Farrar, Charles R.; Sohn, Hoon; Fugate, Michael L.; Czarnecki, Jerry J.

    2001-07-01

    Structural health monitoring is the implementation of a damage detection strategy for aerospace, civil and mechanical engineering infrastructure. Typical damage experienced by this infrastructure might be the development of fatigue cracks, degradation of structural connections, or bearing wear in rotating machinery. The goal of the research effort reported herein is to develop a robust and cost-effective structural health monitoring solution by integrating and extending technologies from various engineering and information technology disciplines. It is the author's opinion that all structural health monitoring systems must be application specific. Therefore, a specific application, monitoring welded moment resisting steel frame connections in structures subjected to seismic excitation, is described along with the motivation for choosing this application. The structural health monitoring solution for this application will integrate structural dynamics, wireless data acquisition, local actuation, micro-electromechanical systems (MEMS) technology, and statistical pattern recognition algorithms. The proposed system is based on an assessment of the deficiencies associated with many current structural health monitoring technologies including past efforts by the authors. This paper provides an example of the integrated approach to structural health monitoring being undertaken at Los Alamos National Laboratory and summarizes progress to date on various aspects of the technology development.

  13. Mobile health monitoring systems.

    PubMed

    Walker, William; Aroul, A L Praveen; Bhatia, Dinesh

    2009-01-01

    Advancements are being made towards a cheap and effective means for health monitoring. A mobile monitoring system is proposed for monitoring a bicycle rider using light weight, low power wireless sensors. Biometric and environmental information pertaining to the bicycle rider is captured, transmitted to, and stored in a remote database with little user interaction required. Remote users have real time access to the captured information through a web application. Possible applications for this system include the monitoring of a soldier in the battlefield and the monitoring of a patient during an ambulance ride. PMID:19965041

  14. Valve Health Monitor (VHM)

    NASA Technical Reports Server (NTRS)

    Perotti, Jose M.; Delgado, H. (Technical Monitor)

    2002-01-01

    This presentation reports on progress being made on developing a Valve Health Monitor (VHM) Smart Current Signature Sensor. Topics cover include: design needs, target valves, current signatures, VHM design approach and VHM status/conclusions.

  15. Lunar Health Monitor (LHM)

    NASA Technical Reports Server (NTRS)

    Lisy, Frederick J.

    2015-01-01

    Orbital Research, Inc., has developed a low-profile, wearable sensor suite for monitoring astronaut health in both intravehicular and extravehicular activities. The Lunar Health Monitor measures respiration, body temperature, electrocardiogram (EKG) heart rate, and other cardiac functions. Orbital Research's dry recording electrode is central to the innovation and can be incorporated into garments, eliminating the need for conductive pastes, adhesives, or gels. The patented dry recording electrode has been approved by the U.S. Food and Drug Administration. The LHM is easily worn under flight gear or with civilian clothing, making the system completely versatile for applications where continuous physiological monitoring is needed. During Phase II, Orbital Research developed a second-generation LHM that allows sensor customization for specific monitoring applications and anatomical constraints. Evaluations included graded exercise tests, lunar mission task simulations, functional battery tests, and resting measures. The LHM represents the successful integration of sensors into a wearable platform to capture long-duration and ambulatory physiological markers.

  16. Wearable Health Monitoring Systems

    NASA Technical Reports Server (NTRS)

    Bell, John

    2015-01-01

    The shrinking size and weight of electronic circuitry has given rise to a new generation of smart clothing that enables biological data to be measured and transmitted. As the variation in the number and type of deployable devices and sensors increases, technology must allow their seamless integration so they can be electrically powered, operated, and recharged over a digital pathway. Nyx Illuminated Clothing Company has developed a lightweight health monitoring system that integrates medical sensors, electrodes, electrical connections, circuits, and a power supply into a single wearable assembly. The system is comfortable, bendable in three dimensions, durable, waterproof, and washable. The innovation will allow astronaut health monitoring in a variety of real-time scenarios, with data stored in digital memory for later use in a medical database. Potential commercial uses are numerous, as the technology enables medical personnel to noninvasively monitor patient vital signs in a multitude of health care settings and applications.

  17. Inductive System Health Monitoring

    NASA Technical Reports Server (NTRS)

    Iverson, David L.

    2004-01-01

    The Inductive Monitoring System (IMS) software was developed to provide a technique to automatically produce health monitoring knowledge bases for systems that are either difficult to model (simulate) with a computer or which require computer models that are too complex to use for real time monitoring. IMS uses nominal data sets collected either directly from the system or from simulations to build a knowledge base that can be used to detect anomalous behavior in the system. Machine learning and data mining techniques are used to characterize typical system behavior by extracting general classes of nominal data from archived data sets. IMS is able to monitor the system by comparing real time operational data with these classes. We present a description of learning and monitoring method used by IMS and summarize some recent IMS results.

  18. Impact of Remote Monitoring on Clinical Outcomes.

    PubMed

    Varma, Niraj; Ricci, Renato Pietro

    2015-12-01

    Follow-up of patients with cardiac implantable electronic devices is challenging due to both their increasing volume and technical complexity coupled to increasing clinical complexity of recipient patients. Remote monitoring (RM) offers an opportunity to resolve some of these difficulties by improving clinic efficiencies and providing a mechanism for device monitoring and patient management. Several recent randomized clinical trials and registries have demonstrated that RM may reduce in-hospital visit numbers, time required for patient follow-up, physician and nurse time, and hospital and social costs. Furthermore, patient retention and adherence to follow-up schedule are significantly improved by RM. Continuous wireless monitoring of data stored in the device memory with automatic alerts allows early detection of device malfunctions and of events, such as atrial fibrillation, ventricular arrhythmias, and heart failure suitable for clinical intervention. Early reaction may improve patient outcome. RM is easy to use and patients showed a high level of acceptance and satisfaction. Implementing RM in daily practice may require changes in clinic workflow. New organizational models promote significant efficiencies regarding physician and nursing time. Data management techniques are under development. Despite these demonstrable advantages of RM, adoption still remains modest, even in health care systems incentivized to use this follow-up method. PMID:26337400

  19. System health monitoring

    SciTech Connect

    Reneke, J.A.; Fryer, M.O.

    1995-08-01

    Well designed large systems include many instrument taking data. These data are used in a variety of ways. They are used to control the system and its components, to monitor system and component health, and often for historical or financial purposes. This paper discusses a new method of using data from low level instrumentation to monitor system and component health. The method uses the covariance of instrument outputs to calculate a measure of system change. The method involves no complicated modeling since it is not a parameter estimation algorithm. The method is iterative and can be implemented on a computer in real time. Examples are presented for a metal lathe and a high efficiency particulate air (HEPA) filter. It is shown that the proposed method is quite sensitive to system changes such as wear out and failure. The method is useful for low level system diagnostics and fault detection.

  20. Food Insecurity And Health Outcomes.

    PubMed

    Gundersen, Craig; Ziliak, James P

    2015-11-01

    Almost fifty million people are food insecure in the United States, which makes food insecurity one of the nation's leading health and nutrition issues. We examine recent research evidence of the health consequences of food insecurity for children, nonsenior adults, and seniors in the United States. For context, we first provide an overview of how food insecurity is measured in the country, followed by a presentation of recent trends in the prevalence of food insecurity. Then we present a survey of selected recent research that examined the association between food insecurity and health outcomes. We show that the literature has consistently found food insecurity to be negatively associated with health. For example, after confounding risk factors were controlled for, studies found that food-insecure children are at least twice as likely to report being in fair or poor health and at least 1.4 times more likely to have asthma, compared to food-secure children; and food-insecure seniors have limitations in activities of daily living comparable to those of food-secure seniors fourteen years older. The Supplemental Nutrition Assistance Program (SNAP) substantially reduces the prevalence of food insecurity and thus is critical to reducing negative health outcomes. PMID:26526240

  1. Linkages among reproductive health, maternal health, and perinatal outcomes.

    PubMed

    Bhutta, Zulfiqar A; Lassi, Zohra S; Blanc, Ann; Donnay, France

    2010-12-01

    Some interventions in women before and during pregnancy may reduce perinatal and neonatal deaths, and recent research has established linkages of reproductive health with maternal, perinatal, and early neonatal health outcomes. In this review, we attempted to analyze the impact of biological, clinical, and epidemiologic aspects of reproductive and maternal health interventions on perinatal and neonatal outcomes through an elucidation of a biological framework for linking reproductive, maternal and newborn health (RHMNH); care strategies and interventions for improved perinatal and neonatal health outcomes; public health implications of these linkages and implementation strategies; and evidence gaps for scaling up such strategies. Approximately 1000 studies (up to June 15, 2010) were reviewed that have addressed an impact of reproductive and maternal health interventions on perinatal and neonatal outcomes. These include systematic reviews, meta-analyses, and stand-alone experimental and observational studies. Evidences were also drawn from recent work undertaken by the Child Health Epidemiology Reference Group (CHERG), the interconnections between maternal and newborn health reviews identified by the Global Alliance for Prevention of Prematurity and Stillbirth (GAPPS), as well as relevant work by the Partnership for Maternal, Newborn and Child Health. Our review amply demonstrates that opportunities for assessing outcomes for both mothers and newborns have been poorly realized and documented. Most of the interventions reviewed will require more greater-quality evidence before solid programmatic recommendations can be made. However, on the basis of our review, birth spacing, prevention of indoor air pollution, prevention of intimate partner violence before and during pregnancy, antenatal care during pregnancy, Doppler ultrasound monitoring during pregnancy, insecticide-treated mosquito nets, birth and newborn care preparedness via community-based intervention

  2. Testing an mHealth Momentary Assessment Routine Outcome Monitoring Application: A Focus on Restoration of Daily Life Positive Mood States

    PubMed Central

    van Os, Jim; Delespaul, Philippe; Barge, Daniela; Bakker, Roberto P.

    2014-01-01

    Background Routine Outcome Monitoring (ROM) is used as a means to enrich the process of treatment with feedback on patient outcomes, facilitating patient involvement and shared decision making. While traditional ROM measures focus on retrospective accounts of symptoms, novel mHealth technology makes it possible to collect real life, in-the-moment ambulatory data that allow for an ecologically valid assessment of personalized and contextualized emotional and behavioural adjustment in the flow daily life (mROM). Method In a sample of 34 patients with major depressive disorder, treated with antidepressants, the combined effect of treatment and natural course was examined over a period of 18 weeks with Ecological Momentary Assessment (EMA). EMA consisted of repeated, within-subject, mini-measurements of experience (eg positive affect, negative affect, medication side effects) and context (eg stressors, situations, activities) at 10 unselected semi-random moments per day, for a period of six days, repeated three times over the 18-week period (baseline, week 6 and week 18). Results EMA measures of emotional and behavioural adjustment were sensitive to the effects of treatment and natural course over the 18-week period, particularly EMA measures focussing on positive mood states and the ability to use natural rewards (impact of positive events on positive mood states), with standardized effect sizes of 0.4–0.5. EMA measures of activities, social interaction, stress-sensitivity and negative mood states were also sensitive to change over time. Conclusion This study supports the use of mROM as a means to involve the patient in the process of needs assessment and treatment. EMA data are meaningful to the patient, as they reflect daily life circumstances. Assessment of treatment response with mROM data allows for an interpretation of the effect of treatment at the level of daily life emotional and social adjustment – as an index of health, obviating the need for an

  3. Health outcomes in type 2 diabetes.

    PubMed

    Reddy, S S

    2000-10-01

    Outcome evaluation is of great interest throughout the healthcare field, but which outcomes are important depends on the viewpoint one holds. For the healthcare organisation costs and resource utilisation are paramount, whereas patients may be interested in being able to work and lead a productive life without long-term complications. Healthcare policy decisions are influenced by varying degrees of social forces, existing regulations and outcome research findings. Ideally, all three are in agreement but often they may be competitive or may not even be included in policy decision making. With respect to improving outcomes, much energy has been spent on developing diabetes care guidelines. However, these have had minimal impact on physician behaviour. Soon after onset or diagnosis of diabetes, we are most concerned with process measures such as micro-albumin levels, blood pressure monitoring, routine eye and foot examinations and lipid profiles. These process measures are related to the development of intermediate outcomes--proteinuria, retinopathy, foot ulcers and dyslipidaemia. Diabetes is an expensive disease but there is accumulating evidence that improved care can lead to better quality of life and reduction in health care resource utilisation. The UKPDS demonstrated that for one percentage point decrease in HbA1c there was a 35% reduction in the risk of complications. Preliminary data from various diabetes management programmes indicate that instituting standardised care may lead to cost savings and improved health. Rationing health care resources wisely requires consideration of multiple factors including quality of life years (QALYs) and healthy year equivalents (HYEs). Formal quantitative methods are used to measure overall desirability of a medical intervention. Questions to be answered include predictability of responsiveness or adverse events to drug therapy. Outcomes research will have a key role in future development of models of diabetes care. PMID

  4. Dietary patterns and health outcomes.

    PubMed

    Kant, Ashima K

    2004-04-01

    A systematic review of the literature on dietary patterns (multiple dietary components operationalized as a single exposure) in relation to nutrient adequacy, lifestyle and demographic variables, and health outcome was conducted. Most of the published reports on the subject have used one of two methods to determine dietary patterns: (a) diet indexes or scores that assess compliance with prevailing dietary guidance as dietary patterns, and (b) data-driven methods that use factor or cluster analysis to derive dietary patterns. Irrespective of the approach used, patterns characterized by fruit/vegetable/whole grain/fish/poultry consumption generally have been reported to relate to micronutrient intake, and to selected biomarkers of dietary exposure and disease risk in the expected direction. Age, income, and education have been reported to be among positive predictors of the so-called more healthful dietary patterns. An inverse association of healthful dietary patterns with all-cause mortality and cardiovascular disease risk was reported in most studies. However, the magnitude of risk reduction was modest and was attenuated after control for confounders. Few published studies showed an association between risk of most incident cancers and dietary patterns. Both of the currently used approaches for extracting dietary patterns have limitations, are subject to dietary measurement errors, and have not generated new diet and disease hypotheses. PMID:15054348

  5. Ultrasonic wireless health monitoring

    NASA Astrophysics Data System (ADS)

    Petit, Lionel; Lefeuvre, Elie; Guyomar, Daniel; Richard, Claude; Guy, Philippe; Yuse, Kaori; Monnier, Thomas

    2006-03-01

    The integration of autonomous wireless elements in health monitoring network increases the reliability by suppressing power supplies and data transmission wiring. Micro-power piezoelectric generators are an attractive alternative to primary batteries which are limited by a finite amount of energy, a limited capacity retention and a short shelf life (few years). Our goal is to implement such an energy harvesting system for powering a single AWT (Autonomous Wireless Transmitter) using our SSH (Synchronized Switch Harvesting) method. Based on a non linear process of the piezoelement voltage, this SSH method optimizes the energy extraction from the mechanical vibrations. This AWT has two main functions : The generation of an identifier code by RF transmission to the central receiver and the Lamb wave generation for the health monitoring of the host structure. A damage index is derived from the variation between the transmitted wave spectrum and a reference spectrum. The same piezoelements are used for the energy harvesting function and the Lamb wave generation, thus reducing mass and cost. A micro-controller drives the energy balance and synchronizes the functions. Such an autonomous transmitter has been evaluated on a 300x50x2 mm 3 composite cantilever beam. Four 33x11x0.3 mm 3 piezoelements are used for the energy harvesting and for the wave lamb generation. A piezoelectric sensor is placed at the free end of the beam to track the transmitted Lamb wave. In this configuration, the needed energy for the RF emission is 0.1 mJ for a 1 byte-information and the Lamb wave emission requires less than 0.1mJ. The AWT can harvested an energy quantity of approximately 20 mJ (for a 1.5 Mpa lateral stress) with a 470 μF storage capacitor. This corresponds to a power density near to 6mW/cm 3. The experimental AWT energy abilities are presented and the damage detection process is discussed. Finally, some envisaged solutions are introduced for the implementation of the required data

  6. [Notes on equity in health outcomes].

    PubMed

    Fresneda-Bautista, Oscar

    2008-12-01

    The article locates analysing health outcomes within a set of elements covering evaluating equity in health and suggests some orientations for such analysis. The model of analysis for examining equity in health which has been adopted by the Health> has been taken as a point of reference. The text approaches the following questions: What is the role played by evaluating health outcomes within the context of equity in health? How can inequities in health outcomes be evaluated? What should be evaluated regarding health outcomes? The final part deals with how the topic of equity in health does not become exhausted in examining unjust inequalities between individuals or groups. PMID:19377730

  7. Hemodynamic monitoring and outcome-a physiological appraisal.

    PubMed

    Chan, Yoo-Kuen; Khan, Zahid Hussain

    2011-12-01

    Hemodynamic monitoring provides us with refined details about the cardiovascular system. In spite of increased availability of the monitoring process and monitoring equipment, hemodynamic monitoring has not significantly improved survival outcome. Care providers should be cognizant of the role of the cardiovascular system and its importance in oxygen delivery to the cells in order to sustain life. Effective hemodynamic monitoring should be able to delineate how well the system is performing in carrying out this role. Different hemodynamic monitors serve in this role to a different extent; some provide very little information on this. The cardiovascular system is only one of the many systems that need to function optimally for survival; others of equal importance include the integrity of the airway, the breathing process, the adequacy of hemoglobin level, and the health of the tissue bed, especially in the brain and the heart. Advances in hemodynamic monitoring with focus on oxygen delivery at the cellular level may ultimately provide the edge to effective monitoring that can impact outcome. PMID:22221689

  8. Monitoring Your Kidney Health

    MedlinePlus

    ... Families For Health Care Professionals Print or Order Publications You can also order print materials from our ... Families For Health Care Professionals Print or Order Publications You can also order print materials from our ...

  9. Health insurance and outcomes: comprehensive assessment of health system outputs.

    PubMed

    Perkins, N A

    1991-01-01

    Outcomes analysis in health care has historically meant the examination of clinical results of inpatient hospitalization. In response to climbing health care and health insurance costs, the organization of health care providers, the location of service delivery and reimbursement mechanisms have changed. As the health care industry changes, so too must the definition of outcomes. This article presents a conceptual framework for the analysis of health outcomes as health industry outputs, with an emphasis on the ways in which such outputs are being assessed and improved. PMID:10116955

  10. Child Health and Young Adult Outcomes

    ERIC Educational Resources Information Center

    Currie, Janet; Stabile, Mark; Manivong, Phongsack; Roos, Leslie L.

    2010-01-01

    Research has shown a strong connection between birth weight and future outcomes. We ask how health problems after birth affect outcomes using data from public health insurance records for 50,000 children born between 1979 and 1987 in the Canadian province of Manitoba. We compare children to siblings born an average of three years apart. We find…

  11. Monitoring Your Kidney Health

    MedlinePlus

    ... Dialysis or Transplant Paying for Kidney Failure Treatment Contact Us Health Information Center Phone: 1-800-860- ... to share this content freely. ​​September 17, 2014​​ ​​ Contact Us Health Information Center Phone: 1-800-860- ...

  12. Client Outcome Evaluation in Mental Health Centers.

    ERIC Educational Resources Information Center

    Southern Regional Education Board, Atlanta, GA.

    Outcome evaluation assesses the results or benefits of mental health services received by clients or communities by comparing descriptive data on the mental health status of clients at different points in time. It aids clinicians and managers in planning programs and managing clinical services. A mental health center should establish goal-oriented…

  13. Environmental conditions and reproductive health outcomes

    EPA Science Inventory

    Environmental exposures range across multiple domains to affect human health. In an effort to learn how environmental factors combine to contribute to health outcomes we constructed a multiple environmental domain index (MEDI) for use in health research. We used principal compone...

  14. Analyzing the outcomes of health promotion practices.

    PubMed

    Pereira Lima, Vera Lucia Góes; Arruda, José Maria; Barroso, Maria Auxiliadora Bessa; Lobato Tavares, Maria de Fátima; Ribeiro Campos, Nora Zamith; Zandonadil, Regina Celi Moreira Basílio; da Rocha, Rosa Maria; Parreira, Clélia Maria de Souza Ferreira; Cohen, Simone Cynamon; Kligerman, Débora Cynamon; Sperandio, Ana Maria Girotti; Correa, Carlos Roberto Silveira; Serrano, Miguel Malo

    2007-01-01

    This article focuses on health promotion (HP) outcomes, illustrated through evaluation of case studies and identification of strategies which have contributed to their success and sustainability. Evaluation research and practice in three distinct sceneries are discussed: (i) institutional and governmental agencies; (ii) communities in the "Manguinhos Complex" and Nova Iguaqu Municipality, and (iii) building of potentially healthy municipality networks. The effectiveness of a social program in a health promotion perspective was based in the "School for Parents" program, undertaken by the First Court of Childhood and Youth of Rio de Janeiro, between 2001 and 2004. The analysis was grounded in the monitoring of 48 parents in charge of children under 18, who were victims of abuse, violence or negligence, and social exclusion, most of all. The study's objectives were: illustrating the evidence of effectiveness of health promotion, discussing the concept of HP effectiveness under macro unfavorable conditions, and identifying strategies that foster sustainability of results. Institutional resources included a multi-professional staff, multidisciplinary approaches, participatory workshops, family case management, partnership with public and private institutions, and volunteer and civil society sponsorship of the families. Evaluation was based on social impact indicators, and psychosocial and contextual determinants. Evaluation methods included program monitoring and quantitative-qualitative methods, through a longitudinal evaluation of 3 years, including one year post program. The evaluation showed highly favorable results concerning "family integration', "quality of family relations" and "human rights mobilization". Unsatisfactory results such as "lack of access to formal employment" are likely related to structural factors and the need for new public policies in areas such as education, professional training, housing, and access to formal employment. The training process

  15. Monitoring of beta cell replacement outcomes.

    PubMed

    Chang, Charles A; Haque, Waqas Z; Yoshimatsu, Gumpei; Balajii, Prathab S; Lawrence, Michael C; Naziruddin, Bashoo

    2016-03-01

    Pancreatic islet transplantation is a promising beta cell replacement treatment for patients with "brittle" type 1 diabetes (T1D) or intractable chronic pancreatitis to restore or preserve pancreatic endocrine function. Early after transplant, a significant islet mass is lost due to an innate inflammatory response, and further loss of the islet graft occurs over time due to immune response, drug toxicity, or metabolic exhaustion. Thus, clinically feasible techniques are essential to monitor islet graft function and survival to maintain appropriate therapy. Currently, islet graft function is monitored using blood glucose levels, insulin and C-peptide levels, and islet imaging. However, these tests are influenced by physiological changes, including beta cell stimulation. Biomarkers that are independent of metabolic stimuli would be more accurate and reliable in detecting islet damage. Antibodies against islet autoantigens are useful but not reliable markers of islet injury due to their presence during the pretransplant period. Several islet-specific proteins such as Glutamate decarboxylase-65, doublecortin, protein phosphatase 1, regulatory (inhibitor) subunit 1A, ubiquitin C-terminal hydrolase-L1, and the high-mobility group box-1 protein have been proposed as candidates to monitor islet damage, but these biomarkers have short half-lives and unreliable detection. Unmethylated insulin DNA has been studied in T1D patients and has been documented as a highly correlative and selective biomarker for beta cell death. More recently, microRNAs (miRNAs) that are selectively expressed in islets have been shown to provide sensitive and accurate quantification of islet damage. Analysis of plasma samples from autologous and allogeneic islet transplant patients has demonstrated the value of miRNA-375 as a specific biomarker to accurately assess islet damage. Use of selective, sensitive, and measurably reproducible biomarkers of islets will lead to effective monitoring of beta

  16. Functional Health Literacy and Smoking Cessation Outcomes

    ERIC Educational Resources Information Center

    Varekojis, Sarah M.; Miller, Larry; Schiller, M. Rosita; Stein, David

    2011-01-01

    Purpose: This paper aims to describe the relationship between functional health literacy level and smoking cessation outcomes. Design/methodology/approach: Participants in an inpatient smoking cessation program in a mid-western city in the USA were enrolled and the Short Test of Functional Health Literacy in Adults was administered while the…

  17. Health Literacy: An Educationally Sensitive Patient Outcome.

    PubMed

    Yin, H Shonna; Jay, Melanie; Maness, Leslie; Zabar, Sondra; Kalet, Adina

    2015-09-01

    We have previously proposed that by identifying a set of Educationally Sensitive Patient Outcomes (ESPOs), medical education outcomes research becomes more feasible and likely to provide meaningful guidance for medical education policy and practice. ESPOs are proximal outcomes that are sensitive to provider education, measurable, and linked to more distal health outcomes. Our previous model included Patient Activation and Clinical Microsystem Activation as ESPOs. In this paper, we discuss how Health Literacy, defined as "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions," is another important ESPO. Between one-third and one-half of all US adults have limited health literacy skills. Providers can be trained to adopt a "universal precautions approach" to addressing patient health literacy, through the acquisition of specific skills (e.g., teachback, "chunking" information, use of plain language written materials) and by learning how to take action to improve the "health literacy environment." While there are several ways to measure health literacy, identifying which measurement tools are most sensitive to provider education is important, but challenging and complex. Further research is needed to test this model and identify additional ESPOs. PMID:26173523

  18. Individualized Behavioral Health Monitoring Tool

    NASA Technical Reports Server (NTRS)

    Mollicone, Daniel

    2015-01-01

    Behavioral health risks during long-duration space exploration missions are among the most difficult to predict, detect, and mitigate. Given the anticipated extended duration of future missions and their isolated, extreme, and confined environments, there is the possibility that behavior conditions and mental disorders will develop among astronaut crew. Pulsar Informatics, Inc., has developed a health monitoring tool that provides a means to detect and address behavioral disorders and mental conditions at an early stage. The tool integrates all available behavioral measures collected during a mission to identify possible health indicator warning signs within the context of quantitatively tracked mission stressors. It is unobtrusive and requires minimal crew time and effort to train and utilize. The monitoring tool can be deployed in space analog environments for validation testing and ultimate deployment in long-duration space exploration missions.

  19. Outcome mapping for health system integration

    PubMed Central

    Tsasis, Peter; Evans, Jenna M; Forrest, David; Jones, Richard Keith

    2013-01-01

    Health systems around the world are implementing integrated care strategies to improve quality, reduce or maintain costs, and improve the patient experience. Yet few practical tools exist to aid leaders and managers in building the prerequisites to integrated care, namely a shared vision, clear roles and responsibilities, and a common understanding of how the vision will be realized. Outcome mapping may facilitate stakeholder alignment on the vision, roles, and processes of integrated care delivery via participative and focused dialogue among diverse stakeholders on desired outcomes and enabling actions. In this paper, we describe an outcome-mapping exercise we conducted at a Local Health Integration Network in Ontario, Canada, using consensus development conferences. Our preliminary findings suggest that outcome mapping may help stakeholders make sense of a complex system and foster collaborative capital, a resource that can support information sharing, trust, and coordinated change toward integration across organizational and professional boundaries. Drawing from the theoretical perspectives of complex adaptive systems and collaborative capital, we also outline recommendations for future outcome-mapping exercises. In particular, we emphasize the potential for outcome mapping to be used as a tool not only for identifying and linking strategic outcomes and actions, but also for studying the boundaries, gaps, and ties that characterize social networks across the continuum of care. PMID:23526058

  20. Outcome mapping for health system integration.

    PubMed

    Tsasis, Peter; Evans, Jenna M; Forrest, David; Jones, Richard Keith

    2013-01-01

    Health systems around the world are implementing integrated care strategies to improve quality, reduce or maintain costs, and improve the patient experience. Yet few practical tools exist to aid leaders and managers in building the prerequisites to integrated care, namely a shared vision, clear roles and responsibilities, and a common understanding of how the vision will be realized. Outcome mapping may facilitate stakeholder alignment on the vision, roles, and processes of integrated care delivery via participative and focused dialogue among diverse stakeholders on desired outcomes and enabling actions. In this paper, we describe an outcome-mapping exercise we conducted at a Local Health Integration Network in Ontario, Canada, using consensus development conferences. Our preliminary findings suggest that outcome mapping may help stakeholders make sense of a complex system and foster collaborative capital, a resource that can support information sharing, trust, and coordinated change toward integration across organizational and professional boundaries. Drawing from the theoretical perspectives of complex adaptive systems and collaborative capital, we also outline recommendations for future outcome-mapping exercises. In particular, we emphasize the potential for outcome mapping to be used as a tool not only for identifying and linking strategic outcomes and actions, but also for studying the boundaries, gaps, and ties that characterize social networks across the continuum of care. PMID:23526058

  1. Wearable sensors for health monitoring

    NASA Astrophysics Data System (ADS)

    Suciu, George; Butca, Cristina; Ochian, Adelina; Halunga, Simona

    2015-02-01

    In this paper we describe several wearable sensors, designed for monitoring the health condition of the patients, based on an experimental model. Wearable sensors enable long-term continuous physiological monitoring, which is important for the treatment and management of many chronic illnesses, neurological disorders, and mental health issues. The system is based on a wearable sensors network, which is connected to a computer or smartphone. The wearable sensor network integrates several wearable sensors that can measure different parameters such as body temperature, heart rate and carbon monoxide quantity from the air. After the portable sensors measuring parameter values, they are transmitted by microprocessor through the Bluetooth to the application developed on computer or smartphone, to be interpreted.

  2. Purchasing population health: aligning financial incentives to improve health outcomes.

    PubMed Central

    Kindig, D A

    1998-01-01

    OBJECTIVE: To review the concept of population health, including its definition, measurement, and determinants, and to suggest an approach for aligning financial incentives toward this goal. DATA SOURCE, STUDY DESIGN, DATA EXTRACTION. Literature review, policy analysis PRINCIPAL FINDINGS: The article presents the argument that a major reason for our slow progress toward health outcome improvement is that there is no operational definition of population health and that financial incentives are not aligned to this goal. Current attempts at process measures as indicators of quality or outcome are not adequate for the task. It is suggested that some measure of health-adjusted life expectancy be adopted for this purpose, and that integrated delivery systems and other agents responsible for nonmedical determinants be rewarded for improvement in this measure. This will require the development of an investment portfolio across the determinants of health based on relative marginal return to health, with horizontal integration strategies across sectoral boundaries. A 20-year three-phase development strategy is proposed, including components of research and acceptance, integrated health system implementation, and cross-sectoral integration. CONCLUSIONS: The U.S. healthcare system is a $1 trillion industry without a definition of its product. Until population outcome measures are developed and rewarded for, we will not solve the twenty-first century challenge of maximizing health outcome improvement for the resources available. Images Figure 1 PMID:9618669

  3. Health impairments and labour market outcomes.

    PubMed

    Drydakis, Nick

    2010-10-01

    Our analysis is based on the 2008 Athens Area Study and exploits detailed information regarding health impairments and labour market outcomes for Greek males. Distinguishing between healthy and heath-impaired employees who have or do not have work limitations, the unobserved productivity effect of health is separated from discrimination. We then estimate a regression model that includes terms to correct for employment selection and endogenous stratification of self-reported health condition. A penalty for productivity limitation exists. Evidence of wage discrimination is also found. Both findings are statistically significant and highlight the necessity for instituting active policies against unequal treatment. PMID:19771458

  4. Solder Joint Health Monitoring Testbed

    NASA Technical Reports Server (NTRS)

    Delaney, Michael M.; Flynn, James G.; Browder, Mark E.

    2009-01-01

    A method of monitoring the health of selected solder joints, called SJ-BIST, has been developed by Ridgetop Group Inc. under a Small Business Innovative Research (SBIR) contract. The primary goal of this research program is to test and validate this method in a flight environment using realistically seeded faults in selected solder joints. An additional objective is to gather environmental data for future development of physics-based and data-driven prognostics algorithms. A test board is being designed using a Xilinx FPGA. These boards will be tested both in flight and on the ground using a shaker table and an altitude chamber.

  5. Exploring models for the roles of health systems’ responsiveness and social determinants in explaining universal health coverage and health outcomes

    PubMed Central

    Bonsel, Gouke J.

    2016-01-01

    Background Intersectoral perspectives of health are present in the rhetoric of the sustainable development goals. Yet its descriptions of systematic approaches for an intersectoral monitoring vision, joining determinants of health, and barriers or facilitators to accessing healthcare services are lacking. Objective To explore models of associations between health outcomes and health service coverage, and health determinants and health systems responsiveness, and thereby to contribute to monitoring, analysis, and assessment approaches informed by an intersectoral vision of health. Design The study is designed as a series of ecological, cross-country regression analyses, covering between 23 and 57 countries with dependent health variables concentrated on the years 2002–2003. Countries cover a range of development contexts. Health outcome and health service coverage dependent variables were derived from World Health Organization (WHO) information sources. Predictor variables representing determinants are derived from the WHO and World Bank databases; variables used for health systems’ responsiveness are derived from the WHO World Health Survey. Responsiveness is a measure of acceptability of health services to the population, complementing financial health protection. Results Health determinants’ indicators – access to improved drinking sources, accountability, and average years of schooling – were statistically significant in particular health outcome regressions. Statistically significant coefficients were more common for mortality rate regressions than for coverage rate regressions. Responsiveness was systematically associated with poorer health and health service coverage. With respect to levels of inequality in health, the indicator of responsiveness problems experienced by the unhealthy poor groups in the population was statistically significant for regressions on measles vaccination inequalities between rich and poor. For the broader determinants, the

  6. Strategies for Monitoring Outcomes in Patients With Bipolar Disorder

    PubMed Central

    2010-01-01

    Practical strategies are available for primary care physicians to monitor psychiatric and medical outcomes as well as treatment adherence in patients with bipolar disorder. Current depressive symptoms can be assessed with tools like the 9-item Patient Health Questionnaire or Beck Depression Inventory. Lifetime presence or absence of manic or hypomanic symptoms can be assessed using the Mood Disorder Questionnaire (MDQ). These measures can be completed quickly by patients prior to appointments. Sensitivity of such ratings, particularly the MDQ, can be increased by having a significant other also rate the patient. Clinicians should also screen mood disorder patients for psychiatric comorbidities that are common in this population such as anxiety and substance use disorders. While patients with bipolar disorder may commonly be nonadherent with prescribed medication regimens, strategies that can help include having frank discussions with the patient, selecting medication collaboratively, adding psychotherapy with a psychoeducation element, monitoring appointment-keeping, using patient self-reports of medication-taking, enlisting the aid of significant others, and measuring plasma drug levels. Medical monitoring is needed to assess the safety and tolerability of psychotropic medications. All of the approved medications for bipolar disorder have at least 1 boxed warning for serious side effects, but are also associated with other common management-limiting side effects such as sedation, tremor, unsteadiness, restlessness, nausea, vomiting, diarrhea, constipation, weight gain, and metabolic problems. Routine monitoring is particularly needed for obesity, metabolic syndrome, and cardiovascular disorders, which lead to high rates of medical morbidity and mortality in patients with bipolar disorder. Monitoring protocols such as the one recommended by the American Diabetes Association for patients taking second-generation antipsychotics can be used for regular assessment

  7. Post-Disaster Reproductive Health Outcomes

    PubMed Central

    Zotti, Marianne E.; Williams, Amy M.; Robertson, McKaylee; Horney, Jennifer; Hsia, Jason

    2015-01-01

    We examined methodological issues in studies of disaster-related effects on reproductive health outcomes and fertility among women of reproductive age and infants in the United States (US). We conducted a systematic literature review of 1,635 articles and reports published in peer-reviewed journals or by the government from January 1981 through December 2010. We classified the studies using three exposure types: (1) physical exposure to toxicants; (2) psychological trauma; and (3) general exposure to disaster. Fifteen articles met our inclusion criteria concerning research focus and design. Overall studies pertained to eight different disasters, with most (n = 6) focused on the World Trade Center attack. Only one study examined pregnancy loss, i.e., occurrence of spontaneous abortions post-disaster. Most studies focused on associations between disaster and adverse birth outcomes, but two studies pertained only to post-disaster fertility while another two examined it in addition to adverse birth outcomes. In most studies disaster-affected populations were assumed to have experienced psychological trauma, but exposure to trauma was measured in only four studies. Furthermore, effects of both physical exposure to toxicants and psychological trauma on disaster-affected populations were examined in only one study. Effects on birth outcomes were not consistently demonstrated, and study methodologies varied widely. Even so, these studies suggest an association between disasters and reproductive health and highlight the need for further studies to clarify associations. We postulate that post-disaster surveillance among pregnant women could improve our understanding of effects of disaster on the reproductive health of US pregnant women. PMID:22752348

  8. Monitoring individual and joint action outcomes in duet music performance.

    PubMed

    Loehr, Janeen D; Kourtis, Dimitrios; Vesper, Cordula; Sebanz, Natalie; Knoblich, Günther

    2013-07-01

    We investigated whether people monitor the outcomes of their own and their partners' individual actions as well as the outcome of their combined actions when performing joint actions together. Pairs of pianists memorized both parts of a piano duet. Each pianist then performed one part while their partner performed the other; EEG was recorded from both. Auditory outcomes (pitches) associated with keystrokes produced by the pianists were occasionally altered in a way that either did or did not affect the joint auditory outcome (i.e., the harmony of a chord produced by the two pianists' combined pitches). Altered auditory outcomes elicited a feedback-related negativity whether they occurred in the pianist's own part or the partner's part, and whether they affected individual or joint action outcomes. Altered auditory outcomes also elicited a P300 whose amplitude was larger when the alteration affected the joint outcome compared with individual outcomes and when the alteration affected the pianist's own part compared with the partner's part. Thus, musicians engaged in joint actions monitor their own and their partner's actions as well as their combined action outcomes, while at the same time maintaining a distinction between their own and others' actions and between individual and joint outcomes. PMID:23489144

  9. Health Monitoring System for Car Seat

    NASA Technical Reports Server (NTRS)

    Elrod, Susan Vinz (Inventor); Dabney, Richard W. (Inventor)

    2004-01-01

    A health monitoring system for use with a child car seat has sensors mounted in the seat to monitor one or more health conditions of the seat's occupant. A processor monitors the sensor's signals and generates status signals related to the monitored conditions. A transmitter wireless transmits the status signals to a remotely located receiver. A signaling device coupled to the receiver produces at least one sensory (e.g., visual, audible, tactile) output based on the status signals.

  10. Improving Health Outcomes for Low Health Literacy Heart Failure Patients.

    PubMed

    Friel, Catherine J

    2016-09-01

    According to the National Assessment of Adult Literacy (2003), only 12% of U.S. adults have a proficient level of health literacy, with adults 65 years and older more likely to have a below basic or a basic health literacy level. An estimated 5.8 million individuals in the United States have heart failure (HF) and it is one of the most common reasons for those aged 65 and over to be hospitalized. Many patients with HF are at risk for poor health outcomes due to low health literacy. This article reviews the literature with regard to the effectiveness of methods used to address low health literacy among HF patients and describes a pilot study implemented by a home care agency in the northeast to address high HF readmission rates. PMID:27580282

  11. The Effect of the Transition to Home Monitoring for the Diagnosis of OSAS on Test Availability, Waiting Time, Patients' Satisfaction, and Outcome in a Large Health Provider System

    PubMed Central

    Etzioni, Tamar; Fliss, Dan; Pillar, Giora; Shapira, Chen

    2014-01-01

    During 2009, the Haifa district of Clalit Health Services (CHS) has switched from in-lab polysomnography (PSG) to home studies for the diagnosis of obstructive sleep apnea (OSA). We assessed the effects of this change on accessibility, waiting time, satisfaction, costs, and CPAP purchase by the patients. Data regarding sleep studies, CPAP purchase, and waiting times were collected retrospectively from the computerized database of CHS. Patients' satisfaction was assessed utilizing a telephone questionnaire introduced to a randomized small sample of 70 patients. Comparisons were made between 2007 and 2008 (in-lab PSGs) and 2010 and 2011 (when most studies were ambulatory). Of about 650000 insured individuals in the Haifa district of CHS, 1471 sleep studies were performed during 2007-2008 compared to 2794 tests during 2010-2011. The average waiting time was 9.9 weeks in 2007-2008 compared to 1.1 weeks in 2010-2011 (P < 0.05). 597 CPAPs were purchased in 2007-2008 compared to 831 in 2010-2011. The overall patients' satisfaction was similar, but discomfort tended to be higher in the in-laboratory group (4.1 vs 2.7 in a scale of 0–10; P = 0.11). Switching to ambulatory diagnosis improved the test accessibility and reduced the waiting times. Patients' satisfaction remained similarly high. The total direct cost of OSA management was reduced. PMID:24876974

  12. The Impact of Health Information Exchange on Health Outcomes

    PubMed Central

    Hincapie, A.; Warholak, T.

    2011-01-01

    Background and Objective Healthcare professionals, industry and policy makers have identified Health Information Exchange (HIE) as a solution to improve patient safety and overall quality of care. The potential benefits of HIE on healthcare have fostered its implementation and adoption in the United States. However,there is a dearth of publications that demonstrate HIE effectiveness. The purpose of this review was to identify and describe evidence of HIE impact on healthcare outcomes. Methods A database search was conducted. The inclusion criteria included original investigations in English that focused on a HIE outcome evaluation. Two independent investigators reviewed the articles. A qualitative coding approach was used to analyze the data. Results Out of 207 abstracts retrieved, five articles met the inclusion criteria. Of these, 3 were randomized controlled trials, 1 involved retrospective review of data, and 1 was a prospective study. We found that HIE benefits on healthcare outcomes are still sparsely evaluated, and that among the measurements used to evaluate HIE healthcare utilization is the most widely used. Conclusions Outcomes evaluation is required to give healthcare providers and policy-makers evidence to incorporate in decision-making processes. This review showed a dearth of HIE outcomes data in the published peer reviewed literature so more research in this area is needed. Future HIE evaluations with different levels of interoperability should incorporate a framework that allows a detailed examination of HIE outcomes that are likely to positively affect care. PMID:23616891

  13. FOREST HEALTH MONITORING FIELD METHODS GUIDE

    EPA Science Inventory

    This EMAP-FHM methods Guide is intended to instruct forest Health Monitors when collecting data on forest health indicators; site condition, growth and regeneration, crown condition, tree damage and mortality assessment, photosynthetically active radiation, vegetation structure, ...

  14. Monitoring visual outcome of cataract surgery in India.

    PubMed Central

    Limburg, H.; Foster, A.; Vaidyanathan, K.; Murthy, G. V.

    1999-01-01

    Two simple methods of assessing visual outcome following cataract surgery were evaluated in India. The first used data obtained from standardized patient records of cataract surgery. The second used data from population-based rapid epidemiological assessments. Analysis of 4168 hospital and eye camp records showed that, with the available standard correction, a good outcome (visual acuity > or = 6/18) was achieved in 37.8%, a borderline outcome (visual acuity 6/246-6/60) in 45.6% and a poor outcome (visual acuity 6/60) in 16.6% of instances. Of 2401 aphakic/pseudophakic eyes examined in a cross-sectional population-based study, outcome was good in 43.5% and poor in 26.4%. For 776 eyes examined in a similar study in a different state, outcome was good in 49.9% and poor in 23.9%. These assessments indicate that outcome with available correction was poor in 15-25% of eyes following cataract surgery. Visual outcome is likely to improve when better correction for aphakia can be provided. Further assessment of the causes of poor visual outcome is needed. The visual outcome following cataract surgery could be monitored on a regular basis by ophthalmologists, using either of the methods evaluated, an exercise which in itself is likely to improve the outcome of surgery. When the proportion of poor outcomes is high (> 10%) further investigation into the causes is warranted. PMID:10427929

  15. Gendered work conditions, health, and work outcomes.

    PubMed

    Bond, Meg A; Punnett, Laura; Pyle, Jean L; Cazeca, Dianne; Cooperman, Manuela

    2004-01-01

    This cross-sectional study of nonfaculty university employees examined associations among gendered work conditions (e.g., sexism and discrimination), job demands, and employee job satisfaction and health. Organizational responsiveness and social support were examined as effect modifiers. Comparisons were made by gender and by the male-female ratio in each job category. The relationship of gendered conditions of work to outcomes differed on the basis of respondents' sex and the job sex ratio. Although the same predictors were hypothesized for job satisfaction, physical health, and psychological distress, there were some differing results. The strongest correlate of job satisfaction was social support; perceived sexism in the workplace also contributed for both men and women. Organizational factors associated with psychological distress differed between female- and male-dominated jobs. PMID:14700456

  16. Patient care outcomes: implications for the Military Health Services System.

    PubMed

    Jennings, B M

    1993-05-01

    Policy makers are targeting patient outcomes and the effectiveness of interventions as possible ways to curb spiraling health care costs. Quality assurance/improvement programs are focusing on patient outcomes as a way to evaluate and improve care delivery. Consequently, members of the Military Health Services System need a solid understanding of the current emphasis on the outcomes of care to be knowledgeable participants in the health care changes precipitated by highlighting patient outcomes. PMID:8502389

  17. The Expanding Relevance of Routinely Collected Outcome Data for Mental Health Care Decision Making.

    PubMed

    Boswell, James F; Constantino, Michael J; Kraus, David R; Bugatti, Matteo; Oswald, Jennifer M

    2016-07-01

    Evidence shows that routine outcome monitoring (ROM) and feedback using standardized measurement tools enhances the outcomes of individual patients. When outcome data from a large number of patients and clinicians are collected, patterns can be tracked and comparisons can be made at multiple levels. Variability in skills and outcomes among clinicians and service settings has been documented, and the relevance of ROM for decision making is rapidly expanding alongside the transforming health care landscape. In this article, we highlight several developing core implications of ROM for mental health care, and frame points of future work and discussion. PMID:25861984

  18. Comparative optimism for severity of negative health outcomes.

    PubMed

    Hevey, D; French, D P

    2012-01-01

    People tend to be comparatively optimistic (i.e., believe that negative outcomes are less likely for themselves than for typical others) regarding their susceptibility to negative health outcomes. The present study investigates the extent to which perceptions of the severity of these health outcomes show similar comparative optimism. A student sample (study 1; N = 200) and a healthy non-student adult sample (study 2; N = 257) completed self-report measures of susceptibility, severity, worry, control and experience in relation to negative health outcomes. Participants in both studies demonstrated significant levels of comparative optimism for both perceived likelihood and severity of health outcomes. Comparative optimism concerning severity was very strongly associated (r = 0.85 to 0.89) with comparative optimism concerning susceptibility. In addition to being comparatively optimistic over their chances of experiencing negative health outcomes, people are also comparatively optimistic regarding how severe the health outcomes will be. PMID:22111753

  19. Multiple Pathways Linking Racism to Health Outcomes

    PubMed Central

    Harrell, Camara Jules P.; Burford, Tanisha I.; Cage, Brandi N.; Nelson, Travette McNair; Shearon, Sheronda; Thompson, Adrian; Green, Steven

    2012-01-01

    This commentary discusses advances in the conceptual understanding of racism and selected research findings in the social neurosciences. The traditional stress and coping model holds that racism constitutes a source of aversive experiences that, when perceived by the individual, eventually lead to poor health outcomes. Current evidence points to additional psychophysiological pathways linking facets of racist environments with physiological reactions that contribute to disease. The alternative pathways emphasize prenatal experiences, subcortical emotional neural circuits, conscious and preconscious emotion regulation, perseverative cognitions, and negative affective states stemming from racist cognitive schemata. Recognition of these pathways challenges change agents to use an array of cognitive and self-controlling interventions in mitigating racism’s impact. Additionally, it charges policy makers to develop strategies that eliminate deep-seated structural aspects of racism in society. PMID:22518195

  20. Using client outcome monitoring as a tool for supervision.

    PubMed

    Swift, Joshua K; Callahan, Jennifer L; Rousmaniere, Tony G; Whipple, Jason L; Dexter, Kyle; Wrape, Elizabeth R

    2015-06-01

    A large body of research has supported the use of client outcome monitoring and client feedback in psychotherapy. However, discussions between supervisors and trainee clinicians in supervision are still largely based on subjective appraisals made by the trainees. In this article, we discuss 3 strategies for integrating client outcome data and feedback into the supervisory process: training students to obtain and use objective client feedback, using specific client data to inform discussions of clients, and identifying patterns of outcomes across clients to facilitate supervisee growth and development. PMID:25286066

  1. A Computer Interview for Multivariate Monitoring of Psychiatric Outcome.

    ERIC Educational Resources Information Center

    Stevenson, John F.; And Others

    Application of computer technology to psychiatric outcome measurement offers the promise of coping with increasing demands for extensive patient interviews repeated longitudinally. Described is the development of a cost-effective multi-dimensional tracking device to monitor psychiatric functioning, building on a previous local computer interview…

  2. Health Technologies for Monitoring and Managing Diabetes: A Systematic Review

    PubMed Central

    Russell-Minda, Elizabeth; Jutai, Jeffrey; Speechley, Mark; Bradley, Kaitlin; Chudyk, Anna; Petrella, Robert

    2009-01-01

    Background The primary objective of this review was to determine the strength of evidence for the effectiveness of self-monitoring devices and technologies for individuals with type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) based on specific health-related outcome measures. Self-monitoring devices included those that assist patients with managing diabetes and preventing cardiovascular complications (CVCs). A secondary objective was to explore issues of feasibility, usability, and compliance among patients and providers. Methods Study criteria included individuals ≥14 years and youth (7–14 years) with T1DM or T2DM, intervention with a self-monitoring device, assessment of clinical outcomes with the device, literature in English, and ≥10 participants. Relevant published literature was searched from 1985 to 2008. Randomized controlled trials and observational studies were included. Data were extracted for clinical outcomes, feasibility and compliance methods, and results. Selected studies were independently evaluated with a validated instrument for assessing methodological quality. Results Eighteen trials were selected. Predominant types of device interventions included self-monitoring of blood glucose, pedometers, and cell phone or wireless technologies. Feasibility and compliance were measured in the majority of studies. Conclusions Self-monitoring of blood glucose continues to be an effective tool for the management of diabetes. Wireless technologies can improve diabetes self-care, and pedometers are effective lifestyle modification tools. The results of this review indicate a need for additional controlled trial research on existing and novel technologies for diabetes self-monitoring, on health outcomes associated with diabetes and CVCs, and device feasibility and compliance. PMID:20144402

  3. A Societal Outcomes Map for Health Research and Policy

    PubMed Central

    Garfinkel, Michele S.; Sarewitz, Daniel; Porter, Alan L.

    2006-01-01

    The linkages between decisions about health research and policy and actual health outcomes may be extraordinarily difficult to specify. We performed a pilot application of a “road mapping” and technology assessment technique to perinatal health to illustrate how this technique can clarify the relations between available options and improved health outcomes. We used a combination of data-mining techniques and qualitative analyses to set up the underlying structure of a societal health outcomes road map. Societal health outcomes road mapping may be a useful tool for enhancing the ability of the public health community, policymakers, and other stakeholders, such as research administrators, to understand health research and policy options. PMID:16449589

  4. Intracranial pressure monitoring and outcomes after traumatic brain injury

    PubMed Central

    Lane, Peter L.; Skoretz, Terry G.; Doig, Gordon; Girotti, Murray J.

    2000-01-01

    Objective Uncontrolled intracranial hypertension after traumatic brain injury (TBI) contributes significantly to the death rate and to poor functional outcome. There is no evidence that intracranial pressure (ICP) monitoring alters the outcome of TBI. The objective of this study was to test the hypothesis that insertion of ICP monitors in patients who have TBI is not associated with a decrease in the death rate. Design Study of case records. Methods The data files from the Ontario Trauma Registry from 1989 to 1995 were examined. Included were all cases with an Injury Severity Score (ISS) greater than 12 from the 14 trauma centres in Ontario. Cases identifying a Maximum Abbreviated Injury Scale score in the head region (MAIS head) greater than 3 were selected for further analysis. Logistic regression analyses were conducted to investigate the relationship between ICP and death. Results Of 9001 registered cases of TBI, an MAIS head greater than 3 was recorded in 5507. Of these patients, 541 (66.8% male, mean age 34.1 years) had an ICP monitor inserted. Their average ISS was 33.4 and 71.7% survived. There was wide variation among the institutions in the rate of insertion of ICP monitors in these patients (ranging from 0.4% to over 20%). Univariate logistic regression indicated that increased MAIS head, ISS, penetrating trauma and the insertion of an ICP monitor were each associated with an increased death rate. However, multivariate analyses controlling for MAIS head, ISS and injury mechanism indicated that ICP monitoring was associated with significantly improved survival (p < 0.015). Conclusions ICP monitor insertion rates vary widely in Ontario’s trauma hospitals. The insertion of an ICP monitor is associated with a statistically significant decrease in death rate among patients with severe TBI. This finding strongly supports the need for a prospective randomized trial of management protocols, including ICP monitoring, in patients with severe TBI. PMID:11129833

  5. Health Care Delivery Performance: Service, Outcomes, and Resource Stewardship

    PubMed Central

    Cowing, Michelle; Davino-Ramaya, Carrie M; Ramaya, Krishnan; Szmerekovsky, Joseph

    2009-01-01

    As competition intensifies within the health care industry, patient satisfaction and service quality are providing the evidentiary basis for patient outcomes. We propose a conceptual model of three interrelated areas, service, health outcomes, and resource stewardship, all affected by the clinician-patient relationship. Our model considers the perspectives of the health care organization, the clinician, and the patient to define a more comprehensive measure of health care delivery performance. Research and managerial aspects, including implementation, are discussed. PMID:20740107

  6. Smartphone-based mobile health monitoring.

    PubMed

    Lee, Yong-Gyu; Jeong, Won Sig; Yoon, Gilwon

    2012-10-01

    We developed a health monitoring system based on the smartphone. A compact and low-power-consuming biosignal monitoring unit (BMU) measured electrocardiogram (ECG), photoplethysmogram (PPG), temperature, oxygen saturation, energy expenditure, and location information. The 2.4 GHz Bluetooth(®) (Bluetooth SIG) network in the BMU communicated with a smartphone. Health information was sent to a remote healthcare server through a built-in 3G or Wi-Fi network in the smartphone. The remote server monitored multiple users in real-time. Normally data of vital signs were being transmitted to the server. In an emergency or for a special care case, additional information such as the waveform of the ECG and PPG were displayed at the server. For increased transmission efficiency, data compression and a simple error correction algorithm were implemented. Using a widespread smartphone, an efficient personal health monitoring system was developed and tested successfully for multiple users. PMID:23061640

  7. STRUCTURAL HEALTH MONITORING OF WELDED CONNECTIONS

    SciTech Connect

    H. SOHN; C. FARRAR; M. FUGATE; J. CZARNECKI

    2001-05-01

    Structural health monitoring is the implementation of a damage detection strategy for aerospace, civil and mechanical engineering infrastructure. Typical damage experienced by this infrastructure might be the development of fatigue cracks, degradation of structural connections, or bearing wear in rotating machinery. The goal of the research effort reported herein is to develop a robust and cost-effective monitoring system for welded beam-column connections in a moment resisting frame structure. The structural health monitoring solution for this application will integrate structural dynamics, wireless data acquisition, local actuation, micro-electromechanical systems (MEMs) technology, and statistical pattern recognition algorithms. This paper provides an example of the integrated approach to structural health monitoring being undertaken at Los Alamos National Laboratory and summarizes progress to date on various aspects of the technology development.

  8. Hybrid Modeling Improves Health and Performance Monitoring

    NASA Technical Reports Server (NTRS)

    2007-01-01

    Scientific Monitoring Inc. was awarded a Phase I Small Business Innovation Research (SBIR) project by NASA's Dryden Flight Research Center to create a new, simplified health-monitoring approach for flight vehicles and flight equipment. The project developed a hybrid physical model concept that provided a structured approach to simplifying complex design models for use in health monitoring, allowing the output or performance of the equipment to be compared to what the design models predicted, so that deterioration or impending failure could be detected before there would be an impact on the equipment's operational capability. Based on the original modeling technology, Scientific Monitoring released I-Trend, a commercial health- and performance-monitoring software product named for its intelligent trending, diagnostics, and prognostics capabilities, as part of the company's complete ICEMS (Intelligent Condition-based Equipment Management System) suite of monitoring and advanced alerting software. I-Trend uses the hybrid physical model to better characterize the nature of health or performance alarms that result in "no fault found" false alarms. Additionally, the use of physical principles helps I-Trend identify problems sooner. I-Trend technology is currently in use in several commercial aviation programs, and the U.S. Air Force recently tapped Scientific Monitoring to develop next-generation engine health-management software for monitoring its fleet of jet engines. Scientific Monitoring has continued the original NASA work, this time under a Phase III SBIR contract with a joint NASA-Pratt & Whitney aviation security program on propulsion-controlled aircraft under missile-damaged aircraft conditions.

  9. Forest health monitoring: Field methods guide

    SciTech Connect

    Tallent-Halsell, N.G.

    1994-10-01

    This guide is intended to instruct Forest Health Monitors when collecting data on forest health indicators; site condition, growth and regeneration, crown condition, tree damage and mortality assessment, photosynthetically active radiation, vegetation structure, ozone bioindicator species, lichen community structure and field logistics. This guide contains information on measuring, observing and recording data related to the above listed forest health indicators. Pertinent quality assurance information is also included.

  10. In situ health monitoring of piezoelectric sensors

    NASA Technical Reports Server (NTRS)

    Jensen, Scott L. (Inventor); Drouant, George J. (Inventor)

    2013-01-01

    An in situ health monitoring apparatus may include an exciter circuit that applies a pulse to a piezoelectric transducer and a data processing system that determines the piezoelectric transducer's dynamic response to the first pulse. The dynamic response can be used to evaluate the operating range, health, and as-mounted resonance frequency of the transducer, as well as the strength of a coupling between the transducer and a structure and the health of the structure.

  11. Outcomes Assessment Planning: An Overview with Applications in Health Sciences.

    ERIC Educational Resources Information Center

    Trent, Ava M.

    2002-01-01

    Provides a brief overview of the process of outcomes assessment and examples of its application in professional health science education. Provides a background for other articles in this issue describing ongoing activities in outcomes assessment in veterinary education and for programs considering developing a plan. Focuses on health professions…

  12. Intimate Partner Violence, PTSD, and Adverse Health Outcomes

    ERIC Educational Resources Information Center

    Dutton, Mary Ann; Green, Bonnie L.; Kaltman, Stacey I.; Roesch, Darren M.; Zeffiro, Thomas A.; Krause, Elizabeth D.

    2006-01-01

    The high prevalence of adverse health outcomes related to intimate partner violence (IPV) is well documented. Yet we know little about the pathways that lead to adverse health outcomes. Research concerning the psychological, biological, neurological, behavioral, and physiological alterations following exposure to IPV--many of which are associated…

  13. Problem-Based Learning: Outcomes Evidence from the Health Professions

    ERIC Educational Resources Information Center

    Albanese, Mark A.; Dast, Laura

    2014-01-01

    Over the past 30 years, problem-based learning (PBL) has become a major force in health professions education and even in the broader educational world. This article focuses on the outcomes that have been found from using PBL in the health professions based on at least 20 reviews done since 1990. The outcomes identified in these reviews are…

  14. 42 CFR 460.202 - Participant health outcomes data.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Participant health outcomes data. 460.202 Section 460.202 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... FOR THE ELDERLY (PACE) Data Collection, Record Maintenance, and Reporting § 460.202 Participant...

  15. 42 CFR 460.202 - Participant health outcomes data.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Participant health outcomes data. 460.202 Section 460.202 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... FOR THE ELDERLY (PACE) Data Collection, Record Maintenance, and Reporting § 460.202 Participant...

  16. 42 CFR 460.202 - Participant health outcomes data.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Participant health outcomes data. 460.202 Section 460.202 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... FOR THE ELDERLY (PACE) Data Collection, Record Maintenance, and Reporting § 460.202 Participant...

  17. 42 CFR 460.202 - Participant health outcomes data.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Participant health outcomes data. 460.202 Section 460.202 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... FOR THE ELDERLY (PACE) Data Collection, Record Maintenance, and Reporting § 460.202 Participant...

  18. 42 CFR 460.202 - Participant health outcomes data.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Participant health outcomes data. 460.202 Section 460.202 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... FOR THE ELDERLY (PACE) Data Collection, Record Maintenance, and Reporting § 460.202 Participant...

  19. Social context, parental monitoring, and multisystemic therapy outcomes.

    PubMed

    Robinson, Brittany A; Winiarski, D Anne; Brennan, Patricia A; Foster, Sharon L; Cunningham, Phillippe B; Whitmore, Elizabeth A

    2015-03-01

    Multisystemic therapy (MST) and other evidence-based treatments targeting juvenile delinquency have been well substantiated in the literature. Although these treatments have been demonstrated to be effective overall at reducing juvenile delinquency, it is well known that they do not benefit all treated youth. Research has yet to examine the potential influence of contextual factors, such as socioeconomic status (SES) and neighborhood characteristics, on treatment outcomes, particularly as they influence parental monitoring, which is often a focus of interventions targeting juvenile delinquency. A primary goal of these treatments is to help parents develop the requisite skills to adequately monitor and discipline their children; however, this goal may be compromised by contextual factors affecting parental effectiveness and, ultimately, treatment efficacy. The objective of this study was to explore the role of SES and neighborhood factors in moderating the effects of parental monitoring across treatment. Using hierarchical linear modeling (HLM), we analyzed these contextual and family predictors of response to MST treatment within a sample of 185 youth (65.4% male) ages 12-18 (M = 15.35; SD = 1.28). Neighborhood factors interacted with parental monitoring, such that monitoring predicted decreases in externalizing behavior only for youth residing in better neighborhoods. In contrast, SES was unrelated to changes in externalizing behaviors in response to MST. Taken together, these results demonstrate a need for further understanding the potential role of the youth's larger social context in predicting MST outcomes. PMID:25365153

  20. Social Context, Parental Monitoring, and Multisystemic Therapy Outcomes

    PubMed Central

    Robinson, Brittany; Winiarski, D Anne; Brennan, Patricia A.; Foster, Sharon L.; Cunningham, Phillippe B.; Whitmore, Elizabeth A.

    2015-01-01

    Multisystemic Therapy (MST) and other evidence-based treatments targeting juvenile delinquency have been well substantiated in the literature. While these treatments have been demonstrated to be effective overall at reducing juvenile delinquency, it is well known that they do not benefit all treated youth. Research has yet to examine the potential influence of contextual factors, such as socioeconomic status (SES) and neighborhood characteristics, on treatment outcomes, particularly as they influence parental monitoring, which is often a focus of interventions targeting juvenile delinquency. A primary goal of these treatments is to help parents develop the requisite skills to adequately monitor and discipline their children; however, this goal may be compromised by contextual factors affecting parental effectiveness and, ultimately, treatment efficacy. The objective of this study was to explore the role of SES and neighborhood factors in moderating the effects of parental monitoring across treatment. Using hierarchical linear modeling (HLM), we analyzed these contextual and family predictors of response to MST treatment within a sample of 185 youth (65.4% male) ages 12-18 (M=15.35; SD=1.28). Neighborhood factors interacted with parental monitoring, such that monitoring predicted decreases in externalizing behavior only for youth residing in better neighborhoods. In contrast, SES was unrelated to changes in externalizing behaviors in response to MST. Taken together, these results demonstrate a need for further understanding the potential role of the youth’s larger social context in predicting MST outcomes. PMID:25365153

  1. Small Autonomous Aircraft Servo Health Monitoring

    NASA Technical Reports Server (NTRS)

    Quintero, Steven

    2008-01-01

    Small air vehicles offer challenging power, weight, and volume constraints when considering implementation of system health monitoring technologies. In order to develop a testbed for monitoring the health and integrity of control surface servos and linkages, the Autonomous Aircraft Servo Health Monitoring system has been designed for small Uninhabited Aerial Vehicle (UAV) platforms to detect problematic behavior from servos and the air craft structures they control, This system will serve to verify the structural integrity of an aircraft's servos and linkages and thereby, through early detection of a problematic situation, minimize the chances of an aircraft accident. Embry-Riddle Aeronautical University's rotary-winged UAV has an Airborne Power management unit that is responsible for regulating, distributing, and monitoring the power supplied to the UAV's avionics. The current sensing technology utilized by the Airborne Power Management system is also the basis for the Servo Health system. The Servo Health system measures the current draw of the servos while the servos are in Motion in order to quantify the servo health. During a preflight check, deviations from a known baseline behavior can be logged and their causes found upon closer inspection of the aircraft. The erratic behavior nay include binding as a result of dirt buildup or backlash caused by looseness in the mechanical linkages. Moreover, the Servo Health system will allow elusive problems to be identified and preventative measures taken to avoid unnecessary hazardous conditions in small autonomous aircraft.

  2. Intelligent Mobile Health Monitoring System (IMHMS)

    NASA Astrophysics Data System (ADS)

    Shahriyar, Rifat; Bari, Md. Faizul; Kundu, Gourab; Ahamed, Sheikh Iqbal; Akbar, Md. Mostofa

    Health monitoring is repeatedly mentioned as one of the main application areas for Pervasive computing. Mobile Health Care is the integration of mobile computing and health monitoring. It is the application of mobile computing technologies for improving communication among patients, physicians, and other health care workers. As mobile devices have become an inseparable part of our life it can integrate health care more seamlessly to our everyday life. It enables the delivery of accurate medical information anytime anywhere by means of mobile devices. Recent technological advances in sensors, low-power integrated circuits, and wireless communications have enabled the design of low-cost, miniature, lightweight and intelligent bio-sensor nodes. These nodes, capable of sensing, processing, and communicating one or more vital signs, can be seamlessly integrated into wireless personal or body area networks for mobile health monitoring. In this paper we present Intelligent Mobile Health Monitoring System (IMHMS), which can provide medical feedback to the patients through mobile devices based on the biomedical and environmental data collected by deployed sensors.

  3. Optical Structural Health Monitoring Device

    NASA Technical Reports Server (NTRS)

    Buckner, Benjamin D.; Markov, Vladimir; Earthman, James C.

    2010-01-01

    This non-destructive, optical fatigue detection and monitoring system relies on a small and unobtrusive light-scattering sensor that is installed on a component at the beginning of its life in order to periodically scan the component in situ. The method involves using a laser beam to scan the surface of the monitored component. The device scans a laser spot over a metal surface to which it is attached. As the laser beam scans the surface, disruptions in the surface cause increases in scattered light intensity. As the disruptions in the surface grow, they will cause the light to scatter more. Over time, the scattering intensities over the scanned line can be compared to detect changes in the metal surface to find cracks, crack precursors, or corrosion. This periodic monitoring of the surface can be used to indicate the degree of fatigue damage on a component and allow one to predict the remaining life and/or incipient mechanical failure of the monitored component. This wireless, compact device can operate for long periods under its own battery power and could one day use harvested power. The prototype device uses the popular open-source TinyOS operating system on an off-the-shelf Mica2 sensor mote, which allows wireless command and control through dynamically reconfigurable multi-node sensor networks. The small size and long life of this device could make it possible for the nodes to be installed and left in place over the course of years, and with wireless communication, data can be extracted from the nodes by operators without physical access to the devices. While a prototype has been demonstrated at the time of this reporting, further work is required in the system s development to take this technology into the field, especially to improve its power management and ruggedness. It should be possible to reduce the size and sensitivity as well. Establishment of better prognostic methods based on these data is also needed. The increase of surface roughness with

  4. Routine outcome monitoring: Coming of age--With the usual developmental challenges.

    PubMed

    Wampold, Bruce E

    2015-12-01

    The articles in this series present a variety of systems that involve routine outcome monitoring and the provision of feedback to therapists and/or patients with the goal of improving the quality of mental health care. Sufficient evidence exists for the adopting 1 of these systems (or 1 that was not discussed in this series); nevertheless, a number of challenges exist. Issues related to identifying the efficacious components, implementation, utilization, scientific inquiry, and the next generation are discussed. PMID:26641376

  5. Evaluating health care quality: the moderating role of outcomes.

    PubMed

    Lytle, R S; Mokwa, M P

    1992-03-01

    An integrative model of health care quality is presented. "Health care quality" is defined as provider conformance to patient requirements at three benefit levels: core, intangible, and tangible. The model is operationalized and tested in a clinical setting, a large center for fertility studies with more than 5000 patients. Health care "process variables" such as physician and patient interactions were not as important in patients' evaluations of health care quality when successful outcomes occurred (pregnancy). However, when patients experienced unsuccessful outcomes (no pregnancy), health care "process variables" were important and had a significant influence on patient perceptions of health care quality. Hence, service outcomes can significantly affect the measurement and interpretation of health care quality. Implications for health care management and research are discussed. PMID:10116754

  6. Role of Video Games in Improving Health-Related Outcomes

    PubMed Central

    Primack, Brian A.; Carroll, Mary V.; McNamara, Megan; Klem, Mary Lou; King, Brandy; Rich, Michael O.; Chan, Chun W.; Nayak, Smita

    2012-01-01

    Context Video games represent a multibillion-dollar industry in the U.S. Although video gaming has been associated with many negative health consequences, it may also be useful for therapeutic purposes. The goal of this study was to determine whether video games may be useful in improving health outcomes. Evidence acquisition Literature searches were performed in February 2010 in six databases: the Center on Media and Child Health Database of Research, MEDLINE, CINAHL, PsycINFO, EMBASE, and the Cochrane Central Register of Controlled Trials. Reference lists were hand-searched to identify additional studies. Only RCTs that tested the effect of video games on a positive, clinically relevant health consequence were included. Study selection criteria were strictly defined and applied by two researchers working independently. Study background information (e.g., location, funding source), sample data (e.g., number of study participants, demographics), intervention and control details, outcomes data, and quality measures were abstracted independently by two researchers. Evidence synthesis Of 1452 articles retrieved using the current search strategy, 38 met all criteria for inclusion. Eligible studies used video games to provide physical therapy, psychological therapy, improved disease self-management, health education, distraction from discomfort, increased physical activity, and skills training for clinicians. Among the 38 studies, a total of 195 health outcomes were examined. Video games improved 69% of psychological therapy outcomes, 59% of physical therapy outcomes, 50% of physical activity outcomes, 46% of clinician skills outcomes, 42% of health education outcomes, 42% of pain distraction outcomes, and 37% of disease self-management outcomes. Study quality was generally poor; for example, two thirds (66%) of studies had follow-up periods of <12 weeks, and only 11% of studies blinded researchers. Conclusions There is potential promise for video games to improve

  7. Maintaining the Health of Software Monitors

    NASA Technical Reports Server (NTRS)

    Person, Suzette; Rungta, Neha

    2013-01-01

    Software health management (SWHM) techniques complement the rigorous verification and validation processes that are applied to safety-critical systems prior to their deployment. These techniques are used to monitor deployed software in its execution environment, serving as the last line of defense against the effects of a critical fault. SWHM monitors use information from the specification and implementation of the monitored software to detect violations, predict possible failures, and help the system recover from faults. Changes to the monitored software, such as adding new functionality or fixing defects, therefore, have the potential to impact the correctness of both the monitored software and the SWHM monitor. In this work, we describe how the results of a software change impact analysis technique, Directed Incremental Symbolic Execution (DiSE), can be applied to monitored software to identify the potential impact of the changes on the SWHM monitor software. The results of DiSE can then be used by other analysis techniques, e.g., testing, debugging, to help preserve and improve the integrity of the SWHM monitor as the monitored software evolves.

  8. From intensive care monitoring to personal health monitoring to ambient intelligence.

    PubMed

    Rienhoff, Otto

    2013-01-01

    The historical roots of IT-based monitoring in health care are described. Since the 1970ies monitoring has been spreading to more and more domains of health care and public health. Today one can observe monitoring of persons in many environments and regarding widely different questions. While these monitoring applications have been introduced ethical questions have been raised to balance the possible positive and negative outcomes of the approaches. Today IT-technology is entering many parts of our life - IT eventually became what had been coined already in the last century by IBM as "electronic dust" which one can find in every part of our environment. As most of these "dust-particles" are able to observe something one can also understand this development as a development into ubiquitous monitoring of nearly everything at any time. The foreseen ambient intelligence worlds are also spaces of ambient monitoring. This article describes this historical development. It emphasizes why ethical and data protection questions are an absolute must in most IT activities today. PMID:23920451

  9. Augmented Fish Health Monitoring, 1992 Annual Report.

    SciTech Connect

    Warren, James W.

    1992-08-01

    The Augmented Fish Health Monitoring Project (Project) had its origin, in the mid-1980's, in perceived differences or inconsistencies in fish disease detection, diagnosis and control capabilities between the five conservation agencies rearing and releasing anadromous salmonids for fishery resource management and mitigation purposes in the Columbia River basin. Agency fish health programs varied greatly. Some agencies had personnel, equipment and funding to frequently monitor the health status of both juvenile production fish and adult salmon or steelhead trout at the time of spawning. Other agencies had much smaller programs and limited resources. These differences became better understood when the Pacific Northwest Fish Health Protection Committee developed its Model Fish Health Protection Program including recommendations for standard fish disease detection procedures. Even though some agencies could not immediately attain the goals set by the Model Program it was unanimously adopted as a desirable objective. Shortly thereafter, a multi-party planning group was assembled to help the Bonneville Power Administration (BPA) find ways to improve agency fish health programs and implement measures under the Fish and Wildlife Program of the Northwest Power Planning Council. The planning group assessed existing agency fish health monitoring capabilities, agreed upon satisfactory levels of capability to detect and identify important fish pathogens, and designed a five-year project establishing comparable fish health monitoring capability in each agency. It was strongly believed that such a project would improve the health and quality of the millions of hatchery fish released annually in the Columbia River basin and improve interagency communications and disease control coordination. During 1986 and 1987 BPA individually negotiated five separate contracts with the fishery agencies to standardize fish health monitoring, develop a common data collection and reporting format

  10. Engine health monitoring: An advanced system

    NASA Technical Reports Server (NTRS)

    Dyson, R. J. E.

    1981-01-01

    The advanced propulsion monitoring system is described. The system was developed in order to fulfill a growing need for effective engine health monitoring. This need is generated by military requirements for increased performance and efficiency in more complex propulsion systems, while maintaining or improving the cost to operate. This program represents a vital technological step in the advancement of the state of the art for monitoring systems in terms of reliability, flexibility, accuracy, and provision of user oriented results. It draws heavily on the technology and control theory developed for modern, complex, electronically controlled engines and utilizes engine information which is a by-product of such a system.

  11. Privacy by design in personal health monitoring.

    PubMed

    Nordgren, Anders

    2015-06-01

    The concept of privacy by design is becoming increasingly popular among regulators of information and communications technologies. This paper aims at analysing and discussing the ethical implications of this concept for personal health monitoring. I assume a privacy theory of restricted access and limited control. On the basis of this theory, I suggest a version of the concept of privacy by design that constitutes a middle road between what I call broad privacy by design and narrow privacy by design. The key feature of this approach is that it attempts to balance automated privacy protection and autonomously chosen privacy protection in a way that is context-sensitive. In personal health monitoring, this approach implies that in some contexts like medication assistance and monitoring of specific health parameters one single automatic option is legitimate, while in some other contexts, for example monitoring in which relatives are receivers of health-relevant information rather than health care professionals, a multi-choice approach stressing autonomy is warranted. PMID:23978898

  12. Acoustic Techniques for Structural Health Monitoring

    NASA Astrophysics Data System (ADS)

    Frankenstein, B.; Augustin, J.; Hentschel, D.; Schubert, F.; Köhler, B.; Meyendorf, N.

    2008-02-01

    Future safety and maintenance strategies for industrial components and vehicles are based on combinations of monitoring systems that are permanently attached to or embedded in the structure, and periodic inspections. The latter belongs to conventional nondestructive evaluation (NDE) and can be enhanced or partially replaced by structural health monitoring systems. However, the main benefit of this technology for the future will consist of systems that can be differently designed based on improved safety philosophies, including continuous monitoring. This approach will increase the efficiency of inspection procedures at reduced inspection times. The Fraunhofer IZFP Dresden Branch has developed network nodes, miniaturized transmitter and receiver systems for active and passive acoustical techniques and sensor systems that can be attached to or embedded into components or structures. These systems have been used to demonstrate intelligent sensor networks for the monitoring of aerospace structures, railway systems, wind energy generators, piping system and other components. Material discontinuities and flaws have been detected and monitored during full scale fatigue testing. This paper will discuss opportunities and future trends in nondestructive evaluation and health monitoring based on new sensor principles and advanced microelectronics. It will outline various application examples of monitoring systems based on acoustic techniques and will indicate further needs for research and development.

  13. Integrating Work and Family: Women's Health Outcomes.

    ERIC Educational Resources Information Center

    Killien, Marcia

    An exploratory study examined the relationship between individual, family, and work variables and working mothers' health. The study also investigated the relationship between health management strategies and health. A cross-sectional survey design was used to gather data from 85 women who were married, employed 20 hours a week or more, and had…

  14. The impact of health insurance on health services utilization and health outcomes in Vietnam.

    PubMed

    Guindon, G Emmanuel

    2014-10-01

    In recent years, a number of low- and middle-income country governments have introduced health insurance schemes. Yet not a great deal is known about the impact of such policy shifts. Vietnam's recent health insurance experience including a health insurance scheme for the poor in 2003 and a compulsory scheme that provides health insurance to all children under six years of age combined with Vietnam's commitment to universal coverage calls for research that examines the impact of health insurance. Taking advantage of Vietnam's unique policy environment, data from the 2002, 2004 and 2006 waves of the Vietnam Household Living Standard Survey and single-difference and difference-in-differences approaches are used to assess whether access to health insurance--for the poor, for children and for students--impacts on health services utilization and health outcomes in Vietnam. For the poor and for students, results suggest health insurance increased the use of inpatient services but not of outpatient services or health outcomes. For young children, results suggest health insurance increased the use of outpatient services (including the use of preventive health services such as vaccination and check-up) but not of inpatient services. PMID:24661805

  15. Robust Strategy for Rocket Engine Health Monitoring

    NASA Technical Reports Server (NTRS)

    Santi, L. Michael

    2001-01-01

    Monitoring the health of rocket engine systems is essentially a two-phase process. The acquisition phase involves sensing physical conditions at selected locations, converting physical inputs to electrical signals, conditioning the signals as appropriate to establish scale or filter interference, and recording results in a form that is easy to interpret. The inference phase involves analysis of results from the acquisition phase, comparison of analysis results to established health measures, and assessment of health indications. A variety of analytical tools may be employed in the inference phase of health monitoring. These tools can be separated into three broad categories: statistical, rule based, and model based. Statistical methods can provide excellent comparative measures of engine operating health. They require well-characterized data from an ensemble of "typical" engines, or "golden" data from a specific test assumed to define the operating norm in order to establish reliable comparative measures. Statistical methods are generally suitable for real-time health monitoring because they do not deal with the physical complexities of engine operation. The utility of statistical methods in rocket engine health monitoring is hindered by practical limits on the quantity and quality of available data. This is due to the difficulty and high cost of data acquisition, the limited number of available test engines, and the problem of simulating flight conditions in ground test facilities. In addition, statistical methods incur a penalty for disregarding flow complexity and are therefore limited in their ability to define performance shift causality. Rule based methods infer the health state of the engine system based on comparison of individual measurements or combinations of measurements with defined health norms or rules. This does not mean that rule based methods are necessarily simple. Although binary yes-no health assessment can sometimes be established by

  16. Achievements in mental health outcome measurement in Australia: Reflections on progress made by the Australian Mental Health Outcomes and Classification Network (AMHOCN)

    PubMed Central

    2012-01-01

    Background Australia’s National Mental Health Strategy has emphasised the quality, effectiveness and efficiency of services, and has promoted the collection of outcomes and casemix data as a means of monitoring these. All public sector mental health services across Australia now routinely report outcomes and casemix data. Since late-2003, the Australian Mental Health Outcomes and Classification Network (AMHOCN) has received, processed, analysed and reported on outcome data at a national level, and played a training and service development role. This paper documents the history of AMHOCN’s activities and achievements, with a view to providing lessons for others embarking on similar exercises. Method We conducted a desktop review of relevant documents to summarise the history of AMHOCN. Results AMHOCN has operated within a framework that has provided an overarching structure to guide its activities but has been flexible enough to allow it to respond to changing priorities. With no precedents to draw upon, it has undertaken activities in an iterative fashion with an element of ‘trial and error’. It has taken a multi-pronged approach to ensuring that data are of high quality: developing innovative technical solutions; fostering ‘information literacy’; maximising the clinical utility of data at a local level; and producing reports that are meaningful to a range of audiences. Conclusion AMHOCN’s efforts have contributed to routine outcome measurement gaining a firm foothold in Australia’s public sector mental health services. PMID:22640939

  17. Design Optimization of Structural Health Monitoring Systems

    SciTech Connect

    Flynn, Eric B.

    2014-03-06

    Sensor networks drive decisions. Approach: Design networks to minimize the expected total cost (in a statistical sense, i.e. Bayes Risk) associated with making wrong decisions and with installing maintaining and running the sensor network itself. Search for optimal solutions using Monte-Carlo-Sampling-Adapted Genetic Algorithm. Applications include structural health monitoring and surveillance.

  18. Intelligent Control and Health Monitoring. Chapter 3

    NASA Technical Reports Server (NTRS)

    Garg, Sanjay; Kumar, Aditya; Mathews, H. Kirk; Rosenfeld, Taylor; Rybarik, Pavol; Viassolo, Daniel E.

    2009-01-01

    Advanced model-based control architecture overcomes the limitations state-of-the-art engine control and provides the potential of virtual sensors, for example for thrust and stall margin. "Tracking filters" are used to adapt the control parameters to actual conditions and to individual engines. For health monitoring standalone monitoring units will be used for on-board analysis to determine the general engine health and detect and isolate sudden faults. Adaptive models open up the possibility of adapting the control logic to maintain desired performance in the presence of engine degradation or to accommodate any faults. Improved and new sensors are required to allow sensing at stations within the engine gas path that are currently not instrumented due in part to the harsh conditions including high operating temperatures and to allow additional monitoring of vibration, mass flows and energy properties, exhaust gas composition, and gas path debris. The environmental and performance requirements for these sensors are summarized.

  19. Wearable sensors for human health monitoring

    NASA Astrophysics Data System (ADS)

    Asada, H. Harry; Reisner, Andrew

    2006-03-01

    Wearable sensors for continuous monitoring of vital signs for extended periods of weeks or months are expected to revolutionize healthcare services in the home and workplace as well as in hospitals and nursing homes. This invited paper describes recent research progress in wearable health monitoring technology and its clinical applications, with emphasis on blood pressure and circulatory monitoring. First, a finger ring-type wearable blood pressure sensor based on photo plethysmogram is presented. Technical issues, including motion artifact reduction, power saving, and wearability enhancement, will be addressed. Second, sensor fusion and sensor networking for integrating multiple sensors with diverse modalities will be discussed for comprehensive monitoring and diagnosis of health status. Unlike traditional snap-shot measurements, continuous monitoring with wearable sensors opens up the possibility to treat the physiological system as a dynamical process. This allows us to apply powerful system dynamics and control methodologies, such as adaptive filtering, single- and multi-channel system identification, active noise cancellation, and adaptive control, to the monitoring and treatment of highly complex physiological systems. A few clinical trials illustrate the potentials of the wearable sensor technology for future heath care services.

  20. Outcomes Assessment in Accredited Health Information Management Programs

    ERIC Educational Resources Information Center

    Bennett, Dorine

    2010-01-01

    The purpose of this study was to determine the use and perceived usefulness of outcomes assessment methods in health information management programs. Additional characteristics of the outcomes assessment practices were recognized. The findings were evaluated for significant differences in results based on age of the program, type of institution,…

  1. Degradation Modelling for Health Monitoring Systems

    NASA Astrophysics Data System (ADS)

    Stetter, R.; Witczak, M.

    2014-12-01

    Condition-monitoring plays an increasingly important role for technical processes in order to improve reliability, availability, maintenance and lifetime of equipment. With increasing demands for efficiency and product quality, plus progress in the integration of automatic control systems in high-cost mechatronic and critical safety processes, the field of health monitoring is gaining interest. A similar research field is concerned with an estimation of the remaining useful life. A central question in these fields is the modelling of degradation; degradation is a process of a gradual and irreversible accumulation of damage which will finally result in a failure of the system. This paper is based on a current research project and explores various degradation modelling techniques. These results are explained on the basis of an industrial product - a system for the generation of health status information for pump systems. The result of this fuzzy-logic based system is a single number indicating the current health of a pump system.

  2. Structural health monitoring of wind turbines

    SciTech Connect

    Simmermacher, T.; James, G.H. III.; Hurtado, J.E.

    1997-09-01

    To properly determine what is needed in a structural health monitoring system, actual operational structures need to be studied. We have found that to effectively monitor the structural condition of an operational structure four areas must be addressed: determination of damage-sensitive parameters, test planning, information condensation, and damage identification techniques. In this work, each of the four areas has been exercised on an operational structure. The structures studied were all be wind turbines of various designs. The experiments are described and lessons learned will be presented. The results of these studies include a broadening of experience in the problems of monitoring actual structures as well as developing a process for implementing such monitoring systems.

  3. The outcomes of health care process in Iran's rural society

    PubMed Central

    Eskandari, Manije; Abbaszadeh, Abbas; Borhani, Fariba

    2013-01-01

    Background: Health care systems in rural areas face numerous challenges in meeting the community's needs and adequate attention has not been paid to this problem. The aim of this study was to describe the outcomes of health care process in rural society. Materials and Methods: Twenty-six participants including twenty-one rural health care providers and five clients were selected according to purposive sampling. The data were collected via semi-structured individual interviews and a mini focus group. Data were analyzed by using qualitative content analysis based on methods described by Granheme and Landman. Results: Data analysis eventually led to formation of one category of inefficiency in health care process in rural society including subcategories such as arbitrary self-therapy, slow care process, dissatisfaction with the care process, superficial caring, job stress and burn out of caregivers, and ineffective caring relationship. Conclusion: Outcomes in health care in rural society of Iran represents inefficiency of the current health care process. These outcomes are related to the cultural and social context of rural communities and the structure of the health system. These outcomes in health care in the rural society of Iran represent impairment of the current health care process. The necessity of modifying the existing care trend with new models designed to improve the health care process is felt. PMID:24403941

  4. Can States Simultaneously Improve Health Outcomes and Reduce Health Outcome Disparities?

    PubMed Central

    Lardinois, Nicholas; Chatterjee, Debanjana

    2016-01-01

    Introduction Reducing racial health disparities is often stated as a population health goal, but specific targets for such improvement are seldom set. It is often assumed that improving overall health outcomes will be linked to disparity reduction, but this is not necessarily the case. Methods We compared the annual change from 1999 through 2013 in combined-race (black and white) mortality with the annual change in absolute and relative racial mortality disparities for US states. Results Median annual improvement in combined-race mortality was 1.08% per year. Annual overall mortality rate reductions ranged from 0.24% per year in Oklahoma to 1.83% per year in Maryland. For disparities, the median for the black–white absolute gap was 3.60% per year, and the median for the relative black-to-white ratio was 1.19% per year. There was no significant correlation between the combined-race measure and either the absolute (0.03) or relative disparity measure reductions (−0.17). Conclusion For mortality in US states over a recent period, improvement in the population mean and disparity reduction do not usually occur together. The disparity reduction rates observed may provide realistic guidance for public and private policy makers in setting goals for reducing population health disparity and creating investment priorities. As a starting point for discussion, the observed national median annual percentage improvement of 1.1 per year combined, 3.6% per year absolute gap reduction, and 1.2% per year relative gap reduction would be modest and reasonable goals. PMID:27560720

  5. Application of the National Institutes of Health Patient-Reported Outcomes Measurement Information System (PROMIS®) to Mental Health Research

    PubMed Central

    Riley, William T.; Pilkonis, Paul; Cella, David

    2013-01-01

    Background The Patient-Reported Outcomes Measurement Information System (PROMIS) is a National Institutes of Health initiative to develop item banks measuring patient-reported outcomes (PROs) and to create and make available a computerized adaptive testing system (CAT) that allows for efficient and precise assessment of PROs in clinical research and practice. Aims of the Study Based on the presentation from a symposium on “Evidence-based Outcomes in Psychiatry: Updates on Measurement Using Patient-Reported Outcomes (PRO)” at the 2011 American Psychiatry Association Convention, this paper provides an overview of PROMIS and its application to mental health research. Methods The PROMIS methodology for item bank development and testing is described, with a focus on the implications of this work for mental health research. Results Utilizing qualitative item review and state-of-the-art applications of item response theory (IRT), PROMIS investigators have developed, tested, and released item banks measuring physical, mental, and social health components. Ongoing efforts continue to add new item banks and further validate existing banks. Discussion PROMIS provides item banks measuring several domains of interest to mental health researchers including emotional distress, social function, and sleep. PROMIS methodology also provides a rigorous standard for the development of new mental health measures. Implications for Health Care Provision Web-based CAT or administration of short forms derived from PROMIS item banks provide efficient and precise dimensional estimates of clinical outcomes that can be utilized to monitor patient progress and assess quality improvement. Implications for Future Research Use of the dimensional PROMIS metrics (and co-calibration of the PROMIS item banks with existing PROs) will allow comparisons of mental health and related health outcomes across disorders and studies. PMID:22345362

  6. Principles in wireless building health monitoring systems.

    NASA Astrophysics Data System (ADS)

    Pentaris, F. P.; Makris, J. P.; Stonham, J.; Vallianatos, F.

    2012-04-01

    Monitoring the structural state of a building is essential for the safety of the people who work, live, visit or just use it as well as for the civil protection of urban areas. Many factors can affect the state of the health of a structure, namely man made, like mistakes in the construction, traffic, heavy loads on the structures, explosions, environmental impacts like wind loads, humidity, chemical reactions, temperature changes and saltiness, and natural hazards like earthquakes and landslides. Monitoring the health of a structure provides the ability to anticipate structural failures and secure the safe use of buildings especially those of public services. This work reviews the state of the art and the challenges of a wireless Structural Health Monitoring (WiSHM). Literature review reveals that although there is significant evolution in wireless structural health monitoring, in many cases, monitoring by itself is not enough to predict when a structure becomes inappropriate and/or unsafe for use, and the damage or low durability of a structure cannot be revealed (Chintalapudi, et al., 2006; Ramos, Aguilar, & Lourenço, 2011). Several features and specifications of WiSHM like wireless sensor networking, reliability and autonomy of sensors, algorithms of data transmission and analysis should still be evolved and improved in order to increase the predictive effectiveness of the SHM (Jinping Ou & Hui Li, 2010; Lu & Loh, 2010) . Acknowledgments This work was supported in part by the ARCHEMEDES III Program of the Ministry of Education of Greece and the European Union in the framework of the project entitled «Interdisciplinary Multi-Scale Research of Earthquake Physics and Seismotectonics at the front of the Hellenic Arc (IMPACT-ARC) ».

  7. A dependencies mapping method for personal health monitoring.

    PubMed

    Rogerson, Simon; Wilford, Sara; Fairweather, Ben

    2013-01-01

    This chapter discusses the research undertaken in developing a comprehensive dependencies map for Personal Health Monitoring (PHM). Included is a discussion of the underlying research approach adopted and how this was operationalized. A new dependencies mapping method has been developed and this is described in detail. Illustrations of the derived tools are given using the PHM analysis undertaken. A summary of the analysis outcomes and the resulting recommendations are discussed. The chapter concludes with some suggestions of ways in which this type of data set can be used in practice to deliver fit-for-purpose PHM systems. PMID:23920459

  8. INDUCTIVE SYSTEM HEALTH MONITORING WITH STATISTICAL METRICS

    NASA Technical Reports Server (NTRS)

    Iverson, David L.

    2005-01-01

    Model-based reasoning is a powerful method for performing system monitoring and diagnosis. Building models for model-based reasoning is often a difficult and time consuming process. The Inductive Monitoring System (IMS) software was developed to provide a technique to automatically produce health monitoring knowledge bases for systems that are either difficult to model (simulate) with a computer or which require computer models that are too complex to use for real time monitoring. IMS processes nominal data sets collected either directly from the system or from simulations to build a knowledge base that can be used to detect anomalous behavior in the system. Machine learning and data mining techniques are used to characterize typical system behavior by extracting general classes of nominal data from archived data sets. In particular, a clustering algorithm forms groups of nominal values for sets of related parameters. This establishes constraints on those parameter values that should hold during nominal operation. During monitoring, IMS provides a statistically weighted measure of the deviation of current system behavior from the established normal baseline. If the deviation increases beyond the expected level, an anomaly is suspected, prompting further investigation by an operator or automated system. IMS has shown potential to be an effective, low cost technique to produce system monitoring capability for a variety of applications. We describe the training and system health monitoring techniques of IMS. We also present the application of IMS to a data set from the Space Shuttle Columbia STS-107 flight. IMS was able to detect an anomaly in the launch telemetry shortly after a foam impact damaged Columbia's thermal protection system.

  9. Optical metabolic imaging for monitoring tracheal health

    NASA Astrophysics Data System (ADS)

    Sharick, Joe T.; Gil, Daniel A.; Choma, Michael A.; Skala, Melissa C.

    2016-04-01

    The health of the tracheal mucosa and submucosa is a vital yet poorly understood component of critical care medicine, and a minimally-invasive method is needed to monitor tracheal health in patients. Of particular interest are the ciliated cells of the tracheal epithelium that move mucus away from the lungs and prevent respiratory infection. Optical metabolic imaging (OMI) allows cellular-level measurement of metabolism, and is a compelling method for assessing tracheal health because ciliary motor proteins require ATP to function. In this pilot study, we apply multiphoton imaging of the fluorescence intensities and lifetimes of metabolic co-enzymes NAD(P)H and FAD to the mucosa and submucosa of ex vivo mouse trachea. We demonstrate the feasibility and potential diagnostic utility of these measurements for assessing tracheal health and pathophysiology at the single-cell level.

  10. Health literacy interventions and outcomes: an updated systematic review.

    PubMed Central

    Berkman, Nancy D; Sheridan, Stacey L; Donahue, Katrina E; Halpern, David J; Viera, Anthony; Crotty, Karen; Holland, Audrey; Brasure, Michelle; Lohr, Kathleen N; Harden, Elizabeth; Tant, Elizabeth; Wallace, Ina; Viswanathan, Meera

    2011-01-01

    OBJECTIVES To update a 2004 systematic review of health care service use and health outcomes related to differences in health literacy level and interventions designed to improve these outcomes for individuals with low health literacy. Disparities in health outcomes and effectiveness of interventions among different sociodemographic groups were also examined. DATA SOURCES We searched MEDLINE®, the Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, PsychINFO, and the Educational Resources Information Center. For health literacy, we searched using a variety of terms, limited to English and studies published from 2003 to May 25, 2010. For numeracy, we searched from 1966 to May 25, 2010. REVIEW METHODS We used standard Evidence-based Practice Center methods of dual review of abstracts, full-text articles, abstractions, quality ratings, and strength of evidence grading. We resolved disagreements by consensus. We evaluated whether newer literature was available for answering key questions, so we broadened our definition of health literacy to include numeracy and oral (spoken) health literacy. We excluded intervention studies that did not measure health literacy directly and updated our approach to evaluate individual study risk of bias and to grade strength of evidence. RESULTS We included good- and fair-quality studies: 81 studies addressing health outcomes (reported in 95 articles including 86 measuring health literacy and 16 measuring numeracy, of which 7 measure both) and 42 studies (reported in 45 articles) addressing interventions. Differences in health literacy level were consistently associated with increased hospitalizations, greater emergency care use, lower use of mammography, lower receipt of influenza vaccine, poorer ability to demonstrate taking medications appropriately, poorer ability to interpret labels and health messages, and, among seniors, poorer overall health status and higher mortality. Health literacy level

  11. Cultural Competence and Children's Mental Health Service Outcomes

    ERIC Educational Resources Information Center

    Mancoske, Ronald J.; Lewis, Marva L.; Bowers-Stephens, Cheryll; Ford, Almarie

    2012-01-01

    This study describes the relationships between clients' perception of cultural competency of mental health providers and service outcomes. A study was conducted of a public children's mental health program that used a community-based, systems of care approach. Data from a subsample (N = 111) of families with youths (average age 12.3) and primarily…

  12. Adherence indicators predict changes in health outcomes: HUB City Steps

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Participant adherence is a major threat to intervention effectiveness. Most researchers have reported effects of a single adherence measure on health outcomes. The objective of this analysis was to evaluate two adherence measures, separately and in combination, for predicting changes in health out...

  13. Predictors of outcome in outpatients with anxiety disorders: the Leiden routine outcome monitoring study.

    PubMed

    Schat, A; van Noorden, M S; Noom, M J; Giltay, E J; van der Wee, N J A; Vermeiren, R R J M; Zitman, F G

    2013-12-01

    Little is known about the predictors of outcome in anxiety disorders in naturalistic outpatient settings. We analyzed 2-year follow-up data collected through Routine Outcome Monitoring (ROM) in a naturalistic sample of 917 outpatients in psychiatric specialty care in order to identify factors predicting outcome. We included patients with panic disorder with or without agoraphobia, agoraphobia without panic, social phobia, or generalized anxiety disorder. Main findings from Cox regression analyses demonstrated that several socio-demographic variables (having a non-Dutch ethnicity [HR = 0.71)], not having a daily occupation [HR = 0.76]) and clinical factors (having a diagnosis of agoraphobia [HR = 0.67], high affective lability [HR = 0.80] and behavior problems [HR = 0.84]) decreased chances of response (defined as 50% reduction of anxiety severity) over the period of two years. Living with family had a protective predictive value [HR = 1.41]. These results may imply that factors that could be thought to limit societal participation, are associated with elevated risk of poor outcome. A comprehensive ROM screening process at intake may aid clinicians in the identification of patients at risk of chronicity. PMID:24074517

  14. Health Monitoring of a Satellite System

    NASA Technical Reports Server (NTRS)

    Chen, Robert H.; Ng, Hok K.; Speyer, Jason L.; Guntur, Lokeshkumar S.; Carpenter, Russell

    2004-01-01

    A health monitoring system based on analytical redundancy is developed for satellites on elliptical orbits. First, the dynamics of the satellite including orbital mechanics and attitude dynamics is modelled as a periodic system. Then, periodic fault detection filters are designed to detect and identify the satellite's actuator and sensor faults. In addition, parity equations are constructed using the algebraic redundant relationship among the actuators and sensors. Furthermore, a residual processor is designed to generate the probability of each of the actuator and sensor faults by using a sequential probability test. Finally, the health monitoring system, consisting of periodic fault detection lters, parity equations and residual processor, is evaluated in the simulation in the presence of disturbances and uncertainty.

  15. Health monitoring for effective management of infrastructure

    NASA Astrophysics Data System (ADS)

    Aktan, A. Emin; Catbas, Fikret N.; Grimmelsman, Kirk A.; Pervizpour, Mesut; Curtis, Joshua M.; Shen, Kaizhen; Qin, Xiaoli

    2002-06-01

    Significance of effectively managing civil infrastructure systems (CIS) throughout CIS life-cycles, and especially during and after natural or man-made disasters is well recognized. Disaster mitigation includes preparedness for hazards to avoid casualties and human suffering, as well as to ensure that critical CIS components can become operational within a short amount of time following a disaster. It follows that mitigating risk due to disasters and CIS managementare intersecting and interacting societal concerns. A coordinated, multi-disciplinary approach that integrates field, theoretical and laboratory research is necessary for innovating both hazard mitigation and infrastructure management. Health monitoring (HM) of CIS is an emerging paradigm for effective management, including emergency response and recovery management. Challenges and opportunities in health monitoring enabled by recent advances in information technology are discussed in this paper. An example of HM research on an actual CIS test-bed is presented.

  16. Ethnicity, aging, and oral health outcomes: a conceptual framework.

    PubMed

    Andersen, R M; Davidson, P L

    1997-05-01

    An expanded version of Andersen's Behavioral Model of Health Services Utilization is used as the theoretical and analytical framework for the International Collaborative Study of Oral Health Outcomes (ICS-II). The conceptual framework for understanding determinants of oral health is based on a "systems" perspective. The framework posits that characteristics of the external environment, the dental care delivery system, and the personal characteristics of the population influence oral health behaviors. The expanded behavioral model conceptualizes health behaviors (oral hygiene practices and dental services utilization) as intermediate dependent variables, which in turn influence oral health outcomes (evaluated, perceived, patient satisfaction). The framework is presented with an increased focus on the effects of race-ethnicity and age cohort, the major exogenous variables used in this study for systematic assessment of the differences in the multitude of factors influencing oral health. The framework can be applied by policy analysis and health services managers to help describe, predict, and explain population-based health behaviors and health outcomes. PMID:9549985

  17. Monitoring the health of control system components

    NASA Technical Reports Server (NTRS)

    Vander Velde, W. E.

    1990-01-01

    One characteristic of intelligent behavior is recognition of impaired capability. So an intelligent system should be able to monitor its own performance and determine when one of its components has failed - causing it to lose some degree of capability. This is especially important in autonomous operation which is one of the primary motivations for intelligent systems. This paper briefly reviews the principal approaches that have been suggested for monitoring control systems for failures of its sensors and actuators. The important characteristics of these methods are noted and two are selected for further consideration. These two methods, the failure detection filter and generalized parity relations, are described. Results of experiments are then given of detection and isolation of sensor failures using data taken on the Mini-Mast facility at the NASA Langley Research Center. The effects of certain design options are illustrated. The paper concludes with some observations about the general problem of monitoring the health of control systems.

  18. Nuclear propulsion control and health monitoring

    NASA Technical Reports Server (NTRS)

    Walter, P. B.; Edwards, R. M.

    1993-01-01

    An integrated control and health monitoring architecture is being developed for the Pratt & Whitney XNR2000 nuclear rocket. Current work includes further development of the dynamic simulation modeling and the identification and configuration of low level controllers to give desirable performance for the various operating modes and faulted conditions. Artificial intelligence and knowledge processing technologies need to be investigated and applied in the development of an intelligent supervisory controller module for this control architecture.

  19. Flexible Structural-Health-Monitoring Sheets

    NASA Technical Reports Server (NTRS)

    Qing, Xinlin; Kuo, Fuo

    2008-01-01

    A generic design for a type of flexible structural-health-monitoring sheet with multiple sensor/actuator types and a method of manufacturing such sheets has been developed. A sheet of this type contains an array of sensing and/or actuation elements, associated wires, and any other associated circuit elements incorporated into various flexible layers on a thin, flexible substrate. The sheet can be affixed to a structure so that the array of sensing and/or actuation elements can be used to analyze the structure in accordance with structural-health-monitoring techniques. Alternatively, the sheet can be designed to be incorporated into the body of the structure, especially if the structure is made of a composite material. Customarily, structural-health monitoring is accomplished by use of sensors and actuators arrayed at various locations on a structure. In contrast, a sheet of the present type can contain an entire sensor/actuator array, making it unnecessary to install each sensor and actuator individually on or in a structure. Sensors of different types such as piezoelectric and fiber-optic can be embedded in the sheet to form a hybrid sensor network. Similarly, the traces for electric communication can be deposited on one or two layers as required, and an entirely separate layer can be employed to shield the sensor elements and traces.

  20. Child Social Exclusion Risk and Child Health Outcomes in Australia

    PubMed Central

    Mohanty, Itismita; Edvardsson, Martin; Abello, Annie; Eldridge, Deanna

    2016-01-01

    Introduction This paper studies the relationship between the risk of child social exclusion, as measured by the Child Social Exclusion (CSE) index and its individual domains, and child health outcomes at the small area level in Australia. The CSE index is Australia’s only national small-area index of the risk of child social exclusion. It includes five domains that capture different components of social exclusion: socio-economic background, education, connectedness, housing and health services. Methods The paper used data from the National Centre for Social and Economic Modelling (NATSEM), University of Canberra for the CSE Index and its domains and two key Australian Institute of Health and Welfare (AIHW) data sources for the health outcome measures: the National Hospital Morbidity Database and the National Mortality Database. Results The results show positive associations between rates of both of the negative health outcomes: potentially preventable hospitalisations (PPH) and avoidable deaths, and the overall risk of child social exclusion as well as with the index domains. This analysis at the small-area level can be used to identify and study areas with unexpectedly good or bad health outcomes relative to their estimated risk of child social exclusion. We show that children’s health outcomes are worse in remote parts of Australia than what would be expected solely based on the CSE index. Conclusions The results of this study suggest that developing composite indices of the risk of child social exclusion can provide valuable guidance for local interventions and programs aimed at improving children’s health outcomes. They also indicate the importance of taking a small-area approach when conducting geographic modelling of disadvantage. PMID:27152596

  1. Integrated Worker Health Protection and Promotion Programs: Overview and Perspectives on Health and Economic Outcomes

    PubMed Central

    Pronk, Nicolaas P.

    2014-01-01

    Objective To describe integrated worker health protection and promotion (IWHPP) program characteristics, to discuss the rationale for integration of OSH and WHP programs, and to summarize what is known about the impact of these programs on health and economic outcomes. Methods A descriptive assessment of the current state of the IWHPP field and a review of studies on the effectiveness of IWHPP programs on health and economic outcomes. Results Sufficient evidence of effectiveness was found for IWHPP programs when health outcomes are considered. Impact on productivity-related outcomes is considered promising, but inconclusive, whereas insufficient evidence was found for health care expenditures. Conclusions Existing evidence supports an integrated approach in terms of health outcomes but will benefit significantly from research designed to support the business case for employers of various company sizes and industry types. PMID:24284747

  2. Toward Improved Public Health Outcomes From Urban Nature

    PubMed Central

    Bush, Robert; Gaston, Kevin J.; Dean, Julie H.; Barber, Elizabeth; Fuller, Richard A.

    2015-01-01

    There is mounting concern for the health of urban populations as cities expand at an unprecedented rate. Urban green spaces provide settings for a remarkable range of physical and mental health benefits, and pioneering health policy is recognizing nature as a cost-effective tool for planning healthy cities. Despite this, limited information on how specific elements of nature deliver health outcomes restricts its use for enhancing population health. We articulate a framework for identifying direct and indirect causal pathways through which nature delivers health benefits, and highlight current evidence. We see a need for a bold new research agenda founded on testing causality that transcends disciplinary boundaries between ecology and health. This will lead to cost-effective and tailored solutions that could enhance population health and reduce health inequalities. PMID:25602866

  3. Toward improved public health outcomes from urban nature.

    PubMed

    Shanahan, Danielle F; Lin, Brenda B; Bush, Robert; Gaston, Kevin J; Dean, Julie H; Barber, Elizabeth; Fuller, Richard A

    2015-03-01

    There is mounting concern for the health of urban populations as cities expand at an unprecedented rate. Urban green spaces provide settings for a remarkable range of physical and mental health benefits, and pioneering health policy is recognizing nature as a cost-effective tool for planning healthy cities. Despite this, limited information on how specific elements of nature deliver health outcomes restricts its use for enhancing population health. We articulate a framework for identifying direct and indirect causal pathways through which nature delivers health benefits, and highlight current evidence. We see a need for a bold new research agenda founded on testing causality that transcends disciplinary boundaries between ecology and health. This will lead to cost-effective and tailored solutions that could enhance population health and reduce health inequalities. PMID:25602866

  4. Health systems performance in sub-Saharan Africa: governance, outcome and equity

    PubMed Central

    2011-01-01

    Background The literature on health systems focuses largely on the performance of healthcare systems operationalised around indicators such as hospital beds, maternity care and immunisation coverage. A broader definition of health systems however, needs to include the wider determinants of health including, possibly, governance and its relationship to health and health equity. The aim of this study was to examine the relationship between health systems outcomes and equity, and governance as a part of a process to extend the range of indicators used to assess health systems performance. Methods Using cross sectional data from 46 countries in the African region of the World Health Organization, an ecological analysis was conducted to examine the relationship between governance and health systems performance. The data were analysed using multiple linear regression and a standard progressive modelling procedure. The under-five mortality rate (U5MR) was used as the health outcome measure and the ratio of U5MR in the wealthiest and poorest quintiles was used as the measure of health equity. Governance was measured using two contextually relevant indices developed by the Mo Ibrahim Foundation. Results Governance was strongly associated with U5MR and moderately associated with the U5MR quintile ratio. After controlling for possible confounding by healthcare, finance, education, and water and sanitation, governance remained significantly associated with U5MR. Governance was not, however, significantly associated with equity in U5MR outcomes. Conclusion This study suggests that the quality of governance may be an important structural determinant of health systems performance, and could be an indicator to be monitored. The association suggests there might be a causal relationship. However, the cross-sectional design, the level of missing data, and the small sample size, forces tentative conclusions. Further research will be needed to assess the causal relationship, and its

  5. Functional health outcomes as a measure of health care quality for Medicare beneficiaries.

    PubMed Central

    Bierman, A S; Lawrence, W F; Haffer, S C; Clancy, C M

    2001-01-01

    OBJECTIVE: the Medicare Health Outcomes Survey (HOS), a new quality measure in the Health Plan Employer Data and Information Set, is designed to assess physical and mental functional health outcomes of Medicare beneficiaries enrolled in Medicare+Choice organizations. We discuss the rationale for the HOS measure together with methodologic challenges in its use and interpretation, using descriptive data from the baseline Medicare HOS to illustrate some of these challenges. DATA SOURCES/STUDY DESIGN: The 1999 Cohort 2 Medicare HOS baseline data were used for a cross-sectional descriptive analysis. A random sample of 1,000 beneficiaries from each health plan with a Medicare+Choice contract was surveyed (N = 156,842; 282 organizations included in these analyses) . PRINCIPAL FINDINGS: The HOS measure is designed to assess a previously unmeasured dimension of quality. Plan-level variation was seen across all baseline measures of sociodemographic characteristics and illness burden. At the individual level socioeconomic position as measured by educational attainment was strongly associated with functional status. The least educated beneficiaries had the highest burden of illness on all measures examined, and there was a consistent and significant gradient in health and functional status across all levels of education. In analyses stratified by race and ethnicity, socioeconomic gradients in f un ct ion persist ed. CONCLUSIONS Despite limitations, by focusing at t en t ion on the need to improve functional health out comes among elderly Medicare beneficiaries enrolled in Medicare+Choice, the HOS can serve as an important new tool to support efforts to improve health care quality. The HOS provides valuable information at the federal, state, and health plan levels that can be used to identify, prioritize, and evaluate quality improvement interventions and monitor progress for the program overall as well as for vulnerable subgroups. To interpret the HOS as a quality measure

  6. Quality of health care, survival and health outcomes in Ghana.

    PubMed

    Lavy, V; Strauss, J; Thomas, D; de Vreyer, P

    1996-06-01

    This paper analyzes the effect of quality and accessibility of health services and other public infrastructure on the health of children in Ghana. We focus on child survival, child height and weight using data from the Ghana Living Standards Survey. The results suggest an important role for public health policy in eliminating the rural-urban disparities in health status and particularly in improving the health status of rural children and reducing their mortality rates. Increased availability of birth services and other related child programs, as well as Improved water and sanitation infrastructure would have an immediate payoff. PMID:10159445

  7. Volunteer Macroinvertebrate Monitoring: Tensions Among Group Goals, Data Quality, and Outcomes

    NASA Astrophysics Data System (ADS)

    Nerbonne, Julia Frost; Nelson, Kristen C.

    2008-09-01

    Volunteer monitoring of natural resources is promoted for its ability to increase public awareness, to provide valuable knowledge, and to encourage policy change that promotes ecosystem health. We used the case of volunteer macroinvertebrate monitoring (VMM) in streams to investigate whether the quality of data collected is correlated with data use and organizers’ perception of whether they have achieved these outcomes. We examined the relation between site and group characteristics, data quality, data use, and perceived outcomes (education, social capital, and policy change). We found that group size and the degree to which citizen groups perform tasks on their own (rather than aided by professionals) positively correlated with the quality of data collected. Group size and number of years monitoring positively influenced whether a group used their data. While one might expect that groups committed to collecting good-quality data would be more likely to use it, there was no relation between data quality and data use, and no relation between data quality and perceived outcomes. More data use was, however, correlated with a group’s feeling of connection to a network of engaged citizens and professionals. While VMM may hold promise for bringing citizens and scientists together to work on joint conservation agendas, our data illustrate that data quality does not correlate with a volunteer group’s desire to use their data to promote regulatory change. Therefore, we encourage scientists and citizens alike to recognize this potential disconnect and strive to be explicit about the role of data in conservation efforts.

  8. Risk-adjusted monitoring of binary surgical outcomes.

    PubMed

    Steiner, S H; Cook, R J; Farewell, V T

    2001-01-01

    A graphical procedure suitable for prospectively monitoring surgical performance is proposed. The approach is based on accumulating evidence from the outcomes of all previous surgical patients in a series using a new type of cumulative sum chart. Cumulative sum procedures are designed to "signal" if sufficient evidence has accumulated that the surgical failure rate has changed substantially. In this way, the chart rapidly detects deterioration (or improvement) in surgical performance while not overreacting to the expected fluctuations due to chance. Through the use of a likelihood-based scoring method, the cumulative sum procedure is adapted so that it adjusts for the surgical risk of each patient estimated preoperatively. The procedure is therefore applicable in situations where it is desirable to adjust for a mix of patients. Signals of the chart lead to investigations of the cause and to the timely introduction of remedial measures designed to avoid unnecessary future failures. PMID:11386623

  9. Residential Proximity to Environmental Hazards and Adverse Health Outcomes

    PubMed Central

    Maantay, Juliana A.; Chakraborty, Jayajit

    2011-01-01

    How living near environmental hazards contributes to poorer health and disproportionate health outcomes is an ongoing concern. We conducted a substantive review and critique of the literature regarding residential proximity to environmental hazards and adverse pregnancy outcomes, childhood cancer, cardiovascular and respiratory illnesses, end-stage renal disease, and diabetes. Several studies have found that living near hazardous wastes sites, industrial sites, cropland with pesticide applications, highly trafficked roads, nuclear power plants, and gas stations or repair shops is related to an increased risk of adverse health outcomes. Government agencies should consider these findings in establishing rules and permitting and enforcement procedures to reduce pollution from environmentally burdensome facilities and land uses. PMID:22028451

  10. Health Monitoring for Airframe Structural Characterization

    NASA Technical Reports Server (NTRS)

    Munns, Thomas E.; Kent, Renee M.; Bartolini, Antony; Gause, Charles B.; Borinski, Jason W.; Dietz, Jason; Elster, Jennifer L.; Boyd, Clark; Vicari, Larry; Ray, Asok; Cooper, E. G. (Technical Monitor)

    2002-01-01

    This study established requirements for structural health monitoring systems, identified and characterized a prototype structural sensor system, developed sensor interpretation algorithms, and demonstrated the sensor systems on operationally realistic test articles. Fiber-optic corrosion sensors (i.e., moisture and metal ion sensors) and low-cycle fatigue sensors (i.e., strain and acoustic emission sensors) were evaluated to validate their suitability for monitoring aging degradation; characterize the sensor performance in aircraft environments; and demonstrate placement processes and multiplexing schemes. In addition, a unique micromachined multimeasure and sensor concept was developed and demonstrated. The results show that structural degradation of aircraft materials could be effectively detected and characterized using available and emerging sensors. A key component of the structural health monitoring capability is the ability to interpret the information provided by sensor system in order to characterize the structural condition. Novel deterministic and stochastic fatigue damage development and growth models were developed for this program. These models enable real time characterization and assessment of structural fatigue damage.

  11. HOUSEHOLD NUCLEATION, DEPENDENCY AND CHILD HEALTH OUTCOMES IN GHANA.

    PubMed

    Annim, Samuel Kobina; Awusabo-Asare, Kofi; Amo-Adjei, Joshua

    2015-09-01

    This study uses three key anthropometric measures of nutritional status among children (stunting, wasting and underweight) to explore the dual effects of household composition and dependency on nutritional outcomes of under-five children in Ghana. The objective is to examine changes in household living arrangements of under-five children to explore the interaction of dependency and nucleation on child health outcomes. The concept of nucleation refers to the changing structure and composition of household living arrangements, from highly extended with its associated socioeconomic system of production and reproduction, social behaviour and values, towards single-family households - especially the nuclear family, containing a husband and wife and their children alone. A negative relationship between levels of dependency, as measured by the number of children in the household, and child health outcomes is premised on the grounds that high dependency depletes resources, both tangible and intangible, to the disadvantage of young children. Data were drawn from the last four rounds of the Ghana Demographic and Health Surveys (GDHSs), from 1993 to 2008, for the first objective - to explore changes in household composition. For the second objective, the study used data from the 2008 GDHS. The results show that, over time, households in Ghana have been changing towards nucleation. The main finding is that in households with the same number of dependent children, in nucleated households children under age 5 have better health outcomes compared with children under age 5 in non-nucleated households. The results also indicate that the effect of dependency on child health outcomes is mediated by household nucleation and wealth status and that, as such, high levels of dependency do not necessarily translate into negative health outcomes for children under age 5, based on anthropometric measures. PMID:25167165

  12. Augmented Fish Health Monitoring, 1989 Annual Report.

    SciTech Connect

    Michak, Patty

    1990-05-01

    Since 1986 Washington Department of Fisheries (WDF) has participated in the Columbia Basin Augmented Fish Health Monitoring Project, funded by Bonneville Power Administration (BPA). This interagency project was developed to provide a standardized level of fish health information from all Agencies rearing fish in the Columbia Basin. Agencies involved in the project are: WDF, Washington Department of Wildlife, Oregon Fish and Wildlife, Idaho Fish and Game, and the US Fish and Wildlife Service. WDF has actively participated in this project, and completed its third year of fish health monitoring, data collection and pathogen inspection during 1989. This report will present data collected from January 1, 1989 to December 31, 1989 and will compare sampling results from screening at spawning for viral pathogens and bacterial kidney disease (BKD), and evaluation of causes of pre-spawning loss. The juvenile analysis will include pre-release examination results, mid-term rearing exam results and evaluation of the Organosomatic Analysis completed on stocks. 2 refs., 4 figs., 15 tabs.

  13. An autonomous structural health monitoring solution

    NASA Astrophysics Data System (ADS)

    Featherston, Carol A.; Holford, Karen M.; Pullin, Rhys; Lees, Jonathan; Eaton, Mark; Pearson, Matthew

    2013-05-01

    Combining advanced sensor technologies, with optimised data acquisition and diagnostic and prognostic capability, structural health monitoring (SHM) systems provide real-time assessment of the integrity of bridges, buildings, aircraft, wind turbines, oil pipelines and ships, leading to improved safety and reliability and reduced inspection and maintenance costs. The implementation of power harvesting, using energy scavenged from ambient sources such as thermal gradients and sources of vibration in conjunction with wireless transmission enables truly autonomous systems, reducing the need for batteries and associated maintenance in often inaccessible locations, alongside bulky and expensive wiring looms. The design and implementation of such a system however presents numerous challenges. A suitable energy source or multiple sources capable of meeting the power requirements of the system, over the entire monitoring period, in a location close to the sensor must be identified. Efficient power management techniques must be used to condition the power and deliver it, as required, to enable appropriate measurements to be taken. Energy storage may be necessary, to match a continuously changing supply and demand for a range of different monitoring states including sleep, record and transmit. An appropriate monitoring technique, capable of detecting, locating and characterising damage and delivering reliable information, whilst minimising power consumption, must be selected. Finally a wireless protocol capable of transmitting the levels of information generated at the rate needed in the required operating environment must be chosen. This paper considers solutions to some of these challenges, and in particular examines SHM in the context of the aircraft environment.

  14. Driving: A Road to Unhealthy Lifestyles and Poor Health Outcomes

    PubMed Central

    Ding, Ding; Gebel, Klaus; Phongsavan, Philayrath; Bauman, Adrian E.; Merom, Dafna

    2014-01-01

    Background Driving is a common part of modern society, but its potential effects on health are not well understood. Purpose The present cross-sectional study (n = 37,570) examined the associations of driving time with a series of health behaviors and outcomes in a large population sample of middle-aged and older adults using data from the Social, Economic, and Environmental Factor Study conducted in New South Wales, Australia, in 2010. Methods Multiple logistic regression was used in 2013 to examine the associations of usual daily driving time with health-related behaviors (smoking, alcohol use, diet, physical activity, sedentary behavior, sleep) and outcomes (obesity, general health, quality of life, psychological distress, time stress, social functioning), adjusted for socio-demographic characteristics. Results Findings suggested that longer driving time was associated with higher odds for smoking, insufficient physical activity, short sleep, obesity, and worse physical and mental health. The associations consistently showed a dose-response pattern and more than 120 minutes of driving per day had the strongest and most consistent associations with the majority of outcomes. Conclusion This study highlights driving as a potential lifestyle risk factor for public health. More population-level multidisciplinary research is needed to understand the mechanism of how driving affects health. PMID:24911017

  15. Do waiting times affect health outcomes? Evidence from coronary bypass.

    PubMed

    Moscelli, Giuseppe; Siciliani, Luigi; Tonei, Valentina

    2016-07-01

    Long waiting times for non-emergency services are a feature of several publicly-funded health systems. A key policy concern is that long waiting times may worsen health outcomes: when patients receive treatment, their health condition may have deteriorated and health gains reduced. This study investigates whether patients in need of coronary bypass with longer waiting times are associated with poorer health outcomes in the English National Health Service over 2000-2010. Exploiting information from the Hospital Episode Statistics (HES), we measure health outcomes with in-hospital mortality and 28-day emergency readmission following discharge. Our results, obtained combining hospital fixed effects and instrumental variable methods, find no evidence of waiting times being associated with higher in-hospital mortality and weak association between waiting times and emergency readmission following a surgery. The results inform the debate on the relative merits of different types of rationing in healthcare systems. They are to some extent supportive of waiting times as an acceptable rationing mechanism, although further research is required to explore whether long waiting times affect other aspects of individuals' life. PMID:27299977

  16. Paths to Success: Optimal and Equitable Health Outcomes for All

    PubMed Central

    Rust, George; Levine, Robert S.; Fry-Johnson, Yvonne; Baltrus, Peter; Ye, Jiali; Mack, Dominic

    2013-01-01

    U.S. health disparities are real, pervasive, and persistent, despite dramatic improvements in civil rights and economic opportunity for racial and ethnic minority and lower socioeconomic groups in the United States. Change is possible, however. Disparities vary widely from one community to another, suggesting that they are not inevitable. Some communities even show paradoxically good outcomes and relative health equity despite significant social inequities. A few communities have even improved from high disparities to more equitable and optimal health outcomes. These positive-deviance communities show that disparities can be overcome and that health equity is achievable. Research must shift from defining the problem (including causes and risk factors) to testing effective interventions, informed by the natural experiments of what has worked in communities that are already moving toward health equity. At the local level, we need multi-dimensional interventions designed in partnership with communities and continuously improved by rapid-cycle surveillance feedback loops of community-level disparities metrics. Similarly coordinated strategies are needed at state and national levels to take success to scale. We propose ten specific steps to follow on a health equity path toward optimal and equitable health outcomes for all Americans. PMID:22643550

  17. A Systematic Review of Personality Disorders and Health Outcomes

    PubMed Central

    Dixon-Gordon, Katherine L.; Whalen, Diana J.; Layden, Brianne K.; Chapman, Alexander L.

    2015-01-01

    Personality disorders have been associated with a wide swath of adverse health outcomes and correspondingly high costs to healthcare systems. To date, however, there has not been a systematic review of the literature on health conditions among individuals with personality disorders. The primary aim of this article is to review research documenting the associations between personality disorders and health conditions. A systematic review of the literature revealed 78 unique empirical English-language peer-reviewed articles examining the association of personality disorders and health outcomes over the past 15 years. Specifically, we reviewed research examining the association of personality disorders with sleep disturbance, obesity, pain conditions, and other chronic health conditions. In addition, we evaluated research on candidate mechanisms underlying health problems in personality disorders and potential treatments for such disorders. Results underscore numerous deleterious health outcomes associated with PD features and PD diagnoses, and suggest potential biological and behavioural factors that may account for these relations. Guidelines for future research in this area are discussed. PMID:26456998

  18. Augmented Fish Health Monitoring, 1987 Annual Report.

    SciTech Connect

    Michak, Patty

    1989-04-01

    Washington Department of Fisheries has divided the sampling and data collection into three major groups: adult analysis, juvenile analysis and database development. The adult analysis done at spawning includes screening for viral pathogens and Bacterial Kidney Disease (BKD). Pre-spawning mortalities are sampled for the presence of bacterial pathogens and parasites to determine causes of pre-spawning loss. Juvenile analysis involves monthly monitoring; pre-release examinations for viral pathogens, BKD and, where appropriate, whirling disease (M. cerebralis); completion of the Organosomatic analysis on four index stocks, and midterm exams on yearling groups for BKD and M. cerebralis. Database development required constructing fish health monitoring forms and a computer based data entry and retrieval system. We have completed a full year of sampling and data collection, January, 1987 to January, 1988. This report will present and analyze this information.

  19. Health monitoring techniques using integrated sensors

    NASA Astrophysics Data System (ADS)

    Pfleiderer, Klaus; Stoessel, Rainer; Busse, Gerhard

    2003-08-01

    Advanced high performance materials and components such as CFRP, GFRP and Smart Structures require improved testing techniques. The first part of our contribution deals with nonlinear vibrometry as a defect selective non-destructive testing method. This method uses higher harmonics (which are generated only at defects) to locate the defect by scanning across the surface of the sample with a laser interferometer. For input coupling of the elastic wave both an external (like ultrasound welding converters) or internal (integrated piezo actuators) excitation source can be used. The external detection tools are a microphone or a scanning laser vibrometer. With this technique, we characterized Smart Structures made of aerospace materials and composites with embedded piezoelectric actuators. The next part is about health monitoring techniques and diagnostics where integrated elements are used for excitation and detection. Thus, we monitored the transfer function over a large frequency spectrum and especially its changes caused e.g. by defects. Changes in the properties of structures by fatigue, impacts, and thermoplasticity have been successfully observed. Also the changes in reinforced plastics under tensile stress have been monitored. The results were correlated with destructive measurements. For health monitoring we also present the impedance analysis of embedded piezo ceramic sensors. A defect causes changes in the modal response of the hole structure and that effect can be detected using the phase angle of the electric impedance of the piezo element. Additionally some types of defects cause a non-linear behavior of the structure which was verified by extracting higher harmonics as a reaction to sinusoidal single frequency excitation.

  20. Engaging stakeholders in review and recommendations for models of outcome monitoring for substance abuse treatment.

    PubMed

    Rush, Brian; Martin, Garth; Corea, Larry; Rotondi, Nooshin Khobzi

    2012-10-01

    We present an example of a collaborative process designed to review models of outcome monitoring for substance abuse services, with a view to assessing the feasibility of different approaches in Ontario, Canada. A conceptual framework that describes the parameters of an outcome monitoring system and four models of outcome monitoring were identified. Consultations were held with stakeholders (managers, directors, researchers, clinicians, and governmental representatives) about the types of information they would like to obtain from an outcome monitoring system. Our process is useful as a model for collaborative research with respect to performance measurement. The study's implications and limitations are noted. PMID:22780842

  1. On-orbit structural health monitoring

    NASA Technical Reports Server (NTRS)

    Rogowski, Robert S.

    1990-01-01

    On-orbit structural health monitoring aboard space platforms requires the development of sensor systems for assessing impact damage from particles and debris, the effects of atomic oxygen erosion, and the integrity of power systems, storage tanks, pressure vessels, and major structural elements. The task of implementing such a smart structure diagnostic system during the initial phase of the NASA Space Station Freedom is evaluated, with a view to more complete smart structures implementation in the course of station evolution. The data processing/cataloguing task may ultimately require AI and neural networks.

  2. Health monitoring method for composite materials

    DOEpatents

    Watkins, Jr., Kenneth S.; Morris, Shelby J.

    2011-04-12

    An in-situ method for monitoring the health of a composite component utilizes a condition sensor made of electrically conductive particles dispersed in a polymeric matrix. The sensor is bonded or otherwise formed on the matrix surface of the composite material. Age-related shrinkage of the sensor matrix results in a decrease in the resistivity of the condition sensor. Correlation of measured sensor resistivity with data from aged specimens allows indirect determination of mechanical damage and remaining age of the composite component.

  3. NASA Applications of Structural Health Monitoring Technology

    NASA Technical Reports Server (NTRS)

    Richards, W Lance; Madaras, Eric I.; Prosser, William H.; Studor, George

    2013-01-01

    This presentation provides examples of research and development that has recently or is currently being conducted at NASA, with a special emphasis on the application of structural health monitoring (SHM) of aerospace vehicles. SHM applications on several vehicle programs are highlighted, including Space Shuttle Orbiter, the International Space Station, Uninhabited Aerial Vehicles, and Expendable Launch Vehicles. Examples of current and previous work are presented in the following categories: acoustic emission impact detection, multi-parameter fiber optic strain-based sensing, wireless sensor system development, and distributed leak detection.

  4. NASA Applications of Structural Health Monitoring Technology

    NASA Technical Reports Server (NTRS)

    Richards, W Lance; Madaras, Eric I.; Prosser, William H.; Studor, George

    2013-01-01

    This presentation provides examples of research and development that has recently or is currently being conducted at NASA, with a special emphasis on the application of structural health monitoring (SHM) of aerospace vehicles. SHM applications on several vehicle programs are highlighted, including Space Shuttle Orbiter, International Space Station, Uninhabited Aerial Vehicles, and Expandable Launch Vehicles. Examples of current and previous work are presented in the following categories: acoustic emission impact detection, multi-parameter fiber optic strain-based sensing, wireless sensor system development, and distributed leak detection.

  5. On-orbit structural health monitoring

    NASA Astrophysics Data System (ADS)

    Rogowski, Robert S.

    1990-12-01

    On-orbit structural health monitoring aboard space platforms requires the development of sensor systems for assessing impact damage from particles and debris, the effects of atomic oxygen erosion, and the integrity of power systems, storage tanks, pressure vessels, and major structural elements. The task of implementing such a smart structure diagnostic system during the initial phase of the NASA Space Station Freedom is evaluated, with a view to more complete smart structures implementation in the course of station evolution. The data processing/cataloguing task may ultimately require AI and neural networks.

  6. Item response theory modeling in health outcomes measurement.

    PubMed

    Reeve, Bryce B

    2003-04-01

    There is a great need in health outcomes research to develop instruments that accurately measure a person's health status with minimal response burden. This need for psychometrically sound and clinically meaningful measures calls for better analytical tools beyond the methods available from traditional measurement theory. Applications of item response theory (IRT) modeling have increased considerably because of its utility for instrument development and evaluation, scale scoring, assessment of cultural equivalence, instrument linking and computerized adaptive testing. IRT models the relationship between a person's response to a survey question and their standing on a health construct, such as fatigue or depression. This review will discuss the theory and basics of IRT models and applications of these models to health outcomes measurement. PMID:19807361

  7. Defining and Assessing Quality Improvement Outcomes: A Framework for Public Health

    PubMed Central

    McLees, Anita W.; Nawaz, Saira; Thomas, Craig; Young, Andrea

    2015-01-01

    We describe an evidence-based framework to define and assess the impact of quality improvement (QI) in public health. Developed to address programmatic and research-identified needs for articulating the value of public health QI in aggregate, this framework proposes a standardized set of measures to monitor and improve the efficiency and effectiveness of public health programs and operations. We reviewed the scientific literature and analyzed QI initiatives implemented through the Centers for Disease Control and Prevention’s National Public Health Improvement Initiative to inform the selection of 5 efficiency and 8 effectiveness measures. This framework provides a model for identifying the types of improvement outcomes targeted by public health QI efforts and a means to understand QI’s impact on the practice of public health. PMID:25689185

  8. Comparison of Select Health Outcomes by Deployment Health Assessment Completion.

    PubMed

    Luse, Tina M; Slosek, Jean; Rennix, Christopher

    2016-02-01

    The Department of Defense (DoD) requires service members to complete regular health assessments for identification of deployment-related physical/behavioral issues and environmental/occupational exposures. Compliance among active duty Department of the Navy personnel varies; however, and the impact of incomplete assessments on generalizability of results is unclear. This study examines the differences between Navy and Marine Corps service members who completed both the Post-Deployment Health Assessment and Post-Deployment Health Reassessment (n = 9,452) as compared to service members who never attempted either form (n = 5,603) in fiscal year 2010. Deployment rosters, assessments, and clinical data were analyzed to determine certified assessment completion rates and incidence of certain health conditions in these populations. Only 38.9% of applicable personnel met the completion and certification criteria for the required assessments. Service members who did not complete the forms were distinctly different demographically and at increased risk for psychotropic drug use, post-traumatic stress disorder diagnosis, and traumatic brain injury diagnosis following deployment. The prevailing assumption that the risk of adverse health effects on operational forces can be estimated using the population that completed the required assessments is incorrect, and the true operational impact and medical burden of these conditions may be underestimated. PMID:26837080

  9. Respiratory health outcomes and air pollution in the Eastern Mediterranean Region: a systematic review.

    PubMed

    Abdo, Nour; Khader, Yousef S; Abdelrahman, Mostafa; Graboski-Bauer, Ashley; Malkawi, Mazen; Al-Sharif, Munjed; Elbetieha, Ahmad M

    2016-06-01

    Exposure to air pollution can cause detrimental health and be an economic burden. With newly developed equipment, monitoring of different air pollutants, identifying the sources, types of air pollutants and their corresponding concentrations, and applying mitigation intervention techniques became a crucial step in public health protection. Countries in the Eastern Mediterranean Region (EMR) are highly exposed to dust storms, have high levels of particulate matter (PM) concentrations, and have a unique climatic as well as topographic and socio-economic structure. This is the first study conducted to systemically and qualitatively assess the health impacts of air pollution in the EMR, identify susceptible populations, and ascertain research and knowledge gaps in the literature to better inform decisions by policy makers. We screened relevant papers and reports published between 2000 and 2014 in research databases. A total of 36 published studies met the inclusion criteria. A variety of indoor and outdoor exposures associated with various acute and chronic respiratory health outcomes were included. Respiratory health outcomes ranged in severity, from allergies and general respiratory complaints to lung cancer and mortality. Several adverse health outcomes were positively associated with various indoor/outdoor air pollutants throughout the EMR. However, epidemiological literature concerning the EMR is limited to a few studies in a few countries. More research is needed to elucidate the health outcomes of air pollution. Standardized reliable assessments on the national level for various air pollutants in different regions should be implemented and made publically available for researchers to utilize in their research. Moreover, advancing and utilizing more sound epidemiological designs and studies on the effect of air pollution on the respiratory health outcomes is needed to portray the actual situation in the region. PMID:27101544

  10. Augmented Fish Health Monitoring in Idaho, 1992 Annual Report.

    SciTech Connect

    Munson, A.Douglas

    1993-12-01

    This report documents the progress of Idaho Department of Fish and Game`s fish health monitoring during the past five years and will serve as a completion report for the Augmented Fish Health Monitoring Project. Anadromous fish at twelve IDFG facilities were monitored for various pathogens and organosomatic analyses were performed to anadromous fish prior to their release. A fish disease database has been developed and data is presently being entered. Alternate funding has been secured to continue fish health monitoring.

  11. Augmented Fish Health Monitoring, 1988 Annual Report.

    SciTech Connect

    Warren, James W.

    1989-08-15

    Augmented Fish Health Monitoring Contract AI79-87BP35585 was implemented on July 20, 1987. Second year activities focused on full implementation of disease surveillance activities and histopathological support services to participating state agencies. Persistent and sometimes severe disease losses were caused by infectious hematopoietic necrosis (IHN) in summer steelhead trout in Idaho and in spring chinook salmon at hatcheries on the lower Columbia River. Diagnostic capability was enhanced by the installation, for field use, of enzyme-linked immunosorbent assay (ELISA) technology at the Dworshak Fish Health Center for the detection and assay of bacterial kidney disease and by a dot-blot'' training session for virus identification at the Lower Columbia Fish Health Center. Complete diagnostic and inspection services were provided to 13 Columbia River basin National Fish hatcheries. Case history data was fully documented in a computerized data base for storage and analysis. This report briefly describes work being done to meet contract requirements for fish disease surveillance at Service facilities in the Columbia River basin. It also summarizes the health status of fish reared at those hatcheries and provides a summary of case history data for calendar year 1988. 2 refs., 4 tabs.

  12. Expected utility theory and risky choices with health outcomes.

    PubMed

    Hellinger, F J

    1989-03-01

    Studies of people's attitude towards risk in the health sector often involve a comparison of the desirability of alternative medical treatments. Since the outcome of a medical treatment cannot be known with certainty, patients and physicians must make a choice that involves risk. Each medical treatment may be characterized as a gamble (or risky option) with a set of outcomes and associated probabilities. Expected utility theory (EUT) is the standard method to predict people's choices under uncertainty. The author presents the results of a survey that suggests people are very risk averse towards gambles involving health-related outcomes. The survey also indicates that there is significant variability in the risk attitudes across individuals for any given gamble and that there is significant variability in the risk attitudes of a given individual across gambles. The variability of risk attitudes of a given individual suggests that risk attitudes are not absolute but are functions of the parameters in the gamble. PMID:2927183

  13. The Digital Divide and Health Outcomes: A Teleretinal Imaging Study

    ERIC Educational Resources Information Center

    Connolly, Kathleen Kihmm

    2013-01-01

    The purpose of this research project was to understand, explore and describe the digital divide and the relationship between technology utilization and health outcomes. Diabetes and diabetic eye disease was used as the real-life context for understanding change and exploring the digital divide. As an investigational framework, a telemedicine…

  14. Stress Carry-Over and College Student Health Outcomes

    ERIC Educational Resources Information Center

    Pedersen, Daphne E.

    2012-01-01

    Objective: Using a stress carry-over perspective, this study examines the relationship between stress stemming from school and family domains and physical and mental health outcomes. Methods: The study sample included 268 undergraduate men and women from a Midwestern university. Participants completed an anonymous online questionnaire. OLS…

  15. Democracy, Performance, and Outcomes in Interdisciplinary Health Care Teams.

    ERIC Educational Resources Information Center

    Coopman, Stephanie J.

    2001-01-01

    Examines interdisciplinary health care teams, focusing on perceptions of team processes and their relationship to assessments of team performance and individual outcomes. Suggests that hospice interdisciplinary teams are perceived by their members as only somewhat democratic in the practice of decision making. (SG)

  16. Individual Factors Predicting Mental Health Court Diversion Outcome

    ERIC Educational Resources Information Center

    Verhaaff, Ashley; Scott, Hannah

    2015-01-01

    Objective: This study examined which individual factors predict mental health court diversion outcome among a sample of persons with mental illness participating in a postcharge diversion program. Method: The study employed secondary analysis of existing program records for 419 persons with mental illness in a court diversion program. Results:…

  17. School Nurse Case Management: Achieving Health and Educational Outcomes

    ERIC Educational Resources Information Center

    Bonaiuto, Maria M.

    2007-01-01

    Educators and health care professionals alike understand that healthy students are likely to be successful learners. The goal of school nurse case management is to support students so that they are ready to learn. This article describes the outcomes of a 4-year process improvement project designed to show the impact of school nurse case management…

  18. Aircraft fiber optic structural health monitoring

    NASA Astrophysics Data System (ADS)

    Mrad, Nezih

    2012-06-01

    Structural Health Monitoring (SHM) is a sought after concept that is expected to advance military maintenance programs, increase platform operational safety and reduce its life cycle cost. Such concept is further considered to constitute a major building block of any Integrated Health Management (IHM) capability. Since 65% to 80% of military assets' Life Cycle Cost (LCC) is devoted to operations and support (O&S), the aerospace industry and military sectors continue to look for opportunities to exploit SHM systems, capability and tools. Over the past several years, countless SHM concepts and technologies have emerged. Among those, fiber optic based systems were identified of significant potential. This paper introduces the elements of an SHM system and investigates key issues impeding the commercial implementation of fiber optic based SHM capability. In particular, this paper presents an experimental study of short gauge, intrinsic, spectrometric-based in-fiber Bragg grating sensors, for potential use as a component of an SHM system. Fiber optic Bragg grating sensors are evaluated against resistance strain gauges for strain monitoring, sensitivity, accuracy, reliability, and fatigue durability. Strain field disturbance is also investigated by "embedding" the sensors under a photoelastic coating in order to illustrate sensor intrusiveness in an embedded configuration.

  19. Role of NDE in bridge health monitoring

    NASA Astrophysics Data System (ADS)

    Aktan, A. Emin; Grimmelsman, Kirk A.

    1999-02-01

    In the last decade, many advanced sensing and measurement technologies have been developed or transferred from defense use to infrastructure applications. It is now possible to measure various properties of a structural system, its elements and materials. However, the development of new technologies and tools should be considered in conjunction with fundamental changes and new paradigms as opposed to simple modifications to civil infrastructure systems engineering practice. It may be useful to start with a bold vision for an integrated bridge structural and operational management capability, and to properly design, develop, validate, demonstrate and standardize the technologies that are needed in conjunction with this vision. The term `health-monitoring', used in relation to intelligent infrastructure, will be helpful for formulating a complete and coherent vision for the bridge management of the future. The writers define `health monitoring,' as the measurement of the operating and loading environment and the critical responses of a structure in order to track and evaluate the symptoms of operational anomalies and/or deterioration or damage that may impact service or safety reliability.

  20. Structural health monitoring of wind turbine blades

    NASA Astrophysics Data System (ADS)

    Rumsey, Mark A.; Paquette, Joshua A.

    2008-03-01

    As electric utility wind turbines increase in size, and correspondingly, increase in initial capital investment cost, there is an increasing need to monitor the health of the structure. Acquiring an early indication of structural or mechanical problems allows operators to better plan for maintenance, possibly operate the machine in a de-rated condition rather than taking the unit off-line, or in the case of an emergency, shut the machine down to avoid further damage. This paper describes several promising structural health monitoring (SHM) techniques that were recently exercised during a fatigue test of a 9 meter glass-epoxy and carbon-epoxy wind turbine blade. The SHM systems were implemented by teams from NASA Kennedy Space Center, Purdue University and Virginia Tech. A commercial off-the-shelf acoustic emission (AE) NDT system gathered blade AE data throughout the test. At a fatigue load cycle rate around 1.2 Hertz, and after more than 4,000,000 fatigue cycles, the blade was diagnostically and visibly failing at the out-board blade spar-cap termination point at 4.5 meters. For safety reasons, the test was stopped just before the blade completely failed. This paper provides an overview of the SHM and NDT system setups and some current test results.

  1. Physical activity and health outcomes: evidence from Canada.

    PubMed

    Humphreys, Brad R; McLeod, Logan; Ruseski, Jane E

    2014-01-01

    Health production models include participation in physical activity as an input. We investigate the relationship between participation in physical activity and health using a bivariate probit model. Participation is identified with an exclusion restriction on a variable reflecting sense of belonging to the community. Estimates based on data from Cycle 3.1 of the Canadian Community Health Survey indicate that participation in physical activity reduces the reported incidence of diabetes, high blood pressure, heart disease, asthma, and arthritis as well as being in fair or poor health. Increasing the intensity above the moderate level and frequency of participation in physical activity appears to have a diminishing marginal impact on adverse health outcomes. Our results provide support for guidelines about engaging in exercise regularly to achieve health benefits. PMID:23364850

  2. Valve Health Monitoring System Utilizing Smart Instrumentation

    NASA Technical Reports Server (NTRS)

    Jensen, Scott L.; Drouant, George J.

    2006-01-01

    The valve monitoring system is a stand alone unit with network capabilities for integration into a higher level health management system. The system is designed for aiding in failure predictions of high-geared ball valves and linearly actuated valves. It performs data tracking and archiving for identifying degraded performance. The data collection types are cryogenic cycles, total cycles, inlet temperature, body temperature torsional strain, linear bonnet strain, preload position, total travel and total directional changes. Events are recorded and time stamped in accordance with the IRIG B True Time. The monitoring system is designed for use in a Class 1 Division II explosive environment. The basic configuration consists of several instrumentation sensor units and a base station. The sensor units are self contained microprocessor controlled and remotely mountable in three by three by two inches. Each unit is potted in a fire retardant substance without any cavities and limited to low operating power for maintaining safe operation in a hydrogen environment. The units are temperature monitored to safeguard against operation outside temperature limitations. Each contains 902-928 MHz band digital transmitters which meet Federal Communication Commission's requirements and are limited to a 35 foot transmission radius for preserving data security. The base-station controller correlates data from the sensor units and generates data event logs on a compact flash memory module for database uploading. The entries are also broadcast over an Ethernet network. Nitrogen purged National Electrical Manufactures Association (NEMA) Class 4 enclosures are used to house the base-station

  3. Adverse health outcomes among cosmetologists and noncosmetologists in the Reproductive Outcomes of Salon Employees (ROSE) study.

    PubMed

    Gallicchio, Lisa; Miller, Susan R; Greene, Teresa; Zacur, Howard; Flaws, Jodi A

    2011-01-01

    The purpose of this study was to examine adverse health outcomes, including those related to cardiovascular and skin health as well as respiratory functions, among cosmetologists aged 21 to 55 yr and to compare data to women of the same age working in other occupations. Self-reported data were analyzed from 450 cosmetologists and 511 women in other occupations who participated in the Reproductive Outcomes of Salon Employees (ROSE) study in Maryland. Odds ratios (OR) and 95% confidence intervals (95% CI) were computed using logistic regression to examine the associations between cosmetologist occupation and each adverse health outcome adjusted for age, education, and smoking status. Cosmetologists were at significantly increased risk of depression compared to noncosmetologists after adjustment for age, education, and smoking status (OR 1.49; 95% CI 1.10, 2.00). There were no statistically significant associations between cosmetology occupation and the other adverse health outcomes, including those related to allergies and skin disorders, in both the unadjusted and adjusted analyses. Cosmetologists may be exposed to chemicals in the salon that lead to depression. Future study needs to be conducted to examine specific chemical exposures in the salon. This will help to provide information required for the development of best occupational safety practices among salon workers. PMID:21120748

  4. Race-Ethnicity and Health Trajectories: Tests of Three Hypotheses across Multiple Groups and Health Outcomes

    ERIC Educational Resources Information Center

    Brown, Tyson H.; O'Rand, Angela M.; Adkins, Daniel E.

    2012-01-01

    Racial-ethnic disparities in static levels of health are well documented. Less is known about racial-ethnic differences in age trajectories of health. The few studies on this topic have examined only single health outcomes and focused on black-white disparities. This study extends prior research by using a life course perspective, panel data from…

  5. Long-Term Refugee Health: Health Behaviors and Outcomes of Cambodian Refugee and Immigrant Women

    ERIC Educational Resources Information Center

    Nelson-Peterman, Jerusha L.; Toof, Robin; Liang, Sidney L.; Grigg-Saito, Dorcas C.

    2015-01-01

    Refugees in the United States have high rates of chronic disease. Both long-term effects of the refugee experience and adjustment to the U.S. health environment may contribute. While there is significant research on health outcomes of newly resettled refugees and long-term mental health experiences of established refugees, there is currently…

  6. Air Pollution and Health: Bridging the Gap from Health Outcomes: Conference Summary

    EPA Science Inventory

    “Air Pollution and Health: Bridging the Gap from Sources to Health Outcomes,” an international specialty conference sponsored by the American Association for Aerosol Research, was held to address key uncertainties in our understanding of adverse health effects related to air po...

  7. Environmental monitoring and assessment program forest health monitoring quality assurance project plan for detection monitoring project

    SciTech Connect

    Cline, S.P.; Alexander, S.A.; Barnard, J.E.

    1995-05-01

    The Quality Assurance Project Plan (QAP) is written specifically for the Detection Minitoring project of the interagency Forest Health Monitoring (FHM) program. Sections 1 through 3 briefly explain key features of the Environmental Monitoring and Assessment Program (EMAP), the FHM program, and their interrelationship, respectively. Section 4 describes the general quality assurance (QA) requirements for the FHM Detection Monitoring project. Section 5 contains the separate QAPs for each forest condition indicator: site condition and tree growth and regeneration, tree crown condition, tree damage assessment, photosynthetically active radiation (PAR), vegetation structure, ozone bioindicator plants, and lichen communities.

  8. PNI Biomarkers and Health Outcomes in College Women

    PubMed Central

    Lee, Shih-Yu; Vasireddi, Mugdha; Chen, Yu Ping; Wang, Yong Tai; Hilliard, Julia

    2014-01-01

    Sleep disturbance has been found to trigger a stress response with a subsequent activation of the psychoneuroimmunological (PNI) pathway associated with adverse health outcomes. This study aimed to assess the association among selected PNI biomarkers, sleep disturbances, and adverse health outcomes (depressive symptoms, physical symptoms). A stratified, quota sample (14 poor sleepers and 15 good sleepers) was drawn from a pool of healthy college women from a larger scale of study. The participants reported their sleep, stress, depressive, and physical symptoms. Wrist actigraphy was used to collect objective sleep data, and the Enzyme-Linked ImmunoSorbent Assay was used to assess PNI biomarkers. Poor sleep quality, higher stress perception, elevated serum serotonin, and lower serum interleukin-10 explained 75.3% of the variances for the depressive symptoms. Poor sleep quality along with delayed peak activity rhythms accounted 31.4% of the physical symptoms. High serotonin and tumor necrosis factor-α were the significant predictors for poor sleep efficiency, and serotonin was the single significant predictor for poor daytime functioning. Stress and sleep disturbances negatively impact the health of college women and should be as part of regular check-ups on campus. PNI effects on health outcomes should be further explored. Educational materials in the areas of sleep hygiene, health impacts from sleep disturbances, and strategies to maintain synchronized circadian rhythms should be mandatorily included in the college curriculum.

  9. Environmental Volunteering and Health Outcomes over a 20-Year Period

    PubMed Central

    Pillemer, Karl; Fuller-Rowell, Thomas E.; Reid, M. C.; Wells, Nancy M.

    2010-01-01

    Purpose: This study tested the hypothesis that volunteering in environmental organizations in midlife is associated with greater physical activity and improved mental and physical health over a 20-year period.  Design and Methods: The study used data from two waves (1974 and 1994) of the Alameda County Study, a longitudinal study of health and mortality that has followed a cohort of 6,928 adults since 1965. Using logistic and multiple regression models, we examined the prospective association between environmental and other volunteerism and three outcomes (physical activity, self-reported health, and depression), with 1974 volunteerism predicting 1994 outcomes, controlling for a number of relevant covariates.  Results: Midlife environmental volunteering was significantly associated with physical activity, self-reported health, and depressive symptoms.  Implications: This population-based study offers the first epidemiological evidence for a significant positive relationship between environmental volunteering and health and well-being outcomes. Further research, including intervention studies, is needed to confirm and shed additional light on these initial findings. PMID:20172902

  10. Previous Violent Events and Mental Health Outcomes in Guatemala

    PubMed Central

    Puac-Polanco, Victor D.; Lopez-Soto, Victor A.; Kohn, Robert; Xie, Dawei; Richmond, Therese S.

    2015-01-01

    Objectives. We analyzed a probability sample of Guatemalans to determine if a relationship exists between previous violent events and development of mental health outcomes in various sociodemographic groups, as well as during and after the Guatemalan Civil War. Methods. We used regression modeling, an interaction test, and complex survey design adjustments to estimate prevalences and test potential relationships between previous violent events and mental health. Results. Many (20.6%) participants experienced at least 1 previous serious violent event. Witnessing someone severely injured or killed was the most common event. Depression was experienced by 4.2% of participants, with 6.5% experiencing anxiety, 6.4% an alcohol-related disorder, and 1.9% posttraumatic stress disorder (PTSD). Persons who experienced violence during the war had 4.3 times the adjusted odds of alcohol-related disorders (P < .05) and 4.0 times the adjusted odds of PTSD (P < .05) compared with the postwar period. Women, indigenous Maya, and urban dwellers had greater odds of experiencing postviolence mental health outcomes. Conclusions. Violence that began during the civil war and continues today has had a significant effect on the mental health of Guatemalans. However, mental health outcomes resulting from violent events decreased in the postwar period, suggesting a nation in recovery. PMID:25713973

  11. Relative Contributions of a Set of Health Factors to Selected Health Outcomes.

    PubMed

    Park, Hyojun; Roubal, Anne M; Jovaag, Amanda; Gennuso, Keith P; Catlin, Bridget B

    2015-12-01

    Although many researchers agree that multiple determinants impact health, there is no consensus regarding the magnitude of the relative contributions of individual health factors to health outcomes. This study presents a method to empirically estimate the relative contributions of health behaviors, clinical care, social and economic factors, and the physical environment to health outcomes using nationally representative county-level data and statistical approaches that account for potential sources of bias. The analyses for this study were conducted in 2014. Data were from the 2010-2013 County Health Rankings & Roadmaps. Data covered 2,996 of 3,141 U.S. counties. Ordinary least squares modeling was used as a baseline model. Multilevel latent growth curve modeling was used to estimate the relative contributions of health factors to health outcomes while accounting for measurement errors and state-specific characteristics. Almost half of the variance of health outcomes was due to state-level variation rather than county-level variation. When adjusted for measurement errors and state-level variation using multilevel latent growth curve modeling, the relative contribution of clinical care decreased and that of social and economic factors increased compared with the baseline model. This study presents how potential sources of bias affected the estimates of the relative contributions of a set of modifiable health factors to health outcomes at the county level. Further verification of these approaches with other data sources could lead to a better understanding of the impact of specific health determinants to health outcomes, and will provide useful information on policy interventions. PMID:26590942

  12. Body Dissatisfaction and Mental Health Outcomes Among Korean College Students.

    PubMed

    You, Sukkyung; Shin, Kyulee

    2016-06-01

    For many years, body dissatisfaction and mental health were thought of as Western phenomena and were studied mostly in Caucasian women. Recent studies, however, suggest that these issues are also present in men and in other ethnic groups. This study examined the association between body dissatisfaction and mental health outcomes, with personality traits and neuroticism playing possible predictive roles, using a Korean sample. A total of 545 college students, from five private universities in South Korea, completed assessment measures for depression, self-esteem, neuroticism, and body esteem scales. After controlling for covariates including body mass index and exercise time, body dissatisfaction was seen to play a mediating role between neuroticism and mental health outcomes. Differences between the sexes were also found in this relationship. For men, body dissatisfaction acted as a mediator between neuroticism and depression. For women, body dissatisfaction acted as a mediator between neuroticism and both depression and self-esteem. PMID:27173851

  13. Oral Health in Women During Preconception and Pregnancy: Implications for Birth Outcomes and Infant Oral Health

    PubMed Central

    Edelstein, Burton L.

    2006-01-01

    The mouth is an obvious portal of entry to the body, and oral health reflects and influences general health and well being. Maternal oral health has significant implications for birth outcomes and infant oral health. Maternal periodontal disease, that is, a chronic infection of the gingiva and supporting tooth structures, has been associated with preterm birth, development of preeclampsia, and delivery of a small-for-gestational age infant. Maternal oral flora is transmitted to the newborn infant, and increased cariogenic flora in the mother predisposes the infant to the development of caries. It is intriguing to consider preconception, pregnancy, or intrapartum treatment of oral health conditions as a mechanism to improve women's oral and general health, pregnancy outcomes, and their children's dental health. However, given the relationship between oral health and general health, oral health care should be a goal in its own right for all individuals. Regardless of the potential for improved oral health to improve pregnancy outcomes, public policies that support comprehensive dental services for vulnerable women of childbearing age should be expanded so that their own oral and general health is safeguarded and their children's risk of caries is reduced. Oral health promotion should include education of women and their health care providers ways to prevent oral disease from occurring, and referral for dental services when disease is present. PMID:16816998

  14. Augmented Fish Health Monitoring, 1990 Annual Report.

    SciTech Connect

    Warren, James W.

    1990-08-15

    Augmented Fish Health Monitoring Contract AI79-87BP35585 was implemented on July 20, 1987. This report briefly describes third-year work being done to meet contract requirements for fish disease surveillance at Service facilities in the Columbia River basin and for histopathological support services provided to participating state agencies. It also summarizes the health status of fish reared at participating Service hatcheries and provides a summary of case history data for calendar year 1989. Items of note included severe disease losses to infectious hematopoietic necrosis (IHN) in summer steelhead trout in Idaho, the detection of IHN virus in juvenile spring chinook salmon at hatcheries on the lower Columbia River, and improved bacterial kidney disease (BKD) detection and adult assay by enzyme-linked immunosorbent assay (ELISA) technology at the Dworshak Fish Health Center. Complete diagnostic and inspection services were provided to 13 Columbia River Basin National Fish Hatcheries. Case history data was fully documented in a computerized data base for storage and analysis and is summarized herein. 2 refs., 1 fig., 4 tabs.

  15. Does pulse oximeter use impact health outcomes? A systematic review

    PubMed Central

    English, Mike; Shepperd, Sasha

    2016-01-01

    Objective Do newborns, children and adolescents up to 19 years have lower mortality rates, lower morbidity and shorter length of stay in health facilities where pulse oximeters are used to inform diagnosis and treatment (excluding surgical care) compared with health facilities where pulse oximeters are not used? Design Studies were obtained for this systematic literature review by systematically searching the Database of Abstracts of Reviews of Effects, Cochrane, Medion, PubMed, Web of Science, Embase, Global Health, CINAHL, WHO Global Health Library, international health organisation and NGO websites, and study references. Patients Children 0–19 years presenting for the first time to hospitals, emergency departments or primary care facilities. Interventions Included studies compared outcomes where pulse oximeters were used for diagnosis and/or management, with outcomes where pulse oximeters were not used. Main outcome measures: mortality, morbidity, length of stay, and treatment and management changes. Results The evidence is low quality and hypoxaemia definitions varied across studies, but the evidence suggests pulse oximeter use with children can reduce mortality rates (when combined with improved oxygen administration) and length of emergency department stay, increase admission of children with previously unrecognised hypoxaemia, and change physicians’ decisions on illness severity, diagnosis and treatment. Pulse oximeter use generally increased resource utilisation. Conclusions As international organisations are investing in programmes to increase pulse oximeter use in low-income settings, more research is needed on the optimal use of pulse oximeters (eg, appropriate oxygen saturation thresholds), and how pulse oximeter use affects referral and admission rates, length of stay, resource utilisation and health outcomes. PMID:26699537

  16. Studying Health Outcomes in Farmworker Populations Exposed to Pesticides

    PubMed Central

    McCauley, Linda A.; Anger, W. Kent; Keifer, Matthew; Langley, Rick; Robson, Mark G.; Rohlman, Diane

    2006-01-01

    A major goal of studying farmworkers is to better understand how their work environment, including exposure to pesticides, affects their health. Although a number of health conditions have been associated with pesticide exposure, clear linkages have yet to be made between exposure and health effects except in cases of acute pesticide exposure. In this article, we review the most common health end points that have been studied and describe the epidemiologic challenges encountered in studying these health effects of pesticides among farmworkers, including the difficulties in accessing the population and challenges associated with obtaining health end point data. The assessment of neurobehavioral health effects serves as one of the most common and best examples of an approach used to study health outcomes in farmworkers and other populations exposed to pesticides. We review the current limitations in neurobehavioral assessment and strategies to improve these analytical methods. Emerging techniques to improve our assessment of health effects associated with pesticide exposure are reviewed. These techniques, which in most cases have not been applied to farmworker populations, hold promise in our ability to study and understand the relationship between pesticide exposure and a variety of health effects in this population. PMID:16760000

  17. Understanding Program Monitoring: The Relationships among Outcomes, Indicators, Measures, and Targets. REL 2014-011

    ERIC Educational Resources Information Center

    Malone, Nolan; Mark, Lauren; Narayan, Krishna

    2014-01-01

    This guide offers educators, program managers, administrators, and researchers a resource for building capacity for monitoring program outcomes. It provides concise definitions of program monitoring components and a framework for assessing program progress. Examples demonstrate the relationships among program components: outcomes, indicators,…

  18. Achieving better health care outcomes for children in foster care.

    PubMed

    Mekonnen, Robin; Noonan, Kathleen; Rubin, David

    2009-04-01

    This article reviews the challenges health care systems face as they attempt to improve health care outcomes for children in foster care. It discusses several of the promising health care strategies occurring outside the perimeter of child welfare and identifies some of the key impasses in working alongside efforts in child welfare reform. The authors posit that the greatest impasse in establishing a reasonable quality of health care for these children is placement instability, in which children move frequently among multiple homes and in and out of the child welfare system. The authors propose potential strategies in which efforts to improve placement stability can serve as a vehicle for multidisciplinary reform across the health care system. PMID:19358924

  19. Effectiveness of a Multilevel Workplace Health Promotion Program on Vitality, Health, and Work-Related Outcomes

    PubMed Central

    Hendriksen, Ingrid J.M.; Snoijer, Mirjam; de Kok, Brenda P.H.; van Vilsteren, Jeroen; Hofstetter, Hedwig

    2016-01-01

    Objective: Evaluation of the effectiveness of a workplace health promotion program on employees’ vitality, health, and work-related outcomes, and exploring the influence of organizational support and the supervisors’ role on these outcomes. Methods: The 5-month intervention included activities at management, team, and individual level targeting self-management to perform healthy behaviors: a kick-off session, vitality training sessions, workshops, individual coaching, and intervision. Outcome measures were collected using questionnaires, health checks, and sickness absence data at baseline, after the intervention and at 10 months follow-up. For analysis linear and generalized mixed models were used. Results: Vitality, work performance, sickness absence, and self-management significantly improved. Good organizational support and involved supervisors were significantly associated with lower sickness absence. Conclusions: Including all organizational levels and focusing on increasing self-management provided promising results for improving vitality, health, and work-related outcomes. PMID:27136605

  20. Structural Health Monitoring of Large Structures

    NASA Technical Reports Server (NTRS)

    Kim, Hyoung M.; Bartkowicz, Theodore J.; Smith, Suzanne Weaver; Zimmerman, David C.

    1994-01-01

    This paper describes a damage detection and health monitoring method that was developed for large space structures using on-orbit modal identification. After evaluating several existing model refinement and model reduction/expansion techniques, a new approach was developed to identify the location and extent of structural damage with a limited number of measurements. A general area of structural damage is first identified and, subsequently, a specific damaged structural component is located. This approach takes advantage of two different model refinement methods (optimal-update and design sensitivity) and two different model size matching methods (model reduction and eigenvector expansion). Performance of the proposed damage detection approach was demonstrated with test data from two different laboratory truss structures. This space technology can also be applied to structural inspection of aircraft, offshore platforms, oil tankers, ridges, and buildings. In addition, its applications to model refinement will improve the design of structural systems such as automobiles and electronic packaging.

  1. Fiber Optic Thermal Health Monitoring of Composites

    NASA Technical Reports Server (NTRS)

    Wu, Meng-Chou; Winfree, William P.; Moore, Jason P.

    2010-01-01

    A recently developed technique is presented for thermographic detection of flaws in composite materials by performing temperature measurements with fiber optic Bragg gratings. Individual optical fibers with multiple Bragg gratings employed as surface temperature sensors were bonded to the surfaces of composites with subsurface defects. The investigated structures included a 10-ply composite specimen with subsurface delaminations of various sizes and depths. Both during and following the application of a thermal heat flux to the surface, the individual Bragg grating sensors measured the temporal and spatial temperature variations. The data obtained from grating sensors were analyzed with thermal modeling techniques of conventional thermography to reveal particular characteristics of the interested areas. Results were compared with the calculations using numerical simulation techniques. Methods and limitations for performing in-situ structural health monitoring are discussed.

  2. Flexible ultrasonic array sensors for health monitoring

    NASA Astrophysics Data System (ADS)

    Kobayashi, M.; Wu, K.-T.; Song, L.; Liu, Q.; Jen, C.-K.

    2007-04-01

    Flexible ultrasonic array transducers which can be attached to the desired structures or materials for nondestructive testing and structural health monitoring applications at room and elevated temperatures are developed. These flexible ultrasonic transducers (UTs) arrays consist of a thin polyimide membrane with a bottom electrode or stainless steel foil, a piezoelectric lead-zirconate-titanate (PZT) composite film and top electrodes. The flexibility is realized owing to the porosity of piezoelectric film and the thinness of substrate and electrodes. Top and bottom electrode materials are silver paste, silver paint or electroless plated nickel alloys. The UT array is configured by the several top electrodes. The flexible UT has been successfully tested at 150°C and also immersed into water as immersion ultrasonic probe operated in the pulse-echo mode with good signal to noise ratio.

  3. Structural health monitoring apparatus and methodology

    NASA Technical Reports Server (NTRS)

    Giurgiutiu, Victor (Inventor); Yu, Lingyu (Inventor); Bottai, Giola Santoni (Inventor)

    2011-01-01

    Disclosed is an apparatus and methodology for structural health monitoring (SHM) in which smart devices interrogate structural components to predict failure, expedite needed repairs, and thus increase the useful life of those components. Piezoelectric wafer active sensors (PWAS) are applied to or integrated with structural components and various data collected there from provide the ability to detect and locate cracking, corrosion, and disbanding through use of pitch-catch, pulse-echo, electro/mechanical impedance, and phased array technology. Stand alone hardware and an associated software program are provided that allow selection of multiple types of SHM investigations as well as multiple types of data analysis to perform a wholesome investigation of a structure.

  4. Flow cytometry for health monitoring in space

    SciTech Connect

    Jett, J.H.; Martin, J.C.; Saunders, G.C.; Stewart, C.C.

    1984-01-01

    Monitoring the health of space station or lunar base residents will be necessary to provide knowledge of the physiological status of astronauts. Flow cytometric techniques are uniquely capable of providing cellular, chromosome, hormone level and enzyme level information. The use of dyes provides the basis for fluorescently labeling specific cellular components. Laser induced fluorescence from stained cells is quantitated in a flow cytometer to measure cellular components such as DNA, RNA and protein. One major application of a flow cytometer will be to perform a complete blood count including hematocrit, hemoglobin content, and numbers of platelets, erythrocytes, granulocytes, lymphocytes and monocytes. A newly developed flow cytometry based fluoroimmunoassay will be able to measure levels of serum enzymes and hormones. It will also be possible to quantitate radiation exposure and some forms of chromosome damage with flow cytometric measurements. With relatively simple modifications to existing technology, it will be possible to construct a flight rated cytometer. 11 references, 6 figures, 2 tables.

  5. Valve health monitoring system utilizing smart instrumentation

    NASA Astrophysics Data System (ADS)

    Jensen, Scott L.; Drouant, George J.

    2006-05-01

    The valve monitoring system is a stand alone unit with network capabilities for integration into a higher level health management system. The system is designed for aiding in failure predictions of high-geared ball valves and linearly actuated valves. It performs data tracking and archiving for identifying degraded performance. The data collection types are: cryogenic cycles, total cycles, inlet temperature, outlet temperature, body temperature, torsional strain, linear bonnet strain, preload position, total travel, and total directional changes. Events are recorded and time stamped in accordance with the IRIG B True Time. The monitoring system is designed for use in a Class 1 Division II explosive environment. The basic configuration consists of several instrumentation sensor units and a base station. The sensor units are self contained microprocessor controlled and remotely mountable in three by three by two inches. Each unit is potted in a fire retardant substance without any cavities and limited to low operating power for maintaining safe operation in a hydrogen environment. The units are temperature monitored to safeguard against operation outside temperature limitations. Each contains 902-928 MHz band digital transmitters which meet Federal Communication Commissions requirements and are limited to a 35 foot transmission radius for preserving data security. The base-station controller correlates related data from the sensor units and generates data event logs on a compact flash memory module for database uploading. The entries are also broadcast over an Ethernet network. Nitrogen purged National Electrical Manufactures Association (NEMA) Class 4 Enclosures are used to house the base-station.

  6. Propulsion Health Monitoring for Enhanced Safety

    NASA Technical Reports Server (NTRS)

    Butz, Mark G.; Rodriguez, Hector M.

    2003-01-01

    This report presents the results of the NASA contract Propulsion System Health Management for Enhanced Safety performed by General Electric Aircraft Engines (GE AE), General Electric Global Research (GE GR), and Pennsylvania State University Applied Research Laboratory (PSU ARL) under the NASA Aviation Safety Program. This activity supports the overall goal of enhanced civil aviation safety through a reduction in the occurrence of safety-significant propulsion system malfunctions. Specific objectives are to develop and demonstrate vibration diagnostics techniques for the on-line detection of turbine rotor disk cracks, and model-based fault tolerant control techniques for the prevention and mitigation of in-flight engine shutdown, surge/stall, and flameout events. The disk crack detection work was performed by GE GR which focused on a radial-mode vibration monitoring technique, and PSU ARL which focused on a torsional-mode vibration monitoring technique. GE AE performed the Model-Based Fault Tolerant Control work which focused on the development of analytical techniques for detecting, isolating, and accommodating gas-path faults.

  7. Evaluation of Diverse Community Asthma Interventions: Balancing Health Outcomes with Developing Community Capacity for Evidence-Based Program Measurement.

    PubMed

    Woodhouse, Lynn D; Livingood, William C; Toal, Russ; Keene, DeAnna; Hines, Robert B; Tedders, Stuart; Charles, Simone M; Lawrence, Raymona H; Gunn, Laura H; Williams, Natalie; Kellum, Andrea

    2015-10-01

    The challenge of evaluating community asthma management programs is complicated by balancing the emphasis on health outcomes with the need to build community process capacity for conducting and monitoring evidence-based programs. The evaluation of a Georgia Childhood Asthma Management Program, a Healthcare Georgia Foundation-supported initiative for multiple diverse programs and settings, provides an example of an approach and the results that address this challenge. A "developmental evaluation" approach was applied, using mixed methods of quantitative and qualitative data collection and analysis, to assess the progress of community asthma prevention programs in building community within the context of: where the community is starting, community-level systems changes, and the community's progress toward becoming more outcome measurement oriented and evidence based. Initial evaluation efforts revealed extensive mobilization of community assets to manage childhood asthma. However, there were minimal planned efforts to assess health outcomes and systems changes, and the lack of a logic model-based program design linking evidence-based practices to outcomes. Following developmental technical assistance within evaluation efforts, all programs developed logic models, linking practices to outcomes with data collection processes to assess progress toward achieving the selected outcomes. This developmental approach across diverse projects and communities, along with a quality improvement benchmarking approach to outcomes, created a focus on health status outcome improvement. Specifically, this approach complemented an emphasis on an improved community process capacity to identify, implement, and monitor evidence-based asthma practices that could be used within each community setting. PMID:25658512

  8. Web Searching for Health: Theoretical Foundations and Connections to Health Related Outcomes

    NASA Astrophysics Data System (ADS)

    Dutta, M. J.; Bodie, G. D.

    Increasingly, consumers are using the Internet to seek out health information. This increasing demand for health information on the Internet has been accompanied by an increase in the number of Websites delivering health information online. This rise in online health information search calls for a theoretical approach that explains consumer health information seeking on the Internet. Based on a review of the literature related to health information seeking, this chapter introduces an integrative model of online health information seeking, arguing that the motivation and ability to seek out health information are two key constructs in predicting health information seeking. Finally, the chapter highlights the implications of adopting the integrative model of online health information seeking in understanding the health outcomes associated with new communication technologies.

  9. Neural system for structural health monitoring

    NASA Astrophysics Data System (ADS)

    Sundaresan, Mannur J.; Schulz, Mark J.; Ghoshal, Anindya; Martin, William N., Jr.; Pratap, Promod R.

    2001-08-01

    This is an overview paper that discusses the concept of an embeddable structural health monitoring system for use in composite and heterogeneous material systems. The sensor system is formed by integrating groups of autonomous unit cells into a structure, much like neurons in biological systems. Each unit cell consists of an embedded processor and a group of distributed sensors that gives the structure the ability to sense damage. In addition, each unit cell periodically updates a central processor on the status of health in its neighborhood. This micro-architectured synthetic nervous system has an advanced sensing capability based on new continuous sensor technology. This technology uses a plurality of serially connected piezoceramic nodes to form a distributed sensor capable of measuring waves generated in structures by damage events, including impact and crack propagation. Simulations show that the neural system can detect faint acoustic waves in large plates. An experiment demonstrates the use of a simple neural system that was able to measure simulated acoustic emissions that were not clearly recognizable by a single conventional piezoceramic sensor.

  10. Information processing for aerospace structural health monitoring

    NASA Astrophysics Data System (ADS)

    Lichtenwalner, Peter F.; White, Edward V.; Baumann, Erwin W.

    1998-06-01

    Structural health monitoring (SHM) technology provides a means to significantly reduce life cycle of aerospace vehicles by eliminating unnecessary inspections, minimizing inspection complexity, and providing accurate diagnostics and prognostics to support vehicle life extension. In order to accomplish this, a comprehensive SHM system will need to acquire data from a wide variety of diverse sensors including strain gages, accelerometers, acoustic emission sensors, crack growth gages, corrosion sensors, and piezoelectric transducers. Significant amounts of computer processing will then be required to convert this raw sensor data into meaningful information which indicates both the diagnostics of the current structural integrity as well as the prognostics necessary for planning and managing the future health of the structure in a cost effective manner. This paper provides a description of the key types of information processing technologies required in an effective SHM system. These include artificial intelligence techniques such as neural networks, expert systems, and fuzzy logic for nonlinear modeling, pattern recognition, and complex decision making; signal processing techniques such as Fourier and wavelet transforms for spectral analysis and feature extraction; statistical algorithms for optimal detection, estimation, prediction, and fusion; and a wide variety of other algorithms for data analysis and visualization. The intent of this paper is to provide an overview of the role of information processing for SHM, discuss various technologies which can contribute to accomplishing this role, and present some example applications of information processing for SHM implemented at the Boeing Company.

  11. Agency attribution: event-related potentials and outcome monitoring.

    PubMed

    Bednark, Jeffery G; Franz, Elizabeth A

    2014-04-01

    Knowledge about the effects of our actions is an underlying feature of voluntary behavior. Given the importance of identifying the outcomes of our actions, it has been proposed that the sensory outcomes of self-made actions are inherently different from those of externally caused outcomes. Thus, the outcomes of self-made actions are likely to be more motivationally significant for an agent. We used event-related potentials to investigate the relationship between the perceived motivational significance of an outcome and the attribution of agency in the presence of others. In our experiment, we assessed agency attribution in the presence of another agent by varying the degree of contiguity between participants' self-made actions and the sensory outcome. Specifically, we assessed the feedback correct-related positivity (fCRP) and the novelty P3 measures of an outcome's motivational significance and unexpectedness, respectively. Results revealed that both the fCRP and participants' agency attributions were significantly influenced by action-outcome contiguity. However, when action-outcome contiguity was ambiguous, novelty P3 amplitude was a reliable indicator of agency attribution. Prior agency attributions were also found to influence attribution in trials with ambiguous and low action-outcome contiguity. Participants' use of multiple cues to determine agency is consistent with the cue integration theory of agency. In addition to these novel findings, this study supports growing evidence suggesting that reinforcement processes play a significant role in the sense of agency. PMID:24504195

  12. Human resources for maternal, newborn and child health: from measurement and planning to performance for improved health outcomes

    PubMed Central

    2011-01-01

    Background There is increasing attention, globally and in countries, to monitoring and addressing the health systems and human resources inputs, processes and outputs that impede or facilitate progress towards achieving the Millennium Development Goals for maternal and child health. We reviewed the situation of human resources for health (HRH) in 68 low- and middle-income countries that together account for over 95% of all maternal and child deaths. Methods We collected and analysed cross-nationally comparable data on HRH availability, distribution, roles and functions from new and existing sources, and information from country reviews of HRH interventions that are associated with positive impacts on health services delivery and population health outcomes. Results Findings from 68 countries demonstrate availability of doctors, nurses and midwives is positively correlated with coverage of skilled birth attendance. Most (78%) of the target countries face acute shortages of highly skilled health personnel, and large variations persist within and across countries in workforce distribution, skills mix and skills utilization. Too few countries appropriately plan for, authorize and support nurses, midwives and community health workers to deliver essential maternal, newborn and child health-care interventions that could save lives. Conclusions Despite certain limitations of the data and findings, we identify some key areas where governments, international partners and other stakeholders can target efforts to ensure a sufficient, equitably distributed and efficiently utilized health workforce to achieve MDGs 4 and 5. PMID:21702913

  13. Testing rank-dependent utility theory for health outcomes.

    PubMed

    Oliver, Adam

    2003-10-01

    Systematic violations of expected utility theory (EU) have been reported in the context of both money and health outcomes. Rank-dependent utility theory (RDU) is currently the most popular and influential alternative theory of choice under circumstances of risk. This paper reports a test of the descriptive performance of RDU compared to EU in the context of health. When one of the options is certain, violations of EU that can be explained by RDU are found. When both options are risky, no evidence that RDU is a descriptive improvement over EU is found, though this finding may be due to the low power of the tests. PMID:14508870

  14. Association between environmental contaminants and health outcomes in indigenous populations of the Circumpolar North

    PubMed Central

    Singh, Kavita; Bjerregaard, Peter; Man Chan, Hing

    2014-01-01

    Background Since the 1990s, research has been carried out to monitor environmental contaminants and their effects on human health in the Arctic. Although evidence shows that Arctic indigenous peoples are exposed to higher levels of contaminants and do worse on several dimensions of health compared with other populations, the contribution of such exposures on adverse outcomes is unclear. Objective The purpose of this review is to provide a synopsis of the published epidemiological literature that has examined association between environmental contaminants and health outcomes in Arctic indigenous populations. Design A literature search was conducted in OVID Medline (1946-January 2014) using search terms that combined concepts of contaminant and indigenous populations in the Arctic. No language or date restrictions were applied. The reference lists of review articles were hand-searched. Results Of 559 citations, 60 studies were relevant. The studies fell under the following categories: paediatric (n=18), reproductive health (n=18), obstetrics and gynaecology (n=9), cardiology (n=7), bone health (n=2), oncology (n=2), endocrinology (n=2) and other (n=2). All studies, except one from Arctic Finland, were either from Nunavik or Greenland. Most studies assessed polychlorinated biphenyls (n=43) and organochlorine pesticides (n=29). Fewer studies examined heavy metals, perfluorinated compounds, or polybrominated diphenyl ethers. Details of study results for each health category are provided. Conclusions It is difficult to make conclusive statements about the effects of environmental contaminants on health due to mixed results, small number of studies and studies being restricted to a small number of regions. Meta-analytical synthesis of the evidence should be considered for priority contaminants and health outcomes. The following research gaps should be addressed in future studies: association of contaminants and health in other Arctic regions (i.e. Inuvialuit Settlement

  15. Patient-reported outcomes: pathways to better health, better services, and better societies.

    PubMed

    Black, N; Burke, L; Forrest, C B; Sieberer, U H Ravens; Ahmed, S; Valderas, J M; Bartlett, S J; Alonso, J

    2016-05-01

    While the use of PROs in research is well established, many challenges lie ahead as their use is extended to other applications. There is consensus that health outcome evaluations that include PROs along with clinician-reported outcomes and administrative data are necessary to inform clinical and policy decisions. The initiatives presented in this paper underline evolving recognition that PROs play a unique role in adding the patient perspective alongside clinical (e.g., blood pressure) and organizational (e.g., admission rates) indicators for evaluating the effects of new products, selecting treatments, evaluating quality of care, and monitoring the health of the population. In this paper, we first explore the use of PRO measures to support drug approval and labeling claims. We critically evaluate the evidence and challenges associated with using PRO measures to improve healthcare delivery at individual and population levels. We further discuss the challenges associated with selecting from the abundance of measures available, opportunities afforded by agreeing on common metrics for constructs of interest, and the importance of establishing an evidence base that supports integrating PRO measures across the healthcare system to improve outcomes. We conclude that the integration of PROs as a key end point within individual patient care, healthcare organization and program performance evaluations, and population surveillance will be essential for evaluating whether increased healthcare expenditure is translating into better health outcomes. PMID:26563251

  16. Improving physical health monitoring for patients with chronic mental health problems who receive antipsychotic medications

    PubMed Central

    Abdallah, Nihad; Conn, Rory; Latif Marini, Abdel

    2016-01-01

    Physical health monitoring is an integral part of caring for patients with mental health problems. It is proven that serious physical health problems are more common among patients with severe mental health illness (SMI), this monitoring can be challenging and there is a need for improvement. The project aimed at improving the physical health monitoring among patients with SMI who are receiving antipsychotic medications. The improvement process focused on ensuring there is a good communication with general practitioners (GPs) as well as patient's education and education of care home staff. GP letters requesting physical health monitoring were updated; care home staff and patients were given more information about the value of regular physical health monitoring. There was an improvement in patients' engagement with the monitoring and the monitoring done by GPs was more adherent to local and national guidelines and was communicated with the mental health service.

  17. Improving physical health monitoring for patients with chronic mental health problems who receive antipsychotic medications.

    PubMed

    Abdallah, Nihad; Conn, Rory; Latif Marini, Abdel

    2016-01-01

    Physical health monitoring is an integral part of caring for patients with mental health problems. It is proven that serious physical health problems are more common among patients with severe mental health illness (SMI), this monitoring can be challenging and there is a need for improvement. The project aimed at improving the physical health monitoring among patients with SMI who are receiving antipsychotic medications. The improvement process focused on ensuring there is a good communication with general practitioners (GPs) as well as patient's education and education of care home staff. GP letters requesting physical health monitoring were updated; care home staff and patients were given more information about the value of regular physical health monitoring. There was an improvement in patients' engagement with the monitoring and the monitoring done by GPs was more adherent to local and national guidelines and was communicated with the mental health service. PMID:27559474

  18. Improving health outcomes with better patient understanding and education.

    PubMed

    Adams, Robert John

    2010-01-01

    A central plank of health care reform is an expanded role for educated consumers interacting with responsive health care teams. However, for individuals to realize the benefits of health education also requires a high level of engagement. Population studies have documented a gap between expectations and the actual performance of behaviours related to participation in health care and prevention. Interventions to improve self-care have shown improvements in self-efficacy, patient satisfaction, coping skills, and perceptions of social support. Significant clinical benefits have been seen from trials of self-management or lifestyle interventions across conditions such as diabetes, coronary heart disease, heart failure and rheumatoid arthritis. However, the focus of many studies has been on short-term outcomes rather that long term effects. There is also some evidence that participation in patient education programs is not spread evenly across socio economic groups. This review considers three other issues that may be important in increasing the public health impact of patient education. The first is health literacy, which is the capacity to seek, understand and act on health information. Although health literacy involves an individual's competencies, the health system has a primary responsibility in setting the parameters of the health interaction and the style, content and mode of information. Secondly, much patient education work has focused on factors such as attitudes and beliefs. That small changes in physical environments can have large effects on behavior and can be utilized in self-management and chronic disease research. Choice architecture involves reconfiguring the context or physical environment in a way that makes it more likely that people will choose certain behaviours. Thirdly, better means of evaluating the impact of programs on public health is needed. The Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework has been

  19. Neighbourhood social capital: measurement issues and associations with health outcomes.

    PubMed

    Mackenbach, J D; Lakerveld, J; van Lenthe, F J; Kawachi, I; McKee, M; Rutter, H; Glonti, K; Compernolle, S; De Bourdeaudhuij, I; Feuillet, T; Oppert, J-M; Nijpels, G; Brug, J

    2016-01-01

    We compared ecometric neighbourhood scores of social capital (contextual variation) to mean neighbourhood scores (individual and contextual variation), using several health-related outcomes (i.e. self-rated health, weight status and obesity-related behaviours). Data were analysed from 5,900 participants in the European SPOTLIGHT survey. Factor analysis of the 13-item social capital scale revealed two social capital constructs: social networks and social cohesion. The associations of ecometric and mean neighbourhood-level scores of these constructs with self-rated health, weight status and obesity-related behaviours were analysed using multilevel regression analyses, adjusted for key covariates. Analyses using ecometric and mean neighbourhood scores, but not mean neighbourhood scores adjusted for individual scores, yielded similar regression coefficients. Higher levels of social network and social cohesion were not only associated with better self-rated health, lower odds of obesity and higher fruit consumption, but also with prolonged sitting and less transport-related physical activity. Only associations with transport-related physical activity and sedentary behaviours were associated with mean neighbourhood scores adjusted for individual scores. As analyses using ecometric scores generated the same results as using mean neighbourhood scores, but different results when using mean neighbourhood scores adjusted for individual scores, this suggests that the theoretical advantage of the ecometric approach (i.e. teasing out individual and contextual variation) may not be achieved in practice. The different operationalisations of social network and social cohesion were associated with several health outcomes, but the constructs that appeared to represent the contextual variation best were only associated with two of the outcomes. PMID:26879117

  20. Elements of an integrated health monitoring framework

    NASA Astrophysics Data System (ADS)

    Fraser, Michael; Elgamal, Ahmed; Conte, Joel P.; Masri, Sami; Fountain, Tony; Gupta, Amarnath; Trivedi, Mohan; El Zarki, Magda

    2003-07-01

    Internet technologies are increasingly facilitating real-time monitoring of Bridges and Highways. The advances in wireless communications for instance, are allowing practical deployments for large extended systems. Sensor data, including video signals, can be used for long-term condition assessment, traffic-load regulation, emergency response, and seismic safety applications. Computer-based automated signal-analysis algorithms routinely process the incoming data and determine anomalies based on pre-defined response thresholds and more involved signal analysis techniques. Upon authentication, appropriate action may be authorized for maintenance, early warning, and/or emergency response. In such a strategy, data from thousands of sensors can be analyzed with near real-time and long-term assessment and decision-making implications. Addressing the above, a flexible and scalable (e.g., for an entire Highway system, or portfolio of Networked Civil Infrastructure) software architecture/framework is being developed and implemented. This framework will network and integrate real-time heterogeneous sensor data, database and archiving systems, computer vision, data analysis and interpretation, physics-based numerical simulation of complex structural systems, visualization, reliability & risk analysis, and rational statistical decision-making procedures. Thus, within this framework, data is converted into information, information into knowledge, and knowledge into decision at the end of the pipeline. Such a decision-support system contributes to the vitality of our economy, as rehabilitation, renewal, replacement, and/or maintenance of this infrastructure are estimated to require expenditures in the Trillion-dollar range nationwide, including issues of Homeland security and natural disaster mitigation. A pilot website (http://bridge.ucsd.edu/compositedeck.html) currently depicts some basic elements of the envisioned integrated health monitoring analysis framework.

  1. Unplanned pregnancy and the impact on sibling health outcomes.

    PubMed

    Lordan, Grace; Frijters, Paul

    2013-08-01

    This work considers whether planning matters with respect to the effect of a new sibling on another siblings' health. Objective health outcomes are observed before and after a new addition to the family. To date, the literature on family size has focused on a quality-quantity trade-off; the more children in a family, the less resources devoted to each child. We present a theoretical framework which highlights that the quantity-quality trade-off may only be relevant in the case of an unplanned sibling. We also suggest that a planned sibling may result in health gains for the other children. We use two waves of data for more than 1800 children from Peru from the Young Lives Project to test our hypothesis. The data relate to the children at 1 and 5 years. For health outcomes, height for age and weight for age Z are considered. The results highlight significant negative independent effects on height for age when an unplanned sibling is added to the household. In addition, we find positive sibling effects on height for age when a planned sibling arrives. We find only small planning effects for weight for age. We view our hypothesis as a pathway that can further explain the quantity-quality trade-off. PMID:22941673

  2. Health Outcomes and Green Renovation of Affordable Housing

    PubMed Central

    Breysse, Jill; Jacobs, David E.; Weber, William; Dixon, Sherry; Kawecki, Carol; Aceti, Susan; Lopez, Jorge

    2011-01-01

    Objective This study sought to determine whether renovating low-income housing using “green” and healthy principles improved resident health and building performance. Methods We investigated resident health and building performance outcomes at baseline and one year after the rehabilitation of low-income housing using Enterprise Green Communities green specifications, which improve ventilation; reduce moisture, mold, pests, and radon; and use sustainable building products and other healthy housing features. We assessed participant health via questionnaire, provided Healthy Homes training to all participants, and measured ventilation, carbon dioxide, and radon. Results Adults reported statistically significant improvements in overall health, asthma, and non-asthma respiratory problems. Adults also reported that their children's overall health improved, with significant improvements in non-asthma respiratory problems. Post-renovation building performance testing indicated that the building envelope was tightened and local exhaust fans performed well. New mechanical ventilation was installed (compared with no ventilation previously), with fresh air being supplied at 70% of the American Society of Heating, Refrigerating, and Air-Conditioning Engineers standard. Radon was <2 picocuries per liter of air following mitigation, and the annual average indoor carbon dioxide level was 982 parts per million. Energy use was reduced by 45% over the one-year post-renovation period. Conclusions We found significant health improvements following low-income housing renovation that complied with green standards. All green building standards should include health requirements. Collaboration of housing, public health, and environmental health professionals through integrated design holds promise for improved health, quality of life, building operation, and energy conservation. PMID:21563714

  3. Can developing countries achieve adequate improvements in child health outcomes without engaging the private sector?

    PubMed Central

    Bustreo, Flavia; Harding, April; Axelsson, Henrik

    2003-01-01

    The private sector exerts a significant and critical influence on child health outcomes in developing countries, including the health of poor children. This article reviews the available evidence on private sector utilization and quality of care. It provides a framework for analysing the private sector's influence on child health outcomes. This influence goes beyond service provision by private providers and nongovernmental organizations (NGOs). Pharmacies, drug sellers, private suppliers, and food producers also have an impact on the health of children. Many governments are experimenting with strategies to engage the private sector to improve child health. The article analyses some of the most promising strategies, and suggests that a number of constraints make it hard for policy-makers to emulate these approaches. Few experiences are clearly described, monitored, and evaluated. The article suggests that improving the impact of child health programmes in developing countries requires a more systematic analysis of how to engage the private sector most effectively. The starting point should include the evaluation of the presence and potential of the private sector, including actors such as professional associations, producer organizations, community groups, and patients' organizations. PMID:14997241

  4. Deriving Implementation Strategies for Outcome Monitoring Feedback from Theory, Research and Practice.

    PubMed

    de Jong, Kim

    2016-05-01

    Outcome monitoring feedback is a promising intervention to enhance outcomes of clinical practice. However, effective implementation can be tough and research suggests that feedback is not equally effective under all circumstances. In this article, feedback theory, research and experience from clinical practice is used to provide implementation strategies. Factors that moderate the effectiveness of outcome monitoring feedback, including feedback, recipient and organization characteristics are discussed. It is important to pay attention to implementation processes, such as providing sufficient training for clinicians, in order for feedback to be capable of enhancing outcomes. PMID:25208490

  5. [Outcome evaluation of a health promotion among the elderly].

    PubMed

    Mnich, E; Hofreuter-Gätgens, K; Salomon, T; Swart, E; von dem Knesebeck, O

    2013-02-01

    The programme "active health promotion in old age" focuses on responsible self determination in old age (empowerment) and places special emphasis on physical activity and nutrition. The intervention, successfully conducted in an urban setting (Hamburg), was tested in a rural area (Kinzigtal, Baden-Wuerttemberg). In this paper we present the results of the outcome evaluation. The intervention group consisted of older people, without care need and without cognitive impairment who lived in their own home (N=468). For the evaluation of the results a pre-post comparison was conducted (2 measuring points within an interval of 12 months). 4 out of 5 participants reported changes in their behaviour after the intervention. However, the pre-post comparison shows significant changes only for nutrition behaviour, but not of physical activity. Health related quality of life (SF-36) did not change after 12 months. These findings indicate that health promotion in old age may lead to changes in nutrition behaviour. PMID:22615028

  6. Health spending, access, and outcomes: trends in industrialized countries.

    PubMed

    Anderson, G F; Poullier, J P

    1999-01-01

    In 1997 the United States spent $3,925 per capita on health or 13.5 percent of gross domestic product (GDP), while the median Organization for Economic Cooperation and Development (OECD) country spent $1,728 or 7.5 percent. From 1990 to 1997 U.S. health spending per capita increased 4.3 percent per year, compared with the OECD median of 3.8 percent. The United States has the lowest percentage of the population with government-assured health insurance. It also has the fewest hospital days per capita, the highest hospital expenditures per day, and substantially higher physician incomes than the other OECD countries. On the available outcome measures, the United States is generally in the bottom half, and its relative ranking has been declining since 1960. PMID:10388215

  7. Structural health monitoring for ship structures

    SciTech Connect

    Farrar, Charles; Park, Gyuhae; Angel, Marian; Bement, Matthew; Salvino, Liming

    2009-01-01

    Currently the Office of Naval Research is supporting the development of structural health monitoring (SHM) technology for U.S. Navy ship structures. This application is particularly challenging because of the physical size of these structures, the widely varying and often extreme operational and environmental conditions associated with these ships missions, lack of data from known damage conditions, limited sensing that was not designed specifically for SHM, and the management of the vast amounts of data that can be collected during a mission. This paper will first define a statistical pattern recognition paradigm for SHM by describing the four steps of (1) Operational Evaluation, (2) Data Acquisition, (3) Feature Extraction, and (4) Statistical Classification of Features as they apply to ship structures. Note that inherent in the last three steps of this process are additional tasks of data cleansing, compression, normalization and fusion. The presentation will discuss ship structure SHM challenges in the context of applying various SHM approaches to sea trials data measured on an aluminum multi-hull high-speed ship, the HSV-2 Swift. To conclude, the paper will discuss several outstanding issues that need to be addressed before SHM can make the transition from a research topic to actual field applications on ship structures and suggest approaches for addressing these issues.

  8. Packaging of structural health monitoring components

    NASA Astrophysics Data System (ADS)

    Kessler, Seth S.; Spearing, S. Mark; Shi, Yong; Dunn, Christopher T.

    2004-07-01

    Structural Health Monitoring (SHM) technologies have the potential to realize economic benefits in a broad range of commercial and defense markets. Previous research conducted by Metis Design and MIT has demonstrated the ability of Lamb waves methods to provide reliable information regarding the presence, location and type of damage in composite specimens. The present NSF funded program was aimed to study manufacturing, packaging and interface concepts for critical SHM components. The intention is to be able to cheaply manufacture robust actuating/sensing devices, and isolate them from harsh operating environments including natural, mechanical, or electrical extremes. Currently the issues related to SHM system durability have remained undressed. During the course of this research several sets of test devices were fabricated and packaged to protect the piezoelectric component assemblies for robust operation. These assemblies were then tested in hot and wet conditions, as well as in electrically noisy environments. Future work will aim to package the other supporting components such as the battery and wireless chip, as well as integrating all of these components together for operation. SHM technology will enable the reduction or complete elimination of scheduled inspections, and will allow condition-based maintenance for increased reliability and reduced overall life-cycle costs.

  9. Enhanced Composites Integrity Through Structural Health Monitoring

    NASA Astrophysics Data System (ADS)

    Giurgiutiu, Victor; Soutis, Constantinos

    2012-10-01

    This paper discusses the topic of how the integrity of safety-critical structural composites can be enhanced by the use of structural health monitoring (SHM) techniques. The paper starts with a presentation of how the certification of flight-critical composite structures can be achieved within the framework of civil aviation safety authority requirements. Typical composites damage mechanisms, which make this process substantially different from that for metallic materials are discussed. The opportunities presented by the use of SHM techniques in future civil aircraft developments are explained. The paper then focuses on active SHM with piezoelectric wafer active sensors (PWAS). After reviewing the PWAS-based SHM options, the paper follows with a discussion of the specifics of guided wave propagation in composites and PWAS-tuning effects. The paper presents a number of experimental results for damage detection in simple flat unidirectional and quasi-isotropic composite specimens. Calibrated through holes of increasing diameter and impact damage of various energies and velocities are considered. The paper ends with conclusions and suggestions for further work.

  10. Air pollutants and health outcomes: Assessment of confounding by influenza

    NASA Astrophysics Data System (ADS)

    Thach, Thuan-Quoc; Wong, Chit-Ming; Chan, King-Pan; Chau, Yuen-Kwan; Neil Thomas, G.; Ou, Chun-Quan; Yang, Lin; Peiris, Joseph S. M.; Lam, Tai-Hing; Hedley, Anthony J.

    2010-04-01

    We assessed confounding of associations between short-term effects of air pollution and health outcomes by influenza using Hong Kong mortality and hospitalization data for 1996-2002. Three measures of influenza were defined: (i) intensity: weekly proportion of positive influenza viruses, (ii) epidemic: weekly number of positive influenza viruses ≥4% of the annual number for ≥2 consecutive weeks, and (iii) predominance: an epidemic period with co-circulation of respiratory syncytial virus <2% of the annual positive isolates for ≥2 consecutive weeks. We examined effects of influenza on associations between nitrogen dioxide (NO 2), sulfur dioxide (SO 2), particulate matter with aerodynamic diameter ≤10 μm (PM 10) and ozone (O 3) and health outcomes including all natural causes mortality, cardiorespiratory mortality and hospitalization. Generalized additive Poisson regression model with natural cubic splines was fitted to control for time-varying covariates to estimate air pollution health effects. Confounding with influenza was assessed using an absolute difference of >0.1% between unadjusted and adjusted excess risks (ER%). Without adjustment, pollutants were associated with positive ER% for all health outcomes except asthma and stroke hospitalization with SO 2 and stroke hospitalization with O 3. Following adjustment, changes in ER% for all pollutants were <0.1% for all natural causes mortality, but >0.1% for mortality from stroke with NO 2 and SO 2, cardiac or heart disease with NO 2, PM 10 and O 3, lower respiratory infections with NO 2 and O 3 and mortality from chronic obstructive pulmonary disease with all pollutants. Changes >0.1% were seen for acute respiratory disease hospitalization with NO 2, SO 2 and O 3 and acute lower respiratory infections hospitalization with PM 10. Generally, influenza does not confound the observed associations of air pollutants with all natural causes mortality and cardiovascular hospitalization, but for some pollutants

  11. FOREWORD: Structural Health Monitoring and Intelligent Infrastructure

    NASA Astrophysics Data System (ADS)

    Wu, Zhishen; Fujino, Yozo

    2005-06-01

    This special issue collects together 19 papers that were originally presented at the First International Conference on Structural Health Monitoring and Intelligent Infrastructure (SHMII-1'2003), held in Tokyo, Japan, on 13-15 November 2003. This conference was organized by the Japan Society of Civil Engineers (JSCE) with partial financial support from the Japan Society for the Promotion of Science (JSPS) and the Ministry of Education, Culture, Sport, Science and Technology, Japan. Many related organizations supported the conference. A total of 16 keynote papers including six state-of-the-art reports from different counties, six invited papers and 154 contributed papers were presented at the conference. The conference was attended by a diverse group of about 300 people from a variety of disciplines in academia, industry and government from all over the world. Structural health monitoring (SHM) and intelligent materials, structures and systems have been the subject of intense research and development in the last two decades and, in recent years, an increasing range of applications in infrastructure have been discovered both for existing structures and for new constructions. SHMII-1'2003 addressed progress in the development of building, transportation, marine, underground and energy-generating structures, and other civilian infrastructures that are periodically, continuously and/or actively monitored where there is a need to optimize their performance. In order to focus the current needs on SHM and intelligent technologies, the conference theme was set as 'Structures/Infrastructures Sustainability'. We are pleased to have the privilege to edit this special issue on SHM and intelligent infrastructure based on SHMII-1'2003. We invited some of the presenters to submit a revised/extended version of their paper that was included in the SHMII-1'2003 proceedings for possible publication in the special issue. Each paper included in this special issue was edited with the same

  12. Promoting health equity: WHO health inequality monitoring at global and national levels

    PubMed Central

    Hosseinpoor, Ahmad Reza; Bergen, Nicole; Schlotheuber, Anne

    2015-01-01

    Background Health equity is a priority in the post-2015 sustainable development agenda and other major health initiatives. The World Health Organization (WHO) has a history of promoting actions to achieve equity in health, including efforts to encourage the practice of health inequality monitoring. Health inequality monitoring systems use disaggregated data to identify disadvantaged subgroups within populations and inform equity-oriented health policies, programs, and practices. Objective This paper provides an overview of a number of recent and current WHO initiatives related to health inequality monitoring at the global and/or national level. Design We outline the scope, content, and intended uses/application of the following: Health Equity Monitor database and theme page; State of inequality: reproductive, maternal, newborn, and child health report; Handbook on health inequality monitoring: with a focus on low- and middle-income countries; Health inequality monitoring eLearning module; Monitoring health inequality: an essential step for achieving health equity advocacy booklet and accompanying video series; and capacity building workshops conducted in WHO Member States and Regions. Conclusions The paper concludes by considering how the work of the WHO can be expanded upon to promote the establishment of sustainable and robust inequality monitoring systems across a variety of health topics among Member States and at the global level. PMID:26387506

  13. National Surveys of Population Health: Big Data Analytics for Mobile Health Monitors

    PubMed Central

    Schatz, Bruce R.

    2015-01-01

    Abstract At the core of the healthcare crisis is fundamental lack of actionable data. Such data could stratify individuals within populations to predict which persons have which outcomes. If baselines existed for all variations of all conditions, then managing health could be improved by matching the measuring of individuals to their cohort in the population. The scale required for complete baselines involves effective National Surveys of Population Health (NSPH). Traditionally, these have been focused upon acute medicine, measuring people to contain the spread of epidemics. In recent decades, the focus has moved to chronic conditions as well, which require smaller measures over longer times. NSPH have long utilized quality of life questionnaires. Mobile Health Monitors, where computing technologies eliminate manual administration, provide richer data sets for health measurement. Older technologies of telephone interviews will be replaced by newer technologies of smartphone sensors to provide deeper individual measures at more frequent timings across larger-sized populations. Such continuous data can provide personal health records, supporting treatment guidelines specialized for population cohorts. Evidence-based medicine will become feasible by leveraging hundreds of millions of persons carrying mobile devices interacting with Internet-scale services for Big Data Analytics. PMID:26858915

  14. Racism and Oral Health Outcomes among Pregnant Canadian Aboriginal Women.

    PubMed

    Lawrence, Herenia P; Cidro, Jaime; Isaac-Mann, Sonia; Peressini, Sabrina; Maar, Marion; Schroth, Robert J; Gordon, Janet N; Hoffman-Goetz, Laurie; Broughton, John R; Jamieson, Lisa

    2016-02-01

    This study assessed links between racism and oral health outcomes among pregnant Canadian Aboriginal women. Baseline data were analyzed for 541 First Nations (94.6%) and Métis (5.4%) women in an early childhood caries preventive trial conducted in urban and on-reserve communities in Ontario and Manitoba. One-third of participants experienced racism in the past year determined by the Measure of Indigenous Racism Experience. In logistic regressions, outcomes significantly associated with incidents of racism included: wearing dentures, off-reserve dental care, asked to pay for dental services, perceived need for preventive care, flossing more than once daily, having fewer than 21 natural teeth, fear of going to dentist, never received orthodontic treatment and perceived impact of oral conditions on quality of life. In the context of dental care, racism experienced by Aboriginal women can be a barrier to accessing services. Programs and policies should address racism's insidious effects on both mothers' and children's oral health outcomes. PMID:26853210

  15. Predictive Modeling for Comfortable Death Outcome Using Electronic Health Records

    PubMed Central

    Lodhi, Muhammad Kamran; Ansari, Rashid; Yao, Yingwei; Keenan, Gail M.; Wilkie, Diana J.; Khokhar, Ashfaq A.

    2016-01-01

    Electronic health record (EHR) systems are used in healthcare industry to observe the progress of patients. With fast growth of the data, EHR data analysis has become a big data problem. Most EHRs are sparse and multi-dimensional datasets and mining them is a challenging task due to a number of reasons. In this paper, we have used a nursing EHR system to build predictive models to determine what factors impact death anxiety, a significant problem for the dying patients. Different existing modeling techniques have been used to develop coarse-grained as well as fine-grained models to predict patient outcomes. The coarse-grained models help in predicting the outcome at the end of each hospitalization, whereas fine-grained models help in predicting the outcome at the end of each shift, therefore providing a trajectory of predicted outcomes. Based on different modeling techniques, our results show significantly accurate predictions, due to relatively noise-free data. These models can help in determining effective treatments, lowering healthcare costs, and improving the quality of end-of-life (EOL) care.

  16. Linking Costs to Health Outcomes for Allocating Scarce Public Health Resources

    PubMed Central

    Corso, Phaedra S.; Ingels, Justin B.; Taylor, Nathaniel; Desai, Samir

    2014-01-01

    Introduction: Resources for public health (PH) are scarce and policymakers face tough decisions in determining their funding priorities. The difficulty of making these decisions is compounded by current PH accounting systems, which are ill-equipped to link fiscal resources to PH outcomes. This paper examines the types of revenues and expenditures, health services, and health outcomes that are being tracked at the local and state PH levels. The authors provide recommendations for strengthening the ability of local and state governments to link expenditures to PH outcomes, both within and across jurisdictions. Framework and Next Steps: The source of revenue data for most local jurisdictions is the accounting systems used for the budgeting and auditing of fiscal activities, and these are primarily linked to specific PH programs. In contrast, expenditure data are mostly generic and typically span multiple PH programs with no link to specific PH activities. Many challenges exist to then link PH activities to health outcomes data, which are often collected through separate reporting systems at the local, state, and national levels. Policy change at the state level and implementation strategies that are standardized across local health departments are required to assess the costs and health outcomes of PH activities. Conclusion: Information linking PH expenditures to health outcomes of PH services could greatly inform the decision-making process. This information will allow investments in PH to be better understood and will provide a strong foundation for the PH services and systems research community to understand variation and drive improvement. Ultimately, these data could be used to improve accountability at the local and state PH department levels. PMID:25848629

  17. Predicting reading outcomes with progress monitoring slopes among middle grade students.

    PubMed

    Tolar, Tammy D; Barth, Amy E; Fletcher, Jack M; Francis, David J; Vaughn, Sharon

    2014-02-01

    Effective implementation of response-to-intervention (RTI) frameworks depends on efficient tools for monitoring progress. Evaluations of growth (i.e., slope) may be less efficient than evaluations of status at a single time point, especially if slopes do not add to predictions of outcomes over status. We examined progress monitoring slope validity for predicting reading outcomes among middle school students by evaluating latent growth models for different progress monitoring measure-outcome combinations. We used multi-group modeling to evaluate the effects of reading ability, reading intervention, and progress monitoring administration condition on slope validity. Slope validity was greatest when progress monitoring was aligned with the outcome (i.e., word reading fluency slope was used to predict fluency outcomes in contrast to comprehension outcomes), but effects varied across administration conditions (viz., repeated reading of familiar vs. novel passages). Unless the progress monitoring measure is highly aligned with outcome, slope may be an inefficient method for evaluating progress in an RTI context. PMID:24659899

  18. Use of Information Systems for Monitoring Mental Health Programs.

    ERIC Educational Resources Information Center

    Southern Regional Education Board, Atlanta, GA.

    The monitoring process and the role of monitoring in mental health center decision making are discussed in relation to information systems. Monitoring requires an information system based on the center's annual plan for programs and budgets. This system must contain at least minimal data on client movement, services, staff activity, and costs. The…

  19. FOREST HEALTH MONITORING PLOT DESIGN AND LOGISTICS STUDY

    EPA Science Inventory

    Concern over the condition of forests in relation to natural and manmade stresses has led to an interagency Forest Health Monitoring program. o improve the efficiency of forest monitoring, the forest group of EPA's Environmental Monitoring and Assessment Program conducted a field...

  20. Manufacturing of Wearable Sensors for Human Health and Performance Monitoring

    NASA Astrophysics Data System (ADS)

    Alizadeh, Azar

    2015-03-01

    Continuous monitoring of physiological and biological parameters is expected to improve performance and medical outcomes by assessing overall health status and alerting for life-saving interventions. Continuous monitoring of these parameters requires wearable devices with an appropriate form factor (lightweight, comfortable, low energy consuming and even single-use) to avoid disrupting daily activities thus ensuring operation relevance and user acceptance. Many previous efforts to implement remote and wearable sensors have suffered from high cost and poor performance, as well as low clinical and end-use acceptance. New manufacturing and system level design approaches are needed to make the performance and clinical benefits of these sensors possible while satisfying challenging economic, regulatory, clinical, and user-acceptance criteria. In this talk we will review several recent design and manufacturing efforts aimed at designing and building prototype wearable sensors. We will discuss unique opportunities and challenges provided by additive manufacturing, including 3D printing, to drive innovation through new designs, faster prototyping and manufacturing, distributed networks, and new ecosystems. We will also show alternative hybrid self-assembly based integration techniques for low cost large scale manufacturing of single use wearable devices. Coauthors: Prabhjot Singh and Jeffrey Ashe.

  1. Health Monitoring System Technology Assessments: Cost Benefits Analysis

    NASA Technical Reports Server (NTRS)

    Kent, Renee M.; Murphy, Dennis A.

    2000-01-01

    The subject of sensor-based structural health monitoring is very diverse and encompasses a wide range of activities including initiatives and innovations involving the development of advanced sensor, signal processing, data analysis, and actuation and control technologies. In addition, it embraces the consideration of the availability of low-cost, high-quality contributing technologies, computational utilities, and hardware and software resources that enable the operational realization of robust health monitoring technologies. This report presents a detailed analysis of the cost benefit and other logistics and operational considerations associated with the implementation and utilization of sensor-based technologies for use in aerospace structure health monitoring. The scope of this volume is to assess the economic impact, from an end-user perspective, implementation health monitoring technologies on three structures. It specifically focuses on evaluating the impact on maintaining and supporting these structures with and without health monitoring capability.

  2. Randomised prior feedback modulates neural signals of outcome monitoring

    PubMed Central

    Mushtaq, Faisal; Wilkie, Richard M.; Mon-Williams, Mark A.; Schaefer, Alexandre

    2016-01-01

    Substantial evidence indicates that decision outcomes are typically evaluated relative to expectations learned from relatively long sequences of previous outcomes. This mechanism is thought to play a key role in general learning and adaptation processes but relatively little is known about the determinants of outcome evaluation when the capacity to learn from series of prior events is difficult or impossible. To investigate this issue, we examined how the feedback-related negativity (FRN) is modulated by information briefly presented before outcome evaluation. The FRN is a brain potential time-locked to the delivery of decision feedback and it is widely thought to be sensitive to prior expectations. We conducted a multi-trial gambling task in which outcomes at each trial were fully randomised to minimise the capacity to learn from long sequences of prior outcomes. Event-related potentials for outcomes (Win/Loss) in the current trial (Outcomet) were separated according to the type of outcomes that occurred in the preceding two trials (Outcomet-1 and Outcomet-2). We found that FRN voltage was more positive during the processing of win feedback when it was preceded by wins at Outcomet-1 compared to win feedback preceded by losses at Outcomet-1. However, no influence of preceding outcomes was found on FRN activity relative to the processing of loss feedback. We also found no effects of Outcomet-2 on FRN amplitude relative to current feedback. Additional analyses indicated that this effect was largest for trials in which participants selected a decision different to the gamble chosen in the previous trial. These findings are inconsistent with models that solely relate the FRN to prediction error computation. Instead, our results suggest that if stable predictions about future events are weak or non-existent, then outcome processing can be determined by affective systems. More specifically, our results indicate that the FRN is likely to reflect the activity of positive

  3. Randomised prior feedback modulates neural signals of outcome monitoring.

    PubMed

    Mushtaq, Faisal; Wilkie, Richard M; Mon-Williams, Mark A; Schaefer, Alexandre

    2016-01-15

    Substantial evidence indicates that decision outcomes are typically evaluated relative to expectations learned from relatively long sequences of previous outcomes. This mechanism is thought to play a key role in general learning and adaptation processes but relatively little is known about the determinants of outcome evaluation when the capacity to learn from series of prior events is difficult or impossible. To investigate this issue, we examined how the feedback-related negativity (FRN) is modulated by information briefly presented before outcome evaluation. The FRN is a brain potential time-locked to the delivery of decision feedback and it is widely thought to be sensitive to prior expectations. We conducted a multi-trial gambling task in which outcomes at each trial were fully randomised to minimise the capacity to learn from long sequences of prior outcomes. Event-related potentials for outcomes (Win/Loss) in the current trial (Outcomet) were separated according to the type of outcomes that occurred in the preceding two trials (Outcomet-1 and Outcomet-2). We found that FRN voltage was more positive during the processing of win feedback when it was preceded by wins at Outcomet-1 compared to win feedback preceded by losses at Outcomet-1. However, no influence of preceding outcomes was found on FRN activity relative to the processing of loss feedback. We also found no effects of Outcomet-2 on FRN amplitude relative to current feedback. Additional analyses indicated that this effect was largest for trials in which participants selected a decision different to the gamble chosen in the previous trial. These findings are inconsistent with models that solely relate the FRN to prediction error computation. Instead, our results suggest that if stable predictions about future events are weak or non-existent, then outcome processing can be determined by affective systems. More specifically, our results indicate that the FRN is likely to reflect the activity of positive

  4. Improving maternal and infant health outcomes in Medicaid and the Children's Health Insurance Program.

    PubMed

    Applegate, Mary; Gee, Rebekah E; Martin, James N

    2014-07-01

    Maternal and infant health is critical to our nation's health. Disparities remain unacceptably high, particularly in the areas of prematurity and infant mortality. In 2012, traditionally distant partners such as federal and state governments, Medicaid and commercial payers, patients, public health and private clinicians, and multiple advocacy groups collaborated to focus on improving birth outcomes. To catalyze the alignment, the Centers for Medicare and Medicaid Services convened an Expert Panel on Improving Maternal and Infant Health Outcomes in Medicaid and the Children's Health Insurance Program. Over a year's time, the Expert Panel assimilated the best available evidence in clinical science and policy from content leaders and patients. These recommendations culminated in the present report, which challenges us as a nation to implement strategies to help all children have the best chance to survive and thrive comparable to that of other westernized nations. PMID:24901270

  5. Structural health monitoring system/method using electroactive polymer fibers

    NASA Technical Reports Server (NTRS)

    Scott-Carnell, Lisa A. (Inventor); Siochi, Emilie J. (Inventor)

    2013-01-01

    A method for monitoring the structural health of a structure of interest by coupling one or more electroactive polymer fibers to the structure and monitoring the electroactive responses of the polymer fiber(s). Load changes that are experienced by the structure cause changes in the baseline responses of the polymer fiber(s). A system for monitoring the structural health of the structure is also provided.

  6. Integrated controls and health monitoring fiberoptic shaft monitor

    NASA Technical Reports Server (NTRS)

    Coleman, P.; Darejeh, H.; Collins, J. J.

    1989-01-01

    Recent work was performed on development optical technology to provide real time monitoring of shaft speed, shaft axial displacement, and shaft orbit of the OTVE hydrostatic bearing tester. Results show shaft axial displacement can be optically measured (at the same time as shaft orbital motion and speed) to within 0.3 mills by two fiber optic deflectometers. The final results of this condition monitoring development effort are presented.

  7. Relationships between patient-centered cancer nursing interventions and desired health outcomes in the context of the health care system.

    PubMed

    Radwin, Laurel E; Cabral, Howard J; Wilkes, Gail

    2009-02-01

    A non-experimental longitudinal prospective study was conducted to examine the relationships between patient-centered nursing interventions (PCNIs), system characteristics, patient characteristics, and desired health outcomes (DHOs) for 173 hematology-oncology patients. Forty-nine nurse participants provided system characteristics data. Confirmatory factor analyses yielded parsimonious scales to operationalize the variables. In the path model, one PCNI-individualization-was positively related to three subsequent DHOs: authentic self-representation, optimism, and sense of well-being. Two additional PCNIs-responsiveness and proficiency-were positively related to subsequent trust in nurses. PCNIs did not vary with patient race, ethnicity, age, gender, or educational level. Patient-centeredness of care for cancer patients may be enhanced by quality improvement activities that measure and monitor these PCNIs and resultant outcomes. PMID:18814304

  8. Examining acute health outcomes due to ozone exposure and their subsequent relationship to chronic disease outcomes

    SciTech Connect

    Ostro, B.D.

    1993-12-01

    Current evidence indicates that individuals exposed to short term elevations in ambient ozone may experience both upper and lower respiratory effects. Some respiratory symptoms and spirometric changes are mild and reversible in nature, while others involve more severe outcomes, including hospital admissions and emergency room visits. However, many questions remain about the effects of acute ozone exposure and the implications of this exposure for chronic disease outcomes. For example, the identification of sensitive subgroups, the delineation of the entire spectrum of health effects due to exposure to ozone, the potential synergy between viral infections and ozone exposure, and the nature of adaptation to ozone are not well characterized. In addition, studies that examine the association between acute responses to ozone and potential biological indicators of a chronic disease process would be desirable. This paper serves to provide an overview of the types of epidemiologic studies that may be appropriate and factors to consider in addressing these questions. 23 refs.

  9. Recommendations for Health Monitoring and Reporting for Zebrafish Research Facilities.

    PubMed

    Collymore, Chereen; Crim, Marcus J; Lieggi, Christine

    2016-07-01

    The presence of subclinical infection or clinical disease in laboratory zebrafish may have a significant impact on research results, animal health and welfare, and transfer of animals between institutions. As use of zebrafish as a model of disease increases, a harmonized method for monitoring and reporting the health status of animals will facilitate the transfer of animals, allow institutions to exclude diseases that may negatively impact their research programs, and improve animal health and welfare. All zebrafish facilities should implement a health monitoring program. In this study, we review important aspects of a health monitoring program, including choice of agents, samples for testing, available testing methodologies, housing and husbandry, cost, test subjects, and a harmonized method for reporting results. Facilities may use these recommendations to implement their own health monitoring program. PMID:26991393

  10. Health-weighted Composite Quality Metrics Offer Promise to Improve Health Outcomes in a Learning Health System.

    PubMed

    Braithwaite, Scott; Stine, Nicholas

    2013-01-01

    Health system leaders sometimes adopt quality metrics without robust supporting evidence of improvements in quality and/or quantity of life, which may impair rather than facilitate improved health outcomes. In brief, there is now no easy way to measure how much "health" is conferred by a health system. However, we argue that this goal is achievable. Health-weighted composite quality metrics have the potential to measure "health" by synthesizing individual evidence-based quality metrics into a summary measure, utilizing relative weightings that reflect the relative amount of health benefit conferred by each constituent quality metric. Previously, it has been challenging to create health-weighted composite quality metrics because of methodological and data limitations. However, advances in health information technology and mathematical modeling of disease progression promise to help mitigate these challenges by making patient-level data (eg, from the electronic health record and mobile health (mHealth) more accessible and more actionable for use. Accordingly, it may now be possible to use health information technology to calculate and track a health-weighted composite quality metric for each patient that reflects the health benefit conferred to that patient by the health system. These health-weighted composite quality metrics can be employed for a multitude of important aims that improve health outcomes, including quality evaluation, population health maximization, health disparity attenuation, panel management, resource allocation, and personalization of care. We describe the necessary attributes, the possible uses, and the likely limitations and challenges of health-weighted composite quality metrics using patient-level health data. PMID:25848572

  11. Exploring Social Quality and Community Health Outcomes: An Ecological Model.

    PubMed

    Jung, Minsoo

    2015-01-01

    Quality of life is widely used as a measure of individual well-being in developed countries. Social quality (SQ), however, describes how favorable the socioenvironmental components are that impact the life chance of an individual. Despite the associations between SQ, including institutional capacity and citizen capacity, and other community indicators, the impact of SQ on community health status has not been fully examined. This study investigated the interrelationships among institutional capacity, citizen capacity, and their associations with community-level health indicators such as mortality and suicide among 230 local governments in South Korea. Under the principles of conceptual suitability, clarity, reliability, consistency, changeability, and comparability, a total of 81 SQ indicators were collected, and 19 indicators of the 81 indicators were selected. The 19 indicators were transformed by the imputation of missing values, standardization, and geographic information system transformation. It was found that the health outcome of local government was superior as social welfare, political participation, and education were higher. According to the result of the regression analysis based on the regional type, social welfare had the most influence on the health level of local government in both metropolises and small-/medium-sized cities. In addition, education and political participation had a positive effect on the health indicator of local metropolis government. However, SQ indicators did not have any meaningful influence at the county level. Therefore, small- and medium-sized cities need to promote the collective health of the local government through improving social welfare, and metropolises need to consider the complex relationship among other indicators while increasing the level of social welfare and education. Meanwhile, counties need to develop health indicators that reflect aged population characteristics and social environment of rural areas

  12. A systematic review of outcome and impact of Master’s in health and health care

    PubMed Central

    2013-01-01

    Background The ‘human resources for health’ crisis has highlighted the need for more health (care) professionals and led to an increased interest in health professional education, including master’s degree programmes. The number of these programmes in low- and middle-income countries (LMIC) is increasing, but questions have been raised regarding their relevance, outcome and impact. We conducted a systematic review to evaluate the outcomes and impact of health-related master’s degree programmes. Methods We searched the databases Scopus, Pubmed, Embase, CINAHL, ERIC, Psychinfo and Cochrane (1999 - November 2011) and selected websites. All papers describing outcomes and impact of health-related Master programmes were included. Three reviewers, two for each article, extracted data independently. The articles were categorised by type of programme, country, defined outcomes and impact, study methods used and level of evidence, and classified according to outcomes: competencies used in practice, graduates’ career progression and impact on graduates’ workplaces and sector/society. Results Of the 33 articles included in the review, most originated from the US and the UK, and only one from a low-income country. The programmes studied were in public health (8), nursing (8), physiotherapy (5), family practice (4) and other topics (8). Outcomes were defined in less than one third of the articles, and impact was not defined at all. Outcomes and impact were measured by self-reported alumni surveys and qualitative methods. Most articles reported that competencies learned during the programme were applied in the workplace and alumni reported career progression or specific job changes. Some articles reported difficulties in using newly gained competencies in the workplace. There was limited evidence of impact on the workplace. Only two articles reported impact on the sector. Most studies described learning approaches, but very few described a mechanism to ensure outcome

  13. Long-Term Refugee Health: Health Behaviors and Outcomes of Cambodian Refugee and Immigrant Women.

    PubMed

    Nelson-Peterman, Jerusha L; Toof, Robin; Liang, Sidney L; Grigg-Saito, Dorcas C

    2015-12-01

    Refugees in the United States have high rates of chronic disease. Both long-term effects of the refugee experience and adjustment to the U.S. health environment may contribute. While there is significant research on health outcomes of newly resettled refugees and long-term mental health experiences of established refugees, there is currently little information about how the combined effects of the refugee experience and the U.S. health environment are related to health practices of refugees in the years and decades after resettlement. We examined cross-sectional survey data for Cambodian refugee and immigrant women 35 to 60 years old (n = 160) from an established refugee community in Lowell, Massachusetts, to examine the potential contributors to health behaviors and outcomes among refugees and immigrants postresettlement. In our representative sample, we found that smoking and betel nut use were very low (4% each). Fewer than 50% of respondents walked for at least 10 minutes on 2 or more days/week. Using World Health Organization standards for overweight/obese for Asians, 73% of respondents were overweight/obese and 56% were obese, indicating increased risk of chronic disease. Depression was also high in this sample (41%). In multivariate models, higher acculturation and age were associated with walking more often; lower education and higher acculturation were related to higher weight; and being divorced/separated or widowed and being older were related to higher risk of depression. The interrelated complex of characteristics, health behaviors, and health outcomes of refugees merits a multifaceted approach to health education and health promotion for long-term refugee health. PMID:26157042

  14. Asset health monitors: development, sustainment, advancement

    NASA Astrophysics Data System (ADS)

    Mauss, Fredrick J.

    2011-04-01

    Pacific Northwest National Laboratory (PNNL) has developed the Captive Carry Health Monitor Unit (HMU) and the Humidity Indicator HMU. Each of these devices provides end users information that can be used to ensure the proper maintenance and performance of the missile. These two efforts have led to the ongoing development and evolution of the next generation Captive Carry HMU and the next generation Humidity Indicator HMU. These next generation efforts are in turn, leading to the future of HMUs. This evolutionary development process inherently allows for direct and indirect impact toward new HMU functionality, operability and performance characteristics by influencing their requirements, testing, communications, data archival, and user interaction. Current designs allow systems to operate in environments outside the limits of typical consumer electronics for up to or exceeding 10 years. These designs are battery powered and typically provided in custom mechanical packages that employ sensors for temperature, shock/vibration, and humidity measurements. The data taken from these sensors is then analyzed onboard using unique algorithms. The algorithms are developed from test data and fielded prototypes. Onboard data analysis provides field users with a simple indication of missile exposure. The HMU provides missile readiness information to the user based on storage and use conditions observed. To continually advance current designs PNNL evaluates the potential for enhancing sensor capabilities by improving performance or power saving features, increasing algorithm and processing abilities, and adding new features. Future work at PNNL includes the utilization of power harvesting, using a defined wireless protocol, and defining a data/information structure. These efforts will lead to improved performance allowing the HMUs to benefit users with direct access to HMUs in the field as well as benefiting those with the ability to make strategic and high-level supply and

  15. A review of health outcomes in patients with psoriasis.

    PubMed

    Li, Kai; Armstrong, April W

    2012-01-01

    Psoriasis, a chronic inflammatory skin condition, is a complex disease in terms of its significant comorbidities and impact on patients' quality of life. The objective of this article is to elucidate the health outcomes of the disease, including its economic and psychosocial burden on the patient. Current treatments options and the economic considerations of treatment costs are reviewed. Psoriasis is a multidimensional disease, so patients benefit from having a multidisciplinary team of dermatologists and other physicians for management of it and of associated comorbid conditions. PMID:22117868

  16. The impact of Telephonic Health Coaching on Health Outcomes in a High-risk Population

    PubMed Central

    Jonk, Yvonne; O'Connor, Heidi; Riise, Kirsten Sundgaard; Eisenberg, David M.; Kreitzer, Mary Jo

    2013-01-01

    Background: Health coaching is a client-centric process to increase motivation and self-efficacy that supports sustainable lifestyle behavior changes and active management of health conditions. This study describes an intervention offered as a benefit to health plan members and examines health and behavioral outcomes of participants. Methods: High-risk health plan enrollees were invited to participate in a telephonic health coaching intervention addressing the whole person and focusing on motivating health behavior changes. Outcomes of self-reported lifestyle behaviors, perceived health, stress levels, quality of life, readiness to make changes, and patient activation levels were reported at baseline and upon program completion. Retrospectively, these data were extracted from administrative and health coaching records of participants during the first 2 full years of the program. Results: Less than 7% of the 114 615 potential candidates self-selected to actively participate in health coaching, those with the highest chronic disease load being the most likely to participate. Of 6940 active participants, 1082 fully completed health inventories, with 570 completing Patient Activation Measure (PAM). The conditions most often represented in the active participants were depression, congestive heart failure, diabetes, hyperlipidemia, hypertension, osteoporosis, asthma, and low back pain. In 6 months or less, 89% of participants met at least one goal. Significant improvements occurred in stress levels, healthy eating, exercise levels, and physical and emotional health, as well as in readiness to make change and PAM scores. Discussion: The types of client-selected goals most often met were physical activity, eating habits, stress management, emotional health, sleep, and pain management, resulting in improved overall quality of life regardless of condition. Positive shifts in activation levels and readiness to change suggest that health coaching is an intervention deserving

  17. Strategies for Monitoring Outcomes in HIV-Exposed Uninfected Children in the United Kingdom

    PubMed Central

    Thorne, Claire; Tookey, Pat

    2016-01-01

    Surveillance of pregnancies in women living with HIV is carried out on a national basis in the United Kingdom (UK) through the National Study of HIV in Pregnancy and Childhood. There are currently around 1100–1200 HIV-exposed uninfected (HEU) infants born every year in the UK, where vertical transmission of HIV now occurs in fewer than 5 in every 1000 pregnancies. By the end of 2014, there was a cumulative total of more than 15,000 HEU children with any combination antiretroviral therapy (cART) exposure and more than 5000 with cART exposure from conception in the UK. HEU infants are increasingly being exposed to newer antiretroviral drugs for which less is known regarding both short- and long-term safety. In this commentary, we describe the approaches that have been taken to explore health outcomes in HEU children born in the UK. This includes the Children exposed to AntiRetroviral Therapy (CHART) Study, which was a consented follow-up study carried out in 2002–2005 of HEU children born in 1996–2004. The CHART Study showed that 4% of HEU children enrolled had a major health or development problem in early childhood; this was within expected UK norms, but the study was limited by small numbers and short-term follow-up. However, the problems with recruitment and retention that were encountered within the CHART Study demonstrated that comprehensive, clinic-based follow-up was not a feasible approach for long-term assessment of HEU children in the UK. We describe an alternative approach developed to monitor some aspects of their long-term health, involving the “flagging” of HEU infants for death and cancer registration with the UK Office for National Statistics. Some of the ethical concerns regarding investigation of long-term outcomes of in utero and perinatal exposure to antiretrovirals, including those relating to consent and confidentiality, are also discussed. PMID:27242792

  18. Strategies for Monitoring Outcomes in HIV-Exposed Uninfected Children in the United Kingdom.

    PubMed

    Thorne, Claire; Tookey, Pat

    2016-01-01

    Surveillance of pregnancies in women living with HIV is carried out on a national basis in the United Kingdom (UK) through the National Study of HIV in Pregnancy and Childhood. There are currently around 1100-1200 HIV-exposed uninfected (HEU) infants born every year in the UK, where vertical transmission of HIV now occurs in fewer than 5 in every 1000 pregnancies. By the end of 2014, there was a cumulative total of more than 15,000 HEU children with any combination antiretroviral therapy (cART) exposure and more than 5000 with cART exposure from conception in the UK. HEU infants are increasingly being exposed to newer antiretroviral drugs for which less is known regarding both short- and long-term safety. In this commentary, we describe the approaches that have been taken to explore health outcomes in HEU children born in the UK. This includes the Children exposed to AntiRetroviral Therapy (CHART) Study, which was a consented follow-up study carried out in 2002-2005 of HEU children born in 1996-2004. The CHART Study showed that 4% of HEU children enrolled had a major health or development problem in early childhood; this was within expected UK norms, but the study was limited by small numbers and short-term follow-up. However, the problems with recruitment and retention that were encountered within the CHART Study demonstrated that comprehensive, clinic-based follow-up was not a feasible approach for long-term assessment of HEU children in the UK. We describe an alternative approach developed to monitor some aspects of their long-term health, involving the "flagging" of HEU infants for death and cancer registration with the UK Office for National Statistics. Some of the ethical concerns regarding investigation of long-term outcomes of in utero and perinatal exposure to antiretrovirals, including those relating to consent and confidentiality, are also discussed. PMID:27242792

  19. US Valuation of Health Outcomes Measured Using the PROMIS-29

    PubMed Central

    Craig, Benjamin M.; Reeve, Bryce B.; Brown, Paul M.; Cella, David; Hays, Ron D.; Lipscomb, Joseph; Pickard, A. Simon; Revicki, Dennis A.

    2015-01-01

    Objectives Health valuation studies enhance economic evaluations of treatments by estimating the value of health-related quality of life (HRQoL). The Patient-Reported Outcomes Measurement Information System® (PROMIS) includes a 29-item short-form HRQOL measure, the PROMIS-29. Methods To value PROMIS-29 responses on a quality-adjusted life year (QALY) scale, we conducted a national survey (N=7557) using quota sampling based on the US 2010 Census. Based on 541 paired comparisons with over 350 responses each, pair-specific probabilities were incorporated into a weighted least-squared estimator. Results All losses in HRQoL influenced choice; however, respondents valued losses in physical function, anxiety, depression, sleep, and pain more than those in fatigue and social functioning. Conclusions This paper introduces a novel approach to valuing HRQoL for economic evaluations using paired comparisons and provides a tool to translate PROMIS-29 responses into QALYs. PMID:25498780

  20. Attention-deficit/hyperactivity disorder and adverse health outcomes

    PubMed Central

    Nigg, Joel

    2015-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is defined by extreme levels of inattention–disorganization and/or hyperactivity–impulsivity. In DSM-IV, the diagnostic criteria required impairment in social, academic, or occupational functioning. With DSM-5 publication imminent in 2013, further evaluation of impairment in ADHD is timely. This article reviews the current state of knowledge on health-related impairments of ADHD, including smoking, drug abuse, accidental injury, sleep, obesity, hypertension, diabetes, and suicidal behavior. It concludes by suggesting the need for new avenues of research on mechanisms of association and the potential for ADHD to be an early warning sign for secondary prevention of some poor health outcomes. PMID:23298633

  1. Linking online sexual activities to health outcomes among teens.

    PubMed

    O'Sullivan, Lucia F

    2014-01-01

    New digital technologies are highly responsive to many of the developmental needs of adolescents, including their need for intimate connection and social identity. This chapter explores adolescents' use of web-based sexual information, texting and "sexting," online dating sites, role-playing games, and sexually explicit media, and presents new data comparing the interpersonal and intrapersonal health outcomes among youth who engage in online sexual activities to those who do not. Despite the media-stoked concerns surrounding adolescents' participation in online sexual activities, the ubiquity of online activities and close overlap between online and offline activities indicate that this type of behavior should not be pathologized or used as a metric of problem behavior. The chapter concludes with implications for parents, educators, researchers, counselors, and health care providers, a call to challenge our deep discomfort around adolescent sexuality and to harness these technologies in ways that help promote growth and positive development. PMID:24962361

  2. Increasing disparities between resource inputs and outcomes, as measured by certain health deliverables, in biomedical research

    PubMed Central

    Bowen, Anthony; Casadevall, Arturo

    2015-01-01

    Society makes substantial investments in biomedical research, searching for ways to better human health. The product of this research is principally information published in scientific journals. Continued investment in science relies on society’s confidence in the accuracy, honesty, and utility of research results. A recent focus on productivity has dominated the competitive evaluation of scientists, creating incentives to maximize publication numbers, citation counts, and publications in high-impact journals. Some studies have also suggested a decreasing quality in the published literature. The efficiency of society’s investments in biomedical research, in terms of improved health outcomes, has not been studied. We show that biomedical research outcomes over the last five decades, as estimated by both life expectancy and New Molecular Entities approved by the Food and Drug Administration, have remained relatively constant despite rising resource inputs and scientific knowledge. Research investments by the National Institutes of Health over this time correlate with publication and author numbers but not with the numerical development of novel therapeutics. We consider several possibilities for the growing input-outcome disparity including the prior elimination of easier research questions, increasing specialization, overreliance on reductionism, a disproportionate emphasis on scientific outputs, and other negative pressures on the scientific enterprise. Monitoring the efficiency of research investments in producing positive societal outcomes may be a useful mechanism for weighing the efficacy of reforms to the scientific enterprise. Understanding the causes of the increasing input-outcome disparity in biomedical research may improve society’s confidence in science and provide support for growing future research investments. PMID:26283360

  3. Increasing disparities between resource inputs and outcomes, as measured by certain health deliverables, in biomedical research.

    PubMed

    Bowen, Anthony; Casadevall, Arturo

    2015-09-01

    Society makes substantial investments in biomedical research, searching for ways to better human health. The product of this research is principally information published in scientific journals. Continued investment in science relies on society's confidence in the accuracy, honesty, and utility of research results. A recent focus on productivity has dominated the competitive evaluation of scientists, creating incentives to maximize publication numbers, citation counts, and publications in high-impact journals. Some studies have also suggested a decreasing quality in the published literature. The efficiency of society's investments in biomedical research, in terms of improved health outcomes, has not been studied. We show that biomedical research outcomes over the last five decades, as estimated by both life expectancy and New Molecular Entities approved by the Food and Drug Administration, have remained relatively constant despite rising resource inputs and scientific knowledge. Research investments by the National Institutes of Health over this time correlate with publication and author numbers but not with the numerical development of novel therapeutics. We consider several possibilities for the growing input-outcome disparity including the prior elimination of easier research questions, increasing specialization, overreliance on reductionism, a disproportionate emphasis on scientific outputs, and other negative pressures on the scientific enterprise. Monitoring the efficiency of research investments in producing positive societal outcomes may be a useful mechanism for weighing the efficacy of reforms to the scientific enterprise. Understanding the causes of the increasing input-outcome disparity in biomedical research may improve society's confidence in science and provide support for growing future research investments. PMID:26283360

  4. Monitoring and optimising outcomes of survivors of critical illness.

    PubMed

    Aitken, Leanne M; Marshall, Andrea P

    2015-02-01

    Recovery after critical illness can be protracted and challenging. Compromise of physical, psychological, cognitive and social function is experienced by some patients and may persist for a number of years. Measurement of recovery outcomes at regular time points throughout the critical illness and recovery pathway is necessary to identify problems and guide selection of interventions to prevent, minimise or overcome that compromise. Optimisation of factors that enhance recovery, such as sleep, nutrition and memories of intensive care, will also assist with promotion of recovery. Effective assessment of recovery requires integration of assessment of outcomes into routine clinical practice by all members of the interdisciplinary team. There must be agreement of appropriate measures and measurement timeframes alongside relevant education and training to ensure optimal assessment and use of the information gained. Assessment outcomes need to be communicated to interdisciplinary team members across the critical illness and recovery trajectory. Adequate resourcing for both the assessment activities and subsequent care is essential to improve patient outcomes after critical illness. PMID:25466983

  5. Inflatable Habitat Health Monitoring: Implementation, Lessons Learned, and Application to Lunar or Martian Habitat Health Monitoring

    NASA Technical Reports Server (NTRS)

    Rojdev, Kristina; Hong, Todd; Hafermalz, Scott; Hunkins, Robert; Valle, Gerald; Toups, Larry

    2009-01-01

    NASA's exploration mission is to send humans to the Moon and Mars, in which the purpose is to learn how to live and work safely in those harsh environments. A critical aspect of living in an extreme environment is habitation, and within that habitation element there are key systems which monitor the habitation environment to provide a safe and comfortable living and working space for humans. Expandable habitats are one of the options currently being considered due to their potential mass and volume efficiencies. This paper discusses a joint project between the National Science Foundation (NSF), ILC Dover, and NASA in which an expandable habitat was deployed in the extreme environment of Antarctica to better understand the performance and operations over a one-year period. This project was conducted through the Innovative Partnership Program (IPP) where the NSF provided the location at McMurdo Station in Antarctica and support at the location, ILC Dover provided the inflatable habitat, and NASA provided the instrumentation and data system for monitoring the habitat. The outcome of this project provided lessons learned in the implementation of an inflatable habitat and the systems that support that habitat. These lessons learned will be used to improve current habitation capabilities and systems to meet the objectives of exploration missions to the moon and Mars.

  6. Child Health and Young Adult Outcomes. NBER Working Paper No. 14482

    ERIC Educational Resources Information Center

    Currie, Janet; Stabile, Mark; Manivong, Phongsack; Roos, Leslie L.

    2008-01-01

    Previous research has shown a strong connection between birth weight and future child outcomes. But this research has not asked how insults to child health after birth affect long-term outcomes, whether health at birth matters primarily because it predicts future health or through some other mechanism, or whether health insults matter more at some…

  7. A Review of Structural Health Review of Structural Health Monitoring Literature 1996-2001.

    SciTech Connect

    Sohn, H.; Farrar, C. R.; Hemez, F. M.; Czarnecki, J. J.

    2002-01-01

    Staff members at Los Alamos National Laboratory (LANL) produced a summary of the structural health monitoring literature in 1995. This presentation will summarize the outcome of an updated review covering the years 1996 - 2001. The updated review follows the LANL statistical pattern recognition paradigm for SHM, which addresses four topics: (1) Operational Evaluation; (2) Data Acquisition and Cleansing; (3) Feature Extraction; and (4) Statistical Modeling for Feature Discrimination. The literature has been reviewed based on how a particular study addresses these four topics. A significant observation from this review is that although there are many more SHM studies being reported, the investigators, in general, have not yet fully embraced the well-developed tools from statistical pattern recognition. As such, the discrimination procedures employed are often lacking the appropriate rigor necessary for this technology to evolve beyond demonstration problems carried out in laboratory setting.

  8. Primary health care contribution to improve health outcomes in Bogota-Colombia: a longitudinal ecological analysis

    PubMed Central

    2012-01-01

    Background Colombia has a highly segmented and fragmented national health system that contributes to inequitable health outcomes. In 2004 the district government of Bogota initiated a Primary Health Care (PHC) strategy to improve health care access and population health status. This study aims to analyse the contribution of the PHC strategy to the improvement of health outcomes controlling for socioeconomic variables. Methods A longitudinal ecological analysis using data from secondary sources was carried out. The analysis used data from 2003 and 2007 (one year before and 3 years after the PHC implementation). A Primary Health Care Index (PHCI) of coverage intensity was constructed. According to the PHCI, localities were classified into two groups: high and low coverage. A multivariate analysis using a Poisson regression model for each year separately and a Panel Poisson regression model to assess changes between the groups over the years was developed. Dependent variables were infant mortality rate, under-5 mortality rate, infant mortality rate due to acute diarrheal disease and pneumonia, prevalence of acute malnutrition, vaccination coverage for diphtheria, pertussis, tetanus (DPT) and prevalence of exclusive breastfeeding. The independent variable was the PHCI. Control variables were sewerage coverage, health system insurance coverage and quality of life index. Results The high PHCI localities as compared with the low PHCI localities showed significant risk reductions of under-5 mortality (13.8%) and infant mortality due to pneumonia (37.5%) between 2003 and 2007. The probability of being vaccinated for DPT also showed a significant increase of 4.9%. The risk of infant mortality and of acute malnutrition in children under-5 years was lesser in the high coverage group than in the low one; however relative changes were not statistically significant. Conclusions Despite the adverse contextual conditions and the limitations imposed by the Colombian health

  9. Early nutrition and health: short- and long-term outcomes.

    PubMed

    Gruszfeld, Dariusz; Socha, Piotr

    2013-01-01

    Maternal diet, nutritional status during pregnancy, and the early diet of the offspring play an important role in later health. The short- and long-term outcomes of early nutrition have been extensively studied in recent decades. One of the most commonly investigated nutritional interventions is breastfeeding, which is associated with a number of positive short- and long-term outcomes. A short-term effect of breastfeeding is reduced morbidity and mortality in children from poor living conditions and in preterm infants. Breastfeeding is associated with better cognitive development and also has a long-term protective effect on obesity risk, prevalence of type 2 diabetes, and a lowering effect on blood pressure. Selected nutrients have undergone extensive investigation to show their role in disease prevention or improved development, e.g. protein intake in infancy seems to be associated with a later risk of obesity or docosahexaenoic acid supplementation has a positive impact on cognitive function. Another consideration is the fast catch-up growth in small for gestational age infants as an important factor associated with adult risk of cardiovascular problems. On the other hand, high protein and energy intake seems to be positively associated with some indicators of cognitive development. Most of the evidence comes from observational studies that cannot exclude potential confounders. Animal studies demonstrate causality but should not be directly extrapolated to humans. The number of randomized controlled studies is increasing but long-term follow-ups are necessary to obtain convincing results. The majority of these trials compare different infant formula compositions and macro- or micronutrient supplementation. One of the major questions is to define a critical (or opportunity) window and a mechanism of nutritional influence on several health outcomes. PMID:24029784

  10. Race-Ethnicity and Health Trajectories: Tests of Three Hypotheses across Multiple Groups and Health Outcomes

    PubMed Central

    Brown, Tyson H.; O’Rand, Angela M.; Adkins, Daniel E.

    2013-01-01

    Racial-ethnic disparities in static levels of health are well documented. Less is known about racial-ethnic differences in age trajectories of health. The few studies on this topic have examined only single health outcomes and focused on black-white disparities. This study extends prior research by using a life course perspective, panel data from the Health and Retirement Study, and multilevel growth curve models to investigate racial-ethnic differences in the trajectories of serious conditions and functional limitations among blacks, Mexican Americans, and whites. We test three hypotheses on the nature of racial-ethnic disparities in health across the life course (aging-as-leveler, persistent inequality, and cumulative disadvantage). Results controlling for mortality selection reveal that support for the hypotheses varies by health outcome, racial-ethnic group, and life stage. Controlling for childhood socioeconomic status, adult social and economic resources, and health behaviors reduces but does not eliminate racial-ethnic disparities in health trajectories. PMID:22940814

  11. Augmented Fish Health Monitoring; Volume I of II, Completion Report.

    SciTech Connect

    Michak, Patty

    1991-05-01

    The Bonneville Power Administration (BPA) initiated the Augmented Fish Health Monitoring project in 1986. This project was a five year interagency project involving fish rearing agencies in the Columbia Basin. Historically, all agencies involved with fish health in the Columbia Basin were conducting various levels of fish health monitoring, pathogen screening and collection. The goals of this project were; to identify, develop and implement a standardized level of fish health methodologies, develop a common data collection and reporting format in the area of artificial production, evaluate and monitor water quality, improve communications between agencies and provide annual evaluation of fish health information for production of healthier smolts. This completion report will contain a project evaluation, review of the goals of the project, evaluation of the specific fish health analyses, an overview of highlights of the project and concluding remarks. 8 refs., 1 fig., 4 tabs.

  12. Prospective monitoring improves outcomes of primary total hip replacement: a cohort study

    PubMed Central

    Streubel, Philipp N; Pachón, Marcela; Kerguelén, Carlos A; Navas, José; Portocarrero, Julio; Pesantez, Rodrigo F; Zayed, Gamal; Carrillo, Germán; Llinás, Adolfo M

    2009-01-01

    Background Over the past decade several studies have questioned current standards of patient safety in health care delivery. In response, our institution started a clinical pathway for total hip replacement in 1996. Prospective monitoring with regular feedback sessions to the individuals involved in patient care did however not start until 2003. The present study evaluates the effect of prospective monitoring on outcomes of total hip replacement. Methods Clinical records of patients undergoing primary elective total hip replacement between 1997 and 2004 were reviewed. Data on adverse events as well as adherence to protocols for venous thromboembolism prophylaxis were extracted retrospectively for the period 1997 to 2001 and prospectively from 2003 to 2004. Results were compared and analyzed in order to establish possible improvement in outcomes. Data was analyzed with Chi-square or Fisher's Exact test for categorical variables and Student's t-test for continuous variables. Alpha was set as less than 5% and analysis was performed with Stata 9.0 for Macintosh. Results Two-hundred and eighty-three patients were included from 1997 to 2001, and 62 from 2003 to 2004. Mean age, male to female ratio and initial diagnosis were similar in both groups. At least one adverse event occurred in 45% of patients in 1997–2001 and in 21% in 2003–2004 (p < 0.001). In-hospital hip dislocations occurred in 6% and 0% (p = 0.05), oliguria in 19% and 5% (p = 0.007), SSI and VTE in 3% and 0% (p = 0.37), adverse drug reactions in 11% and 13% (p = 0.66) and non-adherence to VTE prophylaxis protocols in 15% and 2% of cases respectively (p = 0.002). Conclusion Overall rate of adverse events as well as in-hospital hip dislocations, oliguria and non-adherence to VTE prophylaxis protocols were significantly reduced during the second period. We conclude that clinical pathways alone are insufficient to improve patient safety and require prospective monitoring and continuous feedback to health

  13. Sedentary Behavior and Health Outcomes: An Overview of Systematic Reviews

    PubMed Central

    de Rezende, Leandro Fornias Machado; Rodrigues Lopes, Maurício; Rey-López, Juan Pablo; Matsudo, Victor Keihan Rodrigues; Luiz, Olinda do Carmo

    2014-01-01

    Objective 1) To synthesize the current observational evidence for the association between sedentary behavior and health outcomes using information from systematic reviews. 2) To assess the methodological quality of the systematic reviews found. Methodology/Principal Findings Medline; Excerpta Medica (Embase); PsycINFO; and Web of Science were searched for reviews published up to September 2013. Additional publications were provided by Sedentary Behaviour Research Network members. The methodological quality of the systematic reviews was evaluated using recommended standard criteria from AMSTAR. For each review, improper use of causal language in the description of their main results/conclusion was evaluated. Altogether, 1,044 review titles were identified, 144 were read in their entirety, and 27 were included. Based on the systematic reviews with the best methodological quality, we found in children and adolescents, strong evidence of a relationship between time spent in sedentary behavior and obesity. Moreover, moderate evidence was observed for blood pressure and total cholesterol, self-esteem, social behavior problems, physical fitness and academic achievement. In adults, we found strong evidence of a relationship between sedentary behavior and all-cause mortality, fatal and non-fatal cardiovascular disease, type 2 diabetes and metabolic syndrome. In addition, there is moderate evidence for incidence rates of ovarian, colon and endometrial cancers. Conclusions This overview based on the best available systematics reviews, shows that sedentary behavior may be an important determinant of health, independently of physical activity. However, the relationship is complex because it depends on the type of sedentary behavior and the age group studied. The relationship between sedentary behavior and many health outcomes remains uncertain; thus, further studies are warranted. PMID:25144686

  14. Application of ubiquitous computing in personal health monitoring systems.

    PubMed

    Kunze, C; Grossmann, U; Stork, W; Müller-Glaser, K D

    2002-01-01

    A possibility to significantly reduce the costs of public health systems is to increasingly use information technology. The Laboratory for Information Processing Technology (ITIV) at the University of Karlsruhe is developing a personal health monitoring system, which should improve health care and at the same time reduce costs by combining micro-technological smart sensors with personalized, mobile computing systems. In this paper we present how ubiquitous computing theory can be applied in the health-care domain. PMID:12451864

  15. Secure Remote Health Monitoring with Unreliable Mobile Devices

    PubMed Central

    Shin, Minho

    2012-01-01

    As the nation's healthcare information infrastructure continues to evolve, new technologies promise to provide readily accessible health information that can help people address personal and community health concerns. In particular, wearable and implantable medical sensors and portable computing devices present many opportunities for providing timely health information to health providers, public health professionals, and consumers. Concerns about privacy and information quality, however, may impede the development and deployment of these technologies for remote health monitoring. Patients may fail to apply sensors correctly, device can be stolen or compromised (exposing the medical data therein to a malicious party), low-cost sensors controlled by a capable attacker might generate falsified data, and sensor data sent to the server can be captured in the air by an eavesdropper; there are many opportunities for sensitive health data to be lost, forged, or exposed. In this paper, we design a framework for secure remote health-monitoring systems; we build a realistic risk model for sensor-data quality and propose a new health-monitoring architecture that is secure despite the weaknesses of common personal devices. For evaluation, we plan to implement a proof of concept for secure health monitoring. PMID:22910449

  16. Secure remote health monitoring with unreliable mobile devices.

    PubMed

    Shin, Minho

    2012-01-01

    As the nation's healthcare information infrastructure continues to evolve, new technologies promise to provide readily accessible health information that can help people address personal and community health concerns. In particular, wearable and implantable medical sensors and portable computing devices present many opportunities for providing timely health information to health providers, public health professionals, and consumers. Concerns about privacy and information quality, however, may impede the development and deployment of these technologies for remote health monitoring. Patients may fail to apply sensors correctly, device can be stolen or compromised (exposing the medical data therein to a malicious party), low-cost sensors controlled by a capable attacker might generate falsified data, and sensor data sent to the server can be captured in the air by an eavesdropper; there are many opportunities for sensitive health data to be lost, forged, or exposed. In this paper, we design a framework for secure remote health-monitoring systems; we build a realistic risk model for sensor-data quality and propose a new health-monitoring architecture that is secure despite the weaknesses of common personal devices. For evaluation, we plan to implement a proof of concept for secure health monitoring. PMID:22910449

  17. A Review of Educational Outcomes in the Children's Mental Health Treatment Literature

    ERIC Educational Resources Information Center

    Becker, Kimberly D.; Brandt, Nicole Evangelista; Stephan, Sharon H.; Chorpita, Bruce F.

    2014-01-01

    We examined the measurement of educational outcomes related to children's mental health treatments. A total of 85 papers describing 88 randomized controlled trials that included at least one educational outcome and one mental health outcome were included in these analyses. Forty-five different measures were identified as the primary educational…

  18. Exogenous Hormone Use: Oral Contraceptives, Postmenopausal Hormone Therapy, and Health Outcomes in the Nurses’ Health Study

    PubMed Central

    Grodstein, Francine; Stampfer, Meir J.; Willett, Walter C.; Hu, Frank B.; Manson, JoAnn E.

    2016-01-01

    Objectives. To review the contribution of the Nurses’ Health Study (NHS) to our understanding of the complex relationship between exogenous hormones and health outcomes in women. Methods. We performed a narrative review of the publications of the NHS and NHS II from 1976 to 2016. Results. Oral contraceptive and postmenopausal hormone use were studied in relation to major health outcomes, including cardiovascular disease and cancer. Current or recent oral contraceptive use is associated with a higher risk of cardiovascular disease (mainly among smokers), melanoma, and breast cancer, and a lower risk of colorectal and ovarian cancer. Although hormone therapy is not indicated primarily for chronic disease prevention, findings from the NHS and a recent analysis of the Women’s Health Initiative indicate that younger women who are closer to menopause onset have a more favorable risk–benefit profile than do older women from use of hormone therapy for relief of vasomotor symptoms. Conclusions. With updated information on hormone use, lifestyle factors, and other variables, the NHS and NHS II continue to contribute to our understanding of the complex relationship between exogenous hormones and health outcomes in women. PMID:27459451

  19. Health Insurance, Access to Prescription Medicines and Health Outcomes in Children: A Review

    PubMed Central

    Ungar, Wendy J; Ariely, Rinat

    2016-01-01

    SUMMARY Ensuring optimal access to medications has received increasing attention as health care systems struggle with increasing costs. Although this has been studied extensively in adults, there has been little investigation in pediatric populations, which have different health care needs. A literature review was conducted to examine the evidence regarding the relationship between insurance-mediated access to prescription medicines and outcomes in children. Twelve studies were classified according to i) uninsured versus insured, ii) type of insurance provider and iii), impact of family income. The studies demonstrated that insurance coverage and low cost-sharing are both essential to facilitate access to medications. Increased access was consistently observed for insured compared to uninsured children. Access to prescription drugs frequently differed by type of health provider organization. Adequate family income was an important determinant of access to and receipt of prescriptions. Moreover, income-indexed insurance coverage may increase unmet need. Compared to the literature on access to prescription medicines and health outcomes in adults, there have been few studies in children. Further research relating pharmaceutical policies to pediatric health outcomes is needed to strengthen the quality of policy decision-making regarding access to prescription medicines for children. PMID:19807576

  20. Social Determinants, Race, and Brain Health Outcomes: Findings from the Chicago Health and Aging Project.

    PubMed

    Aggarwal, Neelum T; Everson-Rose, Susan A; Evans, Denis A

    2015-01-01

    The broad spectrum of economic and cultural diversity in the U.S. population correlates with and affects the study of behavioral aspects of health. The purpose of this article is to provide a selective overview of research findings from the Chicago Health and Aging Project (CHAP), which covers a socio-demographically diverse population in Chicago, with a focus on role-related psychosocial factors and observed racial/ethnic differences in aging outcomes. CHAP is a longitudinal, epidemiological study of common chronic conditions of aging with an emphasis on medical, psychosocial, and environmental risk factors for the decline in cognitive function across the older adult lifespan. We briefly summarize the study design and methods used in the CHAP study and characterize the study population and describe the psychosocial data, noting black-white associations as they relate to three common brain health outcomes: cognitive function and Alzheimer's Disease, stroke, and subclinical vascular disease as noted on neuroimaging. PMID:26239039

  1. Piezoelectric Sensor Evaluation for Structural Health Monitoring of Cryogenic Structures

    NASA Technical Reports Server (NTRS)

    Lassiter, John; Engberg, Robert

    2005-01-01

    This viewgraph presentation provides an overview of Structural Health Monitoring (SHM), and profiles piezoelectric sensors useful for SHM of cryogenic structures. The presentation also profiles impedance tests and other SHM tests conducted at Marshall Space Flight Center (MSFC).

  2. CHILD HEALTH CHAMPION AIR QUALITY MONITORING AND EDUCATION PROJECT

    EPA Science Inventory

    In response to two presidential directives, EPA has created the Child Health Champion (CHC) Environmental Monitoring for Public Access and Community Tracking (EMPACT) pilot program in communities where environmental data are not widely available and significant environmental heal...

  3. Occupant Perceptions and a Health Outcome in Retail Stores

    SciTech Connect

    Zhao, Mingjie; Kim, Yang-Seon; Srebric, Jelena

    2015-11-02

    Indoor Environmental Quality (IEQ) in commercial buildings, such as retail stores, can affect employee satisfaction, productivity, and health. This study administered an IEQ survey to retail employees and found correlations between measured IEQ parameters and the survey responses. The survey included 611 employees in 14 retail stores located in Pennsylvania (climate zone 5A) and Texas (climate zone 2A). The survey questionnaire featured ratings of different aspects of IEQ, including thermal comfort, lighting and noise level, indoor smells, overall cleanness, and environmental quality. Simultaneously with the survey, on-site physical measurements were taken to collect data of relative humidity levels, air exchange rates, dry bulb temperatures, and contaminant concentrations. This data was analyzed using multinomial logit regression with independent variables being the measured IEQ parameters, employees’ gender, and age. This study found that employee perception of stuffy smells is related to formaldehyde and PM10 concentrations. Furthermore, the survey also asked the employees to report an annual frequency of common colds as a health indicator. The regression analysis showed that the cold frequency statistically correlates with the measured air exchange rates, outdoor temperatures, and indoor PM concentrations. Overall, the air exchange rate is the most influential parameter on the employee perception of the overall environmental quality and self-reported health outcome.

  4. Program Capacity to Eliminate Outcome Disparities in Addiction Health Services.

    PubMed

    Guerrero, Erick G; Aarons, Gregory A; Grella, Christine E; Garner, Bryan R; Cook, Benjamin; Vega, William A

    2016-01-01

    We evaluated program capacity factors associated with client outcomes in publicly funded substance abuse treatment organizations in one of the most populous and diverse regions of the United States. Using multilevel cross-sectional analyses of program data (n = 97) merged with client data from 2010 to 2011 for adults (n = 8,599), we examined the relationships between program capacity (leadership, readiness for change, and Medi-Cal payment acceptance) and client wait time and treatment duration. Acceptance of Medi-Cal was associated with shorter wait times, whereas organizational readiness for change was positively related to treatment duration. Staff attributes were negatively related to treatment duration. Overall, compared to low program capacity, high program capacity was negatively associated with wait time and positively related to treatment duration. In conclusion, program capacity, an organizational indicator of performance, plays a significant role in access to and duration of treatment. Implications for health care reform implementation in relation to expansion of public health insurance and capacity building to promote health equities are discussed. PMID:25450596

  5. Optimal serum 25-hydroxyvitamin D levels for multiple health outcomes.

    PubMed

    Bischoff-Ferrari, Heike A

    2014-01-01

    Recent evidence suggests that vitamin D deficiency has harmful effects on health and that recent vitamin D intake recommendations may be associated with better health outcomes. In this chapter, evidence is summarized from different studies that evaluate threshold levels for serum 25(OH)D levels in relation to bone mineral density (BMD), lower extremity function, dental health, risk of falls, fractures, cancer prevention, incident hypertension and mortality. For all endpoints, levels in the deficient range (< 50 nmol/l; < 20 ng/ml) are associated with no benefit or adverse effects, while the most advantageous serum levels for 25(OH)D appeared to be close to 75 nmol/l (30 ng/ml). An intake of 800 IU (20 microg) of vitamin D3 (cholecalciferol) per day for all adults may bring 97% of the population to level of at least 50 nmol/l and about 50% up to 75 nmol/l. Thus, higher doses of vitamin D than currently recommended are needed to bring most individuals to75 nmol/l. While estimates suggest that 1600 to 2000 IU vitamin D3 per day may successfully and safely achieve this goal, the implications of higher doses for the total adult population need to be addressed in future studies. PMID:25207384

  6. NETIMIS: Dynamic Simulation of Health Economics Outcomes Using Big Data.

    PubMed

    Johnson, Owen A; Hall, Peter S; Hulme, Claire

    2016-02-01

    Many healthcare organizations are now making good use of electronic health record (EHR) systems to record clinical information about their patients and the details of their healthcare. Electronic data in EHRs is generated by people engaged in complex processes within complex environments, and their human input, albeit shaped by computer systems, is compromised by many human factors. These data are potentially valuable to health economists and outcomes researchers but are sufficiently large and complex enough to be considered part of the new frontier of 'big data'. This paper describes emerging methods that draw together data mining, process modelling, activity-based costing and dynamic simulation models. Our research infrastructure includes safe links to Leeds hospital's EHRs with 3 million secondary and tertiary care patients. We created a multidisciplinary team of health economists, clinical specialists, and data and computer scientists, and developed a dynamic simulation tool called NETIMIS (Network Tools for Intervention Modelling with Intelligent Simulation; http://www.netimis.com ) suitable for visualization of both human-designed and data-mined processes which can then be used for 'what-if' analysis by stakeholders interested in costing, designing and evaluating healthcare interventions. We present two examples of model development to illustrate how dynamic simulation can be informed by big data from an EHR. We found the tool provided a focal point for multidisciplinary team work to help them iteratively and collaboratively 'deep dive' into big data. PMID:26879667

  7. Poverty during pregnancy: Its effects on child health outcomes

    PubMed Central

    Larson, Charles P

    2007-01-01

    It is estimated that nearly 100,000 children are born into poverty each year in Canada. During pregnancy, their mothers are likely to face multiple stressful life events, including lone-mother and teenage pregnancies, unemployment, more crowded or polluted physical environments, and far fewer resources to deal with these exposures. The early child health consequences of poverty and pregnancy are multiple, and often set a newborn child on a life-long course of disparities in health outcomes. Included are greatly increased risks for preterm birth, intrauterine growth restriction, and neonatal or infant death. Poverty has consistently been found to be a powerful determinant of delayed cognitive development and poor school performance. Behaviour problems among young children and adolescents are strongly associated with maternal poverty. Sound evidence in support of policies and programs to reduce these disparities among the poor, including the role of health practitioners, is difficult to find. This is partly because many interventions and programs targeting the poor are not properly evaluated or critically appraised. PMID:19030445

  8. 78 FR 24153 - Notice of Emergency Approval of an Information Collection; National Animal Health Monitoring...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-24

    ...; National Animal Health Monitoring System; Equine Herpesvirus Myeloencephalopathy Study AGENCY: Animal and... information collection for a National Animal Health Monitoring System Equine Herpesvirus Myeloencephalopathy...: National Animal Health Monitoring System; Equine Herpesvirus Myeloencephalopathy Study. OMB Number:...

  9. Improving the Health of People with Intellectual Disabilities: Outcomes of a Health Screening Programme after 1 Year

    ERIC Educational Resources Information Center

    Cooper, S. A.; Morrison, J.; Melville, C.; Finlayson, J.; Allan, L.; Martin, G.; Robinson, N.

    2006-01-01

    Background: People with intellectual disabilities (IDs) have a higher level of health needs, a higher level of which is unmet, compared with the general population. Health screening can detect unmet health needs, but it is unknown whether it effects beneficial health outcomes in the longer term. People with IDs are reliant on health management by…

  10. Shared Sanitation versus Individual Household Latrines: A Systematic Review of Health Outcomes

    PubMed Central

    Heijnen, Marieke; Cumming, Oliver; Peletz, Rachel; Chan, Gabrielle Ka-Seen; Brown, Joe; Baker, Kelly; Clasen, Thomas

    2014-01-01

    Background More than 761 million people rely on shared sanitation facilities. These have historically been excluded from international sanitation targets, regardless of the service level, due to concerns about acceptability, hygiene and access. In connection with a proposed change in such policy, we undertook this review to identify and summarize existing evidence that compares health outcomes associated with shared sanitation versus individual household latrines. Methods and Findings Shared sanitation included any type of facilities intended for the containment of human faeces and used by more than one household, but excluded public facilities. Health outcomes included diarrhoea, helminth infections, enteric fevers, other faecal-oral diseases, trachoma and adverse maternal or birth outcomes. Studies were included regardless of design, location, language or publication status. Studies were assessed for methodological quality using the STROBE guidelines. Twenty-two studies conducted in 21 countries met the inclusion criteria. Studies show a pattern of increased risk of adverse health outcomes associated with shared sanitation compared to individual household latrines. A meta-analysis of 12 studies reporting on diarrhoea found increased odds of disease associated with reliance on shared sanitation (odds ratio (OR) 1.44, 95% CI: 1.18–1.76). Conclusion Evidence to date does not support a change of existing policy of excluding shared sanitation from the definition of improved sanitation used in international monitoring and targets. However, such evidence is limited, does not adequately address likely confounding, and does not identify potentially important distinctions among types of shared facilities. As reliance on shared sanitation is increasing, further research is necessary to determine the circumstances, if any, under which shared sanitation can offer a safe, appropriate and acceptable alternative to individual household latrines. PMID:24743336

  11. Predictive Modeling for End-of-Life Pain Outcome using Electronic Health Records

    PubMed Central

    Lodhi, Muhammad K.; Stifter, Janet; Yao, Yingwei; Ansari, Rashid; Kee-nan, Gail M.; Wilkie, Diana J.; Khokhar, Ashfaq A.

    2016-01-01

    Electronic health record (EHR) systems are being widely used in the healthcare industry nowadays, mostly for monitoring the progress of the patients. EHR data analysis has become a big data problem as data is growing rapidly. Using a nursing EHR system, we built predictive models for determining what factors influence pain in end-of-life (EOL) patients. Utilizing different modeling techniques, we developed coarse-grained and fine-grained models to predict patient pain outcomes. The coarse-grained models help predict the outcome at the end of each hospitalization, whereas fine-grained models help predict the outcome at the end of each shift, thus providing a trajectory of predicted outcomes over the entire hospitalization. These models can help in determining effective treatments for individuals and groups of patients and support standardization of care where appropriate. Using these models may also lower the cost and increase the quality of end-of-life care. Results from these techniques show significantly accurate predictions. PMID:27500287

  12. Practice Guidelines for the Assessment of Clinically Significant Treatment Outcomes in the Children's Mental Health System.

    PubMed

    Chomycz, Suzanne; Schmidt, Fred

    2016-01-01

    The use of program evaluation to monitor client change and improve intervention effectiveness is gaining increasing importance in the mental health field. However, there is a lack of literature available in community-based clinics for those who desire to evaluate the effectiveness of services. Through this article the authors review the literature on the best methods to assess clinically significant treatment outcomes in community-based children's mental health services. The strengths and weaknesses of commonly recommended methods of evaluating change are discussed (i.e., reliable change index, percentage of improvement, normative comparisons, and effect size) using a dataset from a community-based parenting program (N = 308). PMID:26086975

  13. Subnational benchmarking of health systems performance in Africa using health outcome and coverage indicators.

    PubMed

    Noor, Abdisalan Mohamed

    2015-01-01

    National health systems performance (HSP) assessments and benchmarking are critical to understanding how well the delivery of healthcare meets the needs of citizens. Benchmarking HSP has often been done between countries to inform the global public health space. However, its impact is likely to be far greater when implemented sub-nationally to inform actual decisions on resource allocations and performance improvements, especially in high disease burden, low-income countries, where the resource envelope available for health is inadequate. In their study, Roberts and colleagues assemble, analyse and map a minimum set of health intervention and outcome indicators from 1990-2011 to assess and benchmark HSP across the 11 regions of Uganda. This is the first empirical sub-national HSP benchmarking study in the country and the results have potentially important health system policy implications. Please see related research: http://www.biomedcentral.com/1741-7015/13/285. PMID:26654445

  14. Variation In Health Outcomes: The Role Of Spending On Social Services, Public Health, And Health Care, 2000-09.

    PubMed

    Bradley, Elizabeth H; Canavan, Maureen; Rogan, Erika; Talbert-Slagle, Kristina; Ndumele, Chima; Taylor, Lauren; Curry, Leslie A

    2016-05-01

    Although spending rates on health care and social services vary substantially across the states, little is known about the possible association between variation in state-level health outcomes and the allocation of state spending between health care and social services. To estimate that association, we used state-level repeated measures multivariable modeling for the period 2000-09, with region and time fixed effects adjusted for total spending and state demographic and economic characteristics and with one- and two-year lags. We found that states with a higher ratio of social to health spending (calculated as the sum of social service spending and public health spending divided by the sum of Medicare spending and Medicaid spending) had significantly better subsequent health outcomes for the following seven measures: adult obesity; asthma; mentally unhealthy days; days with activity limitations; and mortality rates for lung cancer, acute myocardial infarction, and type 2 diabetes. Our study suggests that broadening the debate beyond what should be spent on health care to include what should be invested in health-not only in health care but also in social services and public health-is warranted. PMID:27140980

  15. Maternal health and knowledge and infant health outcomes in the Ariaal people of northern Kenya.

    PubMed

    Miller, Elizabeth M

    2011-10-01

    There is a strong link between maternal knowledge and child well-being in many populations worldwide. Fewer studies have investigated the links between indigenous systems of medical knowledge and infant outcomes in non-Western societies, such as the Ariaal people of northern Kenya. This study has four goals. First, it defines culture-specific domains of health knowledge in Ariaal mothers using the cultural consensus method, a statistical model that measures knowledge shared by a set of informants. Second, it identifies factors that predict maternal health knowledge. Third, it investigates associations between maternal health knowledge and treatment-seeking behaviors. Finally, it associates health knowledge with biomarkers of infant health. Data collection took place in two separate periods. The first data collection period (October-November 2007) enrolled 41 women to participate in an open-ended interview or true-false consensus questionnaire. The second data collection period (November 2008-January 2009) used information from the cultural consensus analysis to assess how health knowledge impacted infant health outcomes and treatment. Women and infants in this data collection period (n = 251 pairs) underwent anthropometric measurement and participated in a questionnaire that included traditional medicine consensus questions. Data were analyzed using the cultural consensus capabilities in ANTHROPAC 4.98; univariate and multivariate statistics were performed in SAS 9.2. This study found consensus in the domains of infant illness, traditional medicine, Western medicine, and treatment decision-making. Proximity to a medical dispensary and use of public health infrastructure significantly predicted higher levels of maternal health knowledge. Mothers' knowledge of traditional medicine was positively associated with treating infants at a dispensary versus at home. Finally, women with greater knowledge of traditional medicine had infants who were significantly less likely

  16. Perinatal folate supply: relevance in health outcome parameters.

    PubMed

    Fekete, Katalin; Berti, Cristiana; Cetin, Irene; Hermoso, Maria; Koletzko, Berthold V; Decsi, Tamás

    2010-10-01

    The importance of physiological supply of folate is well recognized in human health; the crucial roles of folate in one-carbon metabolism for physiological DNA synthesis and cell division, as well as in the conversion of homocysteine (Hcy) to methionine, and subsequently, to S-adenosylmethionine, have been convincingly demonstrated. Improved folate status may reduce the risk of macrocytic anaemia, cardiovascular diseases, neuropsychiatric disorders and adverse pregnancy outcomes. Inadequate folate status results in a decrease in the methylation cycle and in increased blood levels of the neurotoxic Hcy. The aim of this review is to provide insight into the influence of folate status on pregnancy health outcomes, and to consider increasing evidence of a link between the extent of genome/epigenome damage and elevated risk for adverse obstetrical endpoints. Pregnant women are at risk for folate insufficiency because of the increased need for folate for rapid fetal growth, placental development and enlargement of the uterus. Inadequate folate status may cause fetal malformations, impaired fetal growth, pre-term delivery and maternal anaemia. Even some diseases of the placenta may arise from folate deficiencies. Fetal growth seems to be vulnerable to maternal folate status during the periconception period, because it has the potential to affect both the closure of the neural tube and several epigenetic mechanisms within the placenta and the fetus. Mainly on the basis of the well recognized link between maternal folate status and fetal neural tube defects, women are advised to receive folic acid supplement during the periconceptional period. Because an adequate folate supply seems to play an important role in the implantation and development of the placenta and in improving endothelial function, folic acid supplementation in the late first trimester or early second trimester might also be beneficial. PMID:22296249

  17. Health economics and outcomes research fellowship practices reviewed.

    PubMed

    Suh, Kangho; Gabriel, Susan; Adams, Michelle A; Arcona, Steve

    2015-01-01

    The guidelines for health economics and outcomes research (HEOR) fellowship training programs devised by the American College of Clinical Pharmacy (ACCP) and the International Society of Pharmacoeconomics and Outcomes Research (ISPOR) suggest that continuous improvements are made to ensure that postgraduate training through didactic and professional experiences prepare fellows for HEOR research careers. The HEOR Fellowship Program at Novartis Pharmaceuticals Corporation was standardized to enhance the fellows' HEOR research understanding and align professional skill sets with the ACCP-ISPOR Fellowship Program Guidelines. Based on feedback from an internal task force comprised of HEOR employees and current and former fellows, the HEOR Fellowship Program was normatively and qualitatively assessed to evaluate the current curricular program. Fellowship program activities were instituted to ensure that the suggested minimum level requirements established by the guidelines were being met. Research opportunities enabling fellows to work hand-in-hand with other fellows and HEOR professionals were emphasized. Curricular enhancements in research methodology and professional training and development, and materials for a structured journal club focusing on specific methodological and HEOR research topics were developed. A seminar series (e.g., creating SMART Goals, StrengthsFinder 2.0) and professional courses (e.g., ISPOR short courses, statistics.com) were included to enhance the fellows' short- and long-term professional experience. Additional program attributes include an online reference library developed to enrich the current research facilities and a Statistical Analysis Software training program. Continuously assessing and updating HEOR fellowship programs keeps programs up-to-date in the latest HEOR concepts and approaches used to evaluate health care, both professionally and educationally. PMID:25178521

  18. Vestibulo-ocular monitoring as a predictor of outcome after severe traumatic brain injury

    PubMed Central

    2009-01-01

    Introduction Based on the knowledge that traumatic brainstem damage often leads to alteration in brainstem functions, including the vestibulo-ocular reflex, the present study is designed to determine whether prediction of outcome in the early phase after severe traumatic brain injury is possible by means of vestibulo-ocular monitoring. Methods Vestibulo-ocular monitoring is based on video-oculographic recording of eye movements during galvanic labyrinth polarization. The integrity of vestibulo-ocular reflex is determined from the eye movement response during vestibular galvanic labyrinth polarization stimulation. Vestibulo-ocular monitoring is performed within three days after traumatic brain injury and the oculomotor response compared to outcome after six months (Glasgow Outcome Score). Results Twenty-seven patients underwent vestibulo-ocular monitoring within three days after severe traumatic brain injury. One patient was excluded from the study. In 16 patients oculomotor response was induced, in the remaining 11 patients no oculomotor response was observed. The patients' outcome was classified as Glasgow Outcome Score 1-2 or as Glasgow Outcome Score 3 to 5. Statistical testing supported the hypothesis that those patients with oculomotor response tended to recover (exact two-sided Fisher-Test (P < 10-3)). Conclusions The results indicate that vestibulo-ocular monitoring with galvanic labyrinth polarization performed during the first days after traumatic brain injury helps to predict favourable or unfavourable outcome. As an indicator of brainstem function, vestibulo-ocular monitoring provides a useful, complementary approach to the identification of brainstem lesions by imaging techniques. PMID:19948056

  19. Reproductive health and pregnancy outcomes among French gulf war veterans

    PubMed Central

    Verret, Catherine; Jutand, Mathe-Aline; De Vigan, Catherine; Bégassat, Marion; Bensefa-Colas, Lynda; Brochard, Patrick; Salamon, Roger

    2008-01-01

    Background Since 1993, many studies on the health of Persian Gulf War veterans (PGWVs) have been undertaken. Some authors have concluded that an association exists between Gulf War service and reported infertility or miscarriage, but that effects on PGWV's children were limited. The present study's objective was to describe the reproductive outcome and health of offspring of French Gulf War veterans. Methods The French Study on the Persian Gulf War (PGW) and its Health Consequences is an exhaustive cross-sectional study on all French PGWVs conducted from 2002 to 2004. Data were collected by postal self-administered questionnaire. A case-control study nested in this cohort was conducted to evaluate the link between PGW-related exposures and fathering a child with a birth defect. Results In the present study, 9% of the 5,666 Gulf veterans who participated reported fertility disorders, and 12% of male veterans reported at least one miscarriage among their partners after the PGW. Overall, 4.2% of fathers reported at least one child with a birth defect conceived after the mission. No PGW-related exposure was associated with any birth defect in children fathered after the PGW mission. Concerning the reported health of children born after the PGW, 1.0% of children presented a pre-term delivery and 2.7% a birth defect. The main birth defects reported were musculoskeletal malformations (0.5%) and urinary system malformations (0.3%). Birth defect incidence in PGWV children conceived after the mission was similar to birth defect incidence described by the Paris Registry of Congenital Malformations, except for Down syndrome (PGWV children incidence was lower than Registry incidence). Conclusion This study did not highlight a high frequency of fertility disorders or miscarriage among French PGW veterans. We found no evidence for a link between paternal exposure during the Gulf War and increased risk of birth defects among French PGWV children. PMID:18442369

  20. Thiamine transporter-2 deficiency: outcome and treatment monitoring

    PubMed Central

    2014-01-01

    Background The clinical characteristics distinguishing treatable thiamine transporter-2 deficiency (ThTR2) due to SLC19A3 genetic defects from the other devastating causes of Leigh syndrome are sparse. Methods We report the clinical follow-up after thiamine and biotin supplementation in four children with ThTR2 deficiency presenting with Leigh and biotin-thiamine-responsive basal ganglia disease phenotypes. We established whole-blood thiamine reference values in 106 non-neurological affected children and monitored thiamine levels in SLC19A3 patients after the initiation of treatment. We compared our results with those of 69 patients with ThTR2 deficiency after a review of the literature. Results At diagnosis, the patients were aged 1 month to 17 years, and all of them showed signs of acute encephalopathy, generalized dystonia, and brain lesions affecting the dorsal striatum and medial thalami. One patient died of septicemia, while the remaining patients evidenced clinical and radiological improvements shortly after the initiation of thiamine. Upon follow-up, the patients received a combination of thiamine (10–40 mg/kg/day) and biotin (1–2 mg/kg/day) and remained stable with residual dystonia and speech difficulties. After establishing reference values for the different age groups, whole-blood thiamine quantification was a useful method for treatment monitoring. Conclusions ThTR2 deficiency is a reversible cause of acute dystonia and Leigh encephalopathy in the pediatric years. Brain lesions affecting the dorsal striatum and medial thalami may be useful in the differential diagnosis of other causes of Leigh syndrome. Further studies are needed to validate the therapeutic doses of thiamine and how to monitor them in these patients. PMID:24957181

  1. Monitoring fluid intake in mental health patients.

    PubMed

    Taylor, Daniel

    2016-08-17

    During my second year of nurse training, I had a clinical placement on an acute male psychiatric ward with around 20 male patients. They had a variety of mental health conditions, including depression, bipolar affective disorder and schizophrenia. PMID:27533410

  2. Youth Risk Behavior Surveillance System: Selected 2011 National Health Risk Behaviors and Health Outcomes by Sex

    ERIC Educational Resources Information Center

    Centers for Disease Control and Prevention, 2011

    2011-01-01

    The national Youth Risk Behavior Survey (YRBS) monitors priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States. The national YRBS is conducted every two years during the spring semester and provides data representative of 9th through 12th grade…

  3. Micro-Accelerometers Monitor Equipment Health

    NASA Technical Reports Server (NTRS)

    2014-01-01

    Glenn Research Center awarded SBIR funding to Ann Arbor, Michigan-based Evigia Systems to develop a miniaturized accelerometer to account for gravitational effects in space experiments. The company has gone on to implement the technology in its suite of prognostic sensors, which are used to monitor the integrity of industrial machinery. As a result, five employees have been hired.

  4. Monitoring Rangeland Health by Remote Sensing

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Based on a land-cover classification from NASA’s MODerate resolution Imaging Spectroradiometer (MODIS), rangelands cover 48% of the Earth’s land surface, not including Antarctica. Nearly all analyses imply the most economical means of monitoring large areas of rangelands worldwide is with remote s...

  5. Monitoring intervention coverage in the context of universal health coverage.

    PubMed

    Boerma, Ties; AbouZahr, Carla; Evans, David; Evans, Tim

    2014-09-01

    Monitoring universal health coverage (UHC) focuses on information on health intervention coverage and financial protection. This paper addresses monitoring intervention coverage, related to the full spectrum of UHC, including health promotion and disease prevention, treatment, rehabilitation, and palliation. A comprehensive core set of indicators most relevant to the country situation should be monitored on a regular basis as part of health progress and systems performance assessment for all countries. UHC monitoring should be embedded in a broad results framework for the country health system, but focus on indicators related to the coverage of interventions that most directly reflect the results of UHC investments and strategies in each country. A set of tracer coverage indicators can be selected, divided into two groups-promotion/prevention, and treatment/care-as illustrated in this paper. Disaggregation of the indicators by the main equity stratifiers is critical to monitor progress in all population groups. Targets need to be set in accordance with baselines, historical rate of progress, and measurement considerations. Critical measurement gaps also exist, especially for treatment indicators, covering issues such as mental health, injuries, chronic conditions, surgical interventions, rehabilitation, and palliation. Consequently, further research and proxy indicators need to be used in the interim. Ideally, indicators should include a quality of intervention dimension. For some interventions, use of a single indicator is feasible, such as management of hypertension; but in many areas additional indicators are needed to capture quality of service provision. The monitoring of UHC has significant implications for health information systems. Major data gaps will need to be filled. At a minimum, countries will need to administer regular household health surveys with biological and clinical data collection. Countries will also need to improve the production of

  6. Health Outcomes of HIV-Infected People with Mental Illness

    PubMed Central

    Yehia, Baligh R.; Stephens-Shield, Alisa J.; Momplaisir, Florence; Taylor, Lynne; Gross, Robert; Dubé, Benoit; Glanz, Karen; Brady, Kathleen A.

    2015-01-01

    Improving outcomes for people with HIV and mental illness will be critical to meeting the goals of the US National HIV/AIDS Strategy. In a retrospective analysis of the 2008–2010 cycles of the locally representative Philadelphia Medical Monitoring Project, we compared the proportions of HIV-infected adults with and without mental illness: (1) retained in care (≥2 primary HIV visits separated by ≥90 days in a 12-month period); (2) prescribed antiretroviral therapy (ART) at any point in a 12-month period; and (3) virally suppressed (HIV-1 RNA ≤200 copies/mL at the last measure in the 12-month period). Multivariable regression assessed associations between mental illness and the outcomes, adjusting for age, gender, race/ethnicity, insurance, alcohol abuse, injection drug use, CD4 count, and calendar year. Of 730 HIV-infected persons, representative of 9409 persons in care for HIV in Philadelphia, 49.0 % had mental illness. In adjusted analyses, there were no significant differences in retention (91.3 vs. 90.3 %; AOR 1.30, 95 % CI 0.63–2.56) and prescription of ART (83.2 vs. 88.7 %; AOR 0.79, 95 % CI 0.49–1.25) between those with and without mental illness. However, mentally ill patients were less likely to achieve viral suppression than those without mental illness (65.9 vs. 74.4 %; AOR 0.64, 95 % CI 0.46–0.90). These findings argue for the need to optimize ART adherence in this population. PMID:25931243

  7. Health Outcomes of HIV-Infected People with Mental Illness.

    PubMed

    Yehia, Baligh R; Stephens-Shield, Alisa J; Momplaisir, Florence; Taylor, Lynne; Gross, Robert; Dubé, Benoit; Glanz, Karen; Brady, Kathleen A

    2015-08-01

    Improving outcomes for people with HIV and mental illness will be critical to meeting the goals of the US National HIV/AIDS Strategy. In a retrospective analysis of the 2008-2010 cycles of the locally representative Philadelphia Medical Monitoring Project, we compared the proportions of HIV-infected adults with and without mental illness: (1) retained in care (≥2 primary HIV visits separated by ≥90 days in a 12-month period); (2) prescribed antiretroviral therapy (ART) at any point in a 12-month period; and (3) virally suppressed (HIV-1 RNA ≤200 copies/mL at the last measure in the 12-month period). Multivariable regression assessed associations between mental illness and the outcomes, adjusting for age, gender, race/ethnicity, insurance, alcohol abuse, injection drug use, CD4 count, and calendar year. Of 730 HIV-infected persons, representative of 9409 persons in care for HIV in Philadelphia, 49.0 % had mental illness. In adjusted analyses, there were no significant differences in retention (91.3 vs. 90.3 %; AOR 1.30, 95 % CI 0.63-2.56) and prescription of ART (83.2 vs. 88.7 %; AOR 0.79, 95 % CI 0.49-1.25) between those with and without mental illness. However, mentally ill patients were less likely to achieve viral suppression than those without mental illness (65.9 vs. 74.4 %; AOR 0.64, 95 % CI 0.46-0.90). These findings argue for the need to optimize ART adherence in this population. PMID:25931243

  8. Optimizing Population Health and Economic Outcomes: Innovative Treatment for BPH

    PubMed Central

    2013-01-01

    Optimizing Population Health and Economic Outcomes: Innovative Treatment for Benign Prostatic Hyperplasia (BPH) Transcribed and adapted for publication by Janice L. Clarke, RN, BBA Editorial: David B. Nash, MD, MBA   S-2 Introduction   S-2 Benign Prostatic Hyperplasia (BPH)   S-3 • Overview   S-3• Current BPH Treatment Paradigm   S-4• BPH Continuum of Care: Bladder Health   S-5 New Treatment Option for BPH   S-5 • The UroLift® System   S-6• Positioning of UroLift® in BPH Treatment Paradigm   S-7 New Value Proposition   S-8 • Addressing Bladder Health: Breaking the Cycle   S-8• Cost Benefit Analysis: The Big Picture   S-8 Patient and Family Engagement   S-10 Summary   S-11 PMID:22823180

  9. Distributional Orientation and Health Outcomes in OECD Countries.

    PubMed

    Safaei, Jalil

    2015-01-01

    This study uses data from the Organisation for Economic Co-operation and Development countries over the 2008-2010 period to construct indicators of "pro-primary" and "pro-secondary" distributions. The former is concerned with the original distribution of income through the market, whereas the latter is concerned with the redistribution efforts of the government. The study ranks these countries along these dimensions to create a distributional orientation map for such countries. It finds that the Scandinavian countries occupy the top rankings in terms of equity in pro-primary distribution, followed by countries with a Bismarckian welfare state regime. The Scandinavian countries also rank very high on equity in pro-secondary distribution, along with some of the top-ranking Bismarckian countries. More significantly, the study finds that the countries' health outcomes are associated more strongly with the pro-primary distributional stance than with the pro-secondary distributional stance. A key policy implication is that to achieve better and more equitable health, it is more effective to design a level playing field for market participants in the first place, than to try to mend inequities after the fact through remedial social policy. PMID:26159174

  10. Optimal Sensor Selection for Health Monitoring Systems

    NASA Technical Reports Server (NTRS)

    Santi, L. Michael; Sowers, T. Shane; Aguilar, Robert B.

    2005-01-01

    Sensor data are the basis for performance and health assessment of most complex systems. Careful selection and implementation of sensors is critical to enable high fidelity system health assessment. A model-based procedure that systematically selects an optimal sensor suite for overall health assessment of a designated host system is described. This procedure, termed the Systematic Sensor Selection Strategy (S4), was developed at NASA John H. Glenn Research Center in order to enhance design phase planning and preparations for in-space propulsion health management systems (HMS). Information and capabilities required to utilize the S4 approach in support of design phase development of robust health diagnostics are outlined. A merit metric that quantifies diagnostic performance and overall risk reduction potential of individual sensor suites is introduced. The conceptual foundation for this merit metric is presented and the algorithmic organization of the S4 optimization process is described. Representative results from S4 analyses of a boost stage rocket engine previously under development as part of NASA's Next Generation Launch Technology (NGLT) program are presented.

  11. A Pilot Randomized Trial Evaluating Lymphedema Self-Measurement with Bioelectrical Impedance, Self-Care Adherence, and Health Outcomes

    PubMed Central

    Shih, Ya-Chen Tina; Doersam, Jennifer K.; Rhoten, Bethany Andrews; Schultze, Benjamin S.; Dietrich, Mary S.

    2014-01-01

    Abstract Background: Less than half of breast cancer survivors with lymphedema perform self-care as directed. Effective lymphedema self-care is required to obtain acceptable health outcomes. Self-Regulation Theory suggests that objective self-measurement of physiological conditions is necessary to promote self-regulation/self-care. Bioelectric Impedance Spectroscopy (BIS) represents a potential self-measurement method for arm lymphedema. The purpose of this pilot study was to examine the impact of arm self-measurement on daily self-care activities and health outcomes in breast cancer survivors with lymphedema. Methods and Results: A pilot randomized clinical trial compared outcomes between breast cancer survivors with lymphedema who self-monitored for 3 months and breast cancer survivors with lymphedema who did not self-monitor. Data were collected at baseline, months 1, 2, 3, and 4. Eighty-six women with lymphedema were screened: 62 were eligible, 50 were enrolled, 10 withdrew, and 1 had incomplete data, thus N=39. No between group differences were noted in participant characteristics. The self-monitored group had higher days of garment use (p=0.005) that remained stable after self-monitoring stopped. The median number of days of simple manual lymphatic drainage increased in the intervention group (p=0.004) with a downward trend after self-monitoring ceased. Conclusions: Objective self-monitoring of arms using BIS is possible. Self-monitoring may positively impact self-care behaviors. Highly symptomatic patients may require coaching or other psychological support to improve their self-care. Studies that combine a cognitive behavioral therapy component along with self-measurement should be considered as potential interventions to impact lymphedema self-care. Other applications of self-monitoring warrant investigation. PMID:25412401

  12. Housing Insecurity and the Association With Health Outcomes and Unhealthy Behaviors, Washington State, 2011.

    PubMed

    Stahre, Mandy; VanEenwyk, Juliet; Siegel, Paul; Njai, Rashid

    2015-01-01

    Few studies of associations between housing and health have focused on housing insecurity and health risk behaviors and outcomes. We measured the association between housing insecurity and selected health risk behaviors and outcomes, adjusted for socioeconomic measures, among 8,415 respondents to the 2011 Washington State Behavioral Risk Factor Surveillance System. Housing insecure respondents were about twice as likely as those who were not housing insecure to report poor or fair health status or delay doctor visits because of costs. This analysis supports a call to action among public health practitioners who address disparities to focus on social determinants of health risk behaviors and outcomes. PMID:26160295

  13. Monitoring and Evaluating Psychosocial Intervention Outcomes in Humanitarian Aid

    PubMed Central

    de Jong, Kaz; Ariti, Cono; van der Kam, Saskia; Mooren, Trudy; Shanks, Leslie; Pintaldi, Giovanni; Kleber, Rolf

    2016-01-01

    Existing tools for evaluating psychosocial interventions (un-validated self-reporting questionnaires) are not ideal for use in non-Western conflict settings. We implement a generic method of treatment evaluation, using client and counsellor feedback, in 18 projects in non-Western humanitarian settings. We discuss our findings from the perspective of validity and suggestions for future research. A retrospective analysis is executed using data gathered from psychosocial projects. Clients (n = 7,058) complete two (complaints and functioning) rating scales each session and counsellors rate the client’s status at exit. The client-completed pre- and post-intervention rating scales show substantial changes. Counsellor evaluation of the clients’ status shows a similar trend in improvement. All three multivariable models for each separate scale have similar associations between the scales and the investigated variables despite different cultural settings. The validity is good. Limitations are: ratings give only a general impression and clinical risk factors are not measured. Potential ceiling effects may influence change of scales. The intra and inter-rater reliability of the counsellors’ rating is not assessed. The focus on client and counsellor perspectives to evaluate treatment outcome seems a strong alternative for evaluation instruments frequently used in psychosocial programming. The session client rated scales helps client and counsellor to set mutual treatment objectives and reduce drop-out risk. Further research should test the scales against a cross-cultural valid gold standard to obtain insight into their clinical relevance. PMID:27315263

  14. Monitoring and Evaluating Psychosocial Intervention Outcomes in Humanitarian Aid.

    PubMed

    de Jong, Kaz; Ariti, Cono; van der Kam, Saskia; Mooren, Trudy; Shanks, Leslie; Pintaldi, Giovanni; Kleber, Rolf

    2016-01-01

    Existing tools for evaluating psychosocial interventions (un-validated self-reporting questionnaires) are not ideal for use in non-Western conflict settings. We implement a generic method of treatment evaluation, using client and counsellor feedback, in 18 projects in non-Western humanitarian settings. We discuss our findings from the perspective of validity and suggestions for future research. A retrospective analysis is executed using data gathered from psychosocial projects. Clients (n = 7,058) complete two (complaints and functioning) rating scales each session and counsellors rate the client's status at exit. The client-completed pre- and post-intervention rating scales show substantial changes. Counsellor evaluation of the clients' status shows a similar trend in improvement. All three multivariable models for each separate scale have similar associations between the scales and the investigated variables despite different cultural settings. The validity is good. Limitations are: ratings give only a general impression and clinical risk factors are not measured. Potential ceiling effects may influence change of scales. The intra and inter-rater reliability of the counsellors' rating is not assessed. The focus on client and counsellor perspectives to evaluate treatment outcome seems a strong alternative for evaluation instruments frequently used in psychosocial programming. The session client rated scales helps client and counsellor to set mutual treatment objectives and reduce drop-out risk. Further research should test the scales against a cross-cultural valid gold standard to obtain insight into their clinical relevance. PMID:27315263

  15. Choices in recreational water quality monitoring: new opportunities and health risk trade-offs.

    PubMed

    Nevers, Meredith B; Byappanahalli, Muruleedhara N; Whitman, Richard L

    2013-04-01

    With the recent release of new recreational water quality monitoring criteria, there are more options for regulatory agencies seeking to protect beachgoers from waterborne pathogens. Included are methods that can reduce analytical time, providing timelier estimates of water quality, but the application of these methods has not been examined at most beaches for expectation of health risk and management decisions. In this analysis, we explore health and monitoring outcomes expected at Lake Michigan beaches using protocols for indicator bacteria including culturable Escherichia coli (E. coli; EC), culturable enterococci (ENT), and enterococci as analyzed by qPCR (QENT). Correlations between method results were generally high, except at beaches with historically high concentrations of EC. The "beach action value" was exceeded most often when using EC or ENT as the target indicator; QENT exceeded the limit far less frequently. Measured water quality between years was varied. Although methods with equivalent health expectation have been established, the lack of relationship among method outcomes and annual changes in mean indicator bacteria concentrations complicates the decision-making process. The monitoring approach selected by beach managers may be a combination of available tools that maximizes timely health protection, cost efficiency, and collaboration among beach jurisdictions. PMID:23461425

  16. Choices in recreational water quality monitoring: new opportunities and health risk trade-offs

    USGS Publications Warehouse

    Nevers, Meredith B.; Byappanahalli, Muruleedhara N.; Whitman, Richard L.

    2013-01-01

    With the recent release of new recreational water quality monitoring criteria, there are more options for regulatory agencies seeking to protect beachgoers from waterborne pathogens. Included are methods that can reduce analytical time, providing timelier estimates of water quality, but the application of these methods has not been examined at most beaches for expectation of health risk and management decisions. In this analysis, we explore health and monitoring outcomes expected at Lake Michigan beaches using protocols for indicator bacteria including culturable Escherichia coli (E. coli; EC), culturable enterococci (ENT), and enterococci as analyzed by qPCR (QENT). Correlations between method results were generally high, except at beaches with historically high concentrations of EC. The “beach action value” was exceeded most often when using EC or ENT as the target indicator; QENT exceeded the limit far less frequently. Measured water quality between years was varied. Although methods with equivalent health expectation have been established, the lack of relationship among method outcomes and annual changes in mean indicator bacteria concentrations complicates the decision-making process. The monitoring approach selected by beach managers may be a combination of available tools that maximizes timely health protection, cost efficiency, and collaboration among beach jurisdictions.

  17. Approaches to integrated monitoring for environmental health impact assessment

    PubMed Central

    2012-01-01

    Although Integrated Environmental Health Monitoring (IEHM) is considered an essential tool to better understand complex environmental health issues, there is no consensus on how to develop such a programme. We reviewed four existing frameworks and eight monitoring programmes in the area of environmental health. We identified the DPSEEA (Driving Force-Pressure-State-Exposure-Effect-Action) framework as most suitable for developing an IEHM programme for environmental health impact assessment. Our review showed that most of the existing monitoring programmes have been designed for specific purposes, resulting in narrow scope and limited number of parameters. This therefore limits their relevance for studying complex environmental health topics. Other challenges include limited spatial and temporal data availability, limited development of data sharing mechanisms, heterogeneous data quality, a lack of adequate methodologies to link disparate data sources, and low level of interdisciplinary cooperation. To overcome some of these challenges, we propose a DPSEEA-based conceptual framework for an IEHM programme that would enable monitoring and measuring the impact of environmental changes on human health. We define IEHM as ‘a systemic process to measure, analyse and interpret the state and changes of natural-eco-anthropogenic systems and its related health impact over time at the same location with causative explanations across the various compartments of the cause-effect chain’. We develop a structural work process to integrate information that is based on existing environmental health monitoring programmes. Such a framework allows the development of combined monitoring systems that exhibit a large degree of compatibility between countries and regions. PMID:23171406

  18. Approaches to integrated monitoring for environmental health impact assessment.

    PubMed

    Liu, Hai-Ying; Bartonova, Alena; Pascal, Mathilde; Smolders, Roel; Skjetne, Erik; Dusinska, Maria

    2012-01-01

    Although Integrated Environmental Health Monitoring (IEHM) is considered an essential tool to better understand complex environmental health issues, there is no consensus on how to develop such a programme. We reviewed four existing frameworks and eight monitoring programmes in the area of environmental health. We identified the DPSEEA (Driving Force-Pressure-State-Exposure-Effect-Action) framework as most suitable for developing an IEHM programme for environmental health impact assessment. Our review showed that most of the existing monitoring programmes have been designed for specific purposes, resulting in narrow scope and limited number of parameters. This therefore limits their relevance for studying complex environmental health topics. Other challenges include limited spatial and temporal data availability, limited development of data sharing mechanisms, heterogeneous data quality, a lack of adequate methodologies to link disparate data sources, and low level of interdisciplinary cooperation. To overcome some of these challenges, we propose a DPSEEA-based conceptual framework for an IEHM programme that would enable monitoring and measuring the impact of environmental changes on human health. We define IEHM as 'a systemic process to measure, analyse and interpret the state and changes of natural-eco-anthropogenic systems and its related health impact over time at the same location with causative explanations across the various compartments of the cause-effect chain'. We develop a structural work process to integrate information that is based on existing environmental health monitoring programmes. Such a framework allows the development of combined monitoring systems that exhibit a large degree of compatibility between countries and regions. PMID:23171406

  19. Study monitors health effects of incinerators

    SciTech Connect

    Messer, M.E.

    1993-02-01

    Waste-burning facilities could face tougher EPA regulations if a study of complying incinerators find stack emissions contribute to respiratory disease. A study is underway to determine what, if any, are the adverse health effects on humans resulting from waste burning. Volunteers living in a 2 mile radius of an incinerator were chosen for microscopic examination of cells flushed from their nasal passages.

  20. NDE using sensor based approach to propulsion health monitoring of a turbine engine disk

    NASA Astrophysics Data System (ADS)

    Abdul-Aziz, Ali; Woike, Mark R.; Abumeri, G.; Lekki, John D.; Baaklini, George Y.

    2009-03-01

    Rotor health monitoring and on-line damage detection have been increasingly gaining interest to manufacturers of aircraft engines, primarily to increase safety of operation and lower the high maintenance costs. But health monitoring in the presence of scatter in the loading conditions, crack size, disk geometry, and material property is rather challenging. However, detection factors that cause fractures and hidden internal cracks can be implemented via noninvasive types of health monitoring and or nondestructive evaluation techniques. These evaluations go further to inspect materials discontinuities and other anomalies that have grown to become critical defects that can lead to failure. To address the bulk of these concerning issues and understand the technical aspects leading to these outcomes, a combined analytical and experimental study is being thought. Results produced from the experiments such as blade tip displacement and other data collected from tests conducted at the NASA Glenn Research Center's Rotordynamics Laboratory, a high precision spin rig, are evaluated, discussed and compared with data predicted from finite element analysis simulating the engine rotor disk spinning at various rotational speeds. Further computations using the progressive failure analysis (PFA) approach with GENOA code [6] to additionally assess the structural response, damage initiation, propagation, and failure criterion are also performed. This study presents an inclusive evaluation of an on-line health monitoring of a rotating disk and an examination for the capability of the in-house spin system in support of ongoing research under the NASA Integrated Vehicle Health Management (IVHM) program.

  1. Space Derived Health Aids (AID, Heart Monitor)

    NASA Technical Reports Server (NTRS)

    1981-01-01

    CPI's spinoff from miniaturized pace circuitry is the new heart-assist device, the AID implantable automatic pulse generator. AID pulse generator monitors the heart continuously, recognizes onset of fibrillation, then administers a corrective electrical shock. A mini- computer, a power source, and two electrodes which sense heart activity are included in the unit. An associated system was also developed. It includes an external recorder to be worn by AID patients and a physician's console to display the data stored by the recorder. System provides a record of fibrillation occurrences and the ensuing defibrillation.

  2. Excessive folic acid intake and relation to adverse health outcome.

    PubMed

    Selhub, Jacob; Rosenberg, Irwin H

    2016-07-01

    The recent increase in the intake of folic acid by the general public through fortified foods and supplements, has raised safety concern based on early reports of adverse health outcome in elderly with low B12 status who took high doses of folic acid. These safety concerns are contrary to the 2015 WHO statement that "high folic acid intake has not reliably been shown to be associated with negative healeffects". In the folic acid post-fortification era, we have shown that in elderly participants in NHANES 1999-2002, high plasma folate level is associated with exacerbation of both clinical (anemia and cognitive impairment) and biochemical (high MMA and high Hcy plasma levels) signs of vitamin B12 deficiency. Adverse clinical outcomes in association with high folate intake were also seen among elderly with low plasma B12 levels from the Framingham Original Cohort and in a study from Australia which combined three elderly cohorts. Relation between high folate and adverse biochemical outcomes were also seen in the Sacramento Area Latino Study on Aging (High Hcy, high MMA and lower TC2) and at an outpatient clinic at Yale University where high folate is associated with higher MMA in the elderly but not in the young. Potential detrimental effects of high folic acid intake may not be limited to the elderly nor to those with B12 deficiency. A study from India linked maternal high RBC folate to increased insulin resistance in offspring. Our study suggested that excessive folic acid intake is associated with lower natural killer cells activity in elderly women. In a recent study we found that the risk for unilateral retinoblastoma in offspring is 4 fold higher in women that are homozygotes for the 19 bp deletion in the DHFR gene and took folic acid supplement during pregnancy. In the elderly this polymorphism is associated with lower memory and executive scores, both being significantly worse in those with high plasma folate. These and other data strongly imply that

  3. An Integrated Health Monitoring System for Fission Surface Power

    NASA Astrophysics Data System (ADS)

    Hashemian, H. M.; Shumaker, B. D.; McCulley, J. R.; Morton, G. W.

    Based on such criteria as safety and mission success, programmatic risk, affordability, and extensibility/flexibility, the National Aeronautics and Space Administration (NASA) has chosen fission surface power (FSP) as the primary energy source for building a sustained human presence on the Moon, exploring Mars, and extremely long-duration space missions. The current benchmark FSP system has a mission life of at least 8 years during which time there is no opportunity for repair, sensor calibrations, or periodic maintenance tasks that are normally performed on terrestrial-based nuclear power plants during scheduled outages. Current technology relies heavily on real-time human interaction, monitoring and control. However; due to the long communication times between the Earth and Moon, or Mars, real-time human control is not possible, resulting in a critical need to develop autonomous health monitoring technology for FSP systems.This paper describes the design and development of an autonomous health monitoring system that will (1) provide on-line calibration monitoring, (2) reduce uncertainties in sensor measurements, and (3) provide sensor validation and fault detection capabilities for the control systems of various FSP subsystems. The health monitoring system design integrates a number of signal processing algorithms and techniques such as cross-calibration, empirical modeling using neural networks, and physical modeling under a modular signal processing platform that will enable robust sensor and system monitoring without the need for human interaction. Prototypes of the health monitoring system have been tested and validated on data acquired from preliminary subsystem testing of NASA's FSP Technology Demonstration Unit (TDU) as well as simulated laboratory data. Results from this testing have demonstrated the utility and benefits that such autonomous health monitoring systems can provide to FSP subsystems and other potential applications within NASA such as launch

  4. Wireless intelligent sensor network for autonomous structural health monitoring

    NASA Astrophysics Data System (ADS)

    Sazonov, Edward; Janoyan, Kerop; Jha, Ratan

    2004-07-01

    Life cycle monitoring of civil infrastructure such as bridges and buildings is critical to the long-term operational cost and safety of aging structures. The widespread use of Structural Health Monitoring (SHM) systems is limited due to unavailability of specialized data acquisition equipment, high cost of generic equipment, and absence of fully automatic decision support systems. The goals of the presented project include: first, design of a Wireless Intelligent Sensor and Actuator Network (WISAN) and creation of an inexpensive set of instrumentation for the tasks of structural health monitoring; second, development of a SHM method, which is suitable for autonomous structural health monitoring. The design of the wireless sensor network is aimed at applications of structural health monitoring, addressing the issues of achieving a low cost per sensor, higher reliability, sources of energy for the network nodes, energy-efficient distribution of the computational load, security and coexistence in the ISM radio bands. The practical applicability of the sensor network is increased through utilization of computational intelligence and support of signal generation capabilities. The automated SHM method is based on the method of modal strain energy, though other SHM methods will be supported as well. The automation tasks include automation of the modal identification through ambient vibrations, classification of the acquired mode shapes, and automatic evaluation of the structural health.

  5. Augmented Fish Health Monitoring; Volume II of II, Completion Report.

    SciTech Connect

    Michak, Patty

    1991-12-01

    The Bonneville Power Administration (BPA) initiated the Augmented Fish Health Monitoring project in 1986. This project was a five year interagency project involving fish rearing agencies in the Columbia Basin. Participating agencies included: Washington Department of Fisheries (WDF), Oregon Department of Fish and Wildlife, Idaho Department of Fish and Game, and the US Fish and Wildlife Service (USFWS). This is the final data report for the Augmented Fish Health Monitoring project. Data collected and sampling results for 1990 and 1991 are presented within this report. An evaluation of this project can be found in Augmented Fish Health Monitoring, Volume 1, Completion Report.'' May, 1991. Pathogen detection methods remained the same from methods described in Augmented Fish Health Monitoring, Annual Report 1989,'' May, 1990. From January 1, 1990 to June 30, 1991 fish health monitoring sampling was conducted. In 1990 21 returning adult stocks were sampled. Juvenile pre-release exams were completed on 20 yearling releases, and 13 sub-yearling releases in 1990. In 1991 17 yearling releases and 11 sub-yearling releases were examined. Midterm sampling was completed on 19 stocks in 1990. Organosomatic analysis was performed at release on index station stocks; Cowlitz spring and fall chinook, Lewis river early coho and Lyons Ferry fall chinook.

  6. Space Shuttle Main Engine: Advanced Health Monitoring System

    NASA Technical Reports Server (NTRS)

    Singer, Chirs

    1999-01-01

    The main gola of the Space Shuttle Main Engine (SSME) Advanced Health Management system is to improve flight safety. To this end the new SSME has robust new components to improve the operating margen and operability. The features of the current SSME health monitoring system, include automated checkouts, closed loop redundant control system, catastropic failure mitigation, fail operational/ fail-safe algorithms, and post flight data and inspection trend analysis. The features of the advanced health monitoring system include: a real time vibration monitor system, a linear engine model, and an optical plume anomaly detection system. Since vibration is a fundamental measure of SSME turbopump health, it stands to reason that monitoring the vibration, will give some idea of the health of the turbopumps. However, how is it possible to avoid shutdown, when it is not necessary. A sensor algorithm has been developed which has been exposed to over 400 test cases in order to evaluate the logic. The optical plume anomaly detection (OPAD) has been developed to be a sensitive monitor of engine wear, erosion, and breakage.

  7. Systematic literature review to evaluate and characterize the health economics and outcomes research studies in India

    PubMed Central

    Mishra, Divya; Nair, Sunita R.

    2015-01-01

    Aim: This systematic literature review was conducted to identify, evaluate, and characterize the variety, quality, and intent of the health economics and outcomes research studies being conducted in India. Materials and Methods: Studies published in English language between 1999 and 2012 were retrieved from Embase and PubMed databases using relevant search strategies. Two researchers independently reviewed the studies as per Cochrane methodology; information on the type of research and the outcomes were extracted. Quality of reporting was assessed for model-based health economic studies using a published 100-point Quality of Health Economic Studies (QHES) instrument. Results: Of 546 studies screened, 132 were included in the review. The broad study categories were cost-effectiveness analyses [(CEA) 54 studies], cost analyses (19 studies), and burden of illness [(BOI) 18 studies]. The outcomes evaluated were direct and indirect costs, and incremental cost-effectiveness ratio (ICER), quality-adjusted life years (QALYs), and disability-adjusted life years (DALYs). Direct medical costs assessed cost of medicines, monitoring costs, consultation and hospital charges, along with direct non-medical costs (travel and food for patients and care givers). Loss of productivity and loss of income of patients and care givers were identified as the components of indirect cost. Overall, 33 studies assessed the quality of life (QoL), and the WHO Quality of Life-BREF (WHOQOL-BREF) was the most commonly used instrument. Quality assessment for modeling studies showed that most studies were of high quality [mean (range) QHES score to be 75.5 (34-93)]. Conclusions: This review identified various patterns of pharmacoeconomic studies and good-quality CEA studies. However, there is a need for better assessment of utilization of healthcare resources in India. PMID:25657899

  8. HealthPartners adopts community business model to deepen focus on nonclinical factors of health outcomes.

    PubMed

    Isham, George J; Zimmerman, Donna J; Kindig, David A; Hornseth, Gary W

    2013-08-01

    Clinical care contributes only 20 percent to overall health outcomes, according to a population health model developed at the University of Wisconsin. Factors contributing to the remainder include lifestyle behaviors, the physical environment, and social and economic forces--all generally considered outside the realm of care. In 2010 Minnesota-based HealthPartners decided to target nonclinical community health factors as a formal part of its strategic business plan to improve public health in the Twin Cities area. The strategy included creating partnerships with businesses and institutions that are generally unaccustomed to working together or considering how their actions could help improve community health. This article describes efforts to promote healthy eating in schools, reduce the stigma of mental illness, improve end-of-life decision making, and strengthen an inner-city neighborhood. Although still in their early stages, the partnerships can serve as encouragement for organizations inside and outside health care that are considering undertaking similar efforts in their markets. PMID:23918490

  9. MEASURING THE IMPACT OF PARTICULATE MATTER REDUCTIONS BY ENVIRONMENTAL HEALTH OUTCOME INDICATORS

    EPA Science Inventory

    Quantifiable indicators will measure the progress of local and national PM reduction strategies in lowering population exposure to PM and positively impacting public health. These environmental health outcome indicators will ultimately serve to inform and evaluate environmen...

  10. A Review of Research on Health Outcomes for Workers, Home and Host Communities of Population Mobility Associated with Extractive Industries.

    PubMed

    Carney, Jason G; Gushulak, Brian D

    2016-06-01

    With a growing awareness of the association between extractive industries, the nature of work in remote locations, population mobility and health status, there is a need to advance an evidence-based approach to ensuring the health of migrant and mobile populations, and the home and host communities with whom they interact. Through a narrative synthesis of peer-reviewed and grey literature, this review examines what is known, and the nature of research activity concerning the range of health impacts determined by the social conditions inherent with population mobility alongside mining and extractive industries; and the extent to which health outcomes impact on workers, and home and host communities. While much of the literature reviewed in the study considered health in a traditional disease or illness based approach, it is clear that many risk factors for the health of mobile workers in the sector reflect broader social determinants. To support the mitigation of individual and population vulnerability to infectious disease endemics, consideration of both the etiology and the social conditions that give rise to adverse health outcomes is required, including an improvement to workers' living conditions, the expansion of diagnostic and medical services, and an approach that ensures the right to health for mobile populations. To further improve upon the rich body of research, resources are required to implement robust data collection including epidemiological surveillance, outbreak monitoring and investigation, and the long term tracking of standardized health information at both origin locations and destination communities. PMID:26902231

  11. Thermal indicating paints for ammunition health monitoring

    NASA Astrophysics Data System (ADS)

    Zunino, James L., III; Iqbal, Zafar

    2010-04-01

    Thermochromic semiconductive polymers that change color in response to external stimuli, such as heat and radiation, can be utilized to monitor the temperature range and elapsed time profiles of stored and prepositioned munitions. These polymers are being tailored to create paints and coatings that will alert Army logistic staff of dangerous temperature exposures. Irreversible indication via color change in multiple thermal bands, 145 F - 164 F (63o-73°C), 165 F - 184 F (74° - 84° C) and over 185 F (>85°C) are possible with these thermochromic polymers. The resulting active coating can be visually inspected to determine if safe temperatures were exceeded. More detailed information, including cumulative time of exposure in certain temperature bands through changes in optical chromaticity describing the vividness or dullness of a color, can be assessed using a hand-held optical densitometer.

  12. State Constitutional Commitment to Health and Health Care and Population Health Outcomes: Evidence From Historical US Data

    PubMed Central

    2015-01-01

    Objectives. I investigated whether the introduction of health and health care provisions in US state constitutions can make health systems more equitable and improve health outcomes by urging state policymakers and administrative agencies to uphold their human rights obligations at state level. Methods. I constructed a panel of infant mortality rates from 50 US states over the period 1929 through 2000 to examine their association with the timing and details of introducing a constitutional right to health and health care provisions. Results. The introduction of a stronger constitutional commitment that obligates state legislature to provide health care was associated with a subsequent reduction in the infant mortality rate of approximately 7.8%. The introduction of provisions explicitly targeting the poor was also associated with a reduction in the infant mortality rate of 6.5%. These health benefits are primarily evident in non-White populations. Conclusions. This empirical result supports Elizabeth Leonard’s view that although state constitutional rights have been poorly enforced through the judiciary, a constitutional expression of health care duties has fueled the political and social process, ultimately allowing states to identify the best way to address citizens’ health inequality concerns. PMID:25905857

  13. Analysis of Regulatory Guidance for Health Monitoring

    NASA Technical Reports Server (NTRS)

    Munns, Thomas E.; Beard, Richard E.; Culp, Aubrey M.; Murphy, Dennis A.; Kent, Renee M.; Cooper, Eric G. (Technical Monitor)

    2000-01-01

    The purpose of this study was to assess the connection between current FAA regulations and the incorporation of Health Management (HM) systems into commercial aircraft. To address the overall objectives ARINC: (1) investigated FAA regulatory guidance, (2) investigated airline maintenance practices, (3) systematically identified regulations and practices that would be affected or could act as barriers to the introduction of HM technology, and (4) assessed regulatory and operational tradeoffs that should be considered for implementation. The assessment procedure was validated on a postulated structural HM capability for the B757 horizontal stabilizer.

  14. Sensor modules for structural health monitoring and reliability of components

    NASA Astrophysics Data System (ADS)

    Kroening, Michael; Berthold, Axel; Meyendorf, Norbert

    2005-05-01

    Safety and availability of ageing infrastructures require periodic or continuous monitoring of the structure"s integrity. Innovative design criteria for new infrastructure components may allow material and energy conservation if components are continuously monitored by using advanced sensor systems. This concept for recurring Structural Health Monitoring will replace a significant part of conventional NDE by new maintenance concepts. The goal consists in sensor networks based on advanced principles of testing technology with integrated signal/data processing and data communication. NDE modeling is required for the quantification of measurement results. Finally, a decision on the integrity of the structure based on sensor results requires detailed knowledge about material behavior and modeling capacity for materials and components. IZFP has developed sensor concepts for complex solutions applicable to Structural Health Monitoring for different applications. These applications include railroad inspection, aircraft inspection, inspection of wind energy systems, power electric switches and micro gas valves. Basic concepts and applications of sensor networks will be presented.

  15. Discounting of qualitatively different delayed health outcomes in current and never smokers

    PubMed Central

    Friedel, Jonathan E.; DeHart, William B.; Frye, Charles C. J.; Rung, Jillian M.; Odum, Amy L.

    2016-01-01

    In delay discounting, temporally remote outcomes have less value. Cigarette smoking is associated with steeper discounting of money and consumable outcomes. It is presently unclear whether smokers discount health outcomes more than non-smokers. We sought to establish the generality of steep discounting for different types of health outcomes in cigarette smokers. Seventy participants (38 smokers and 32 non-smokers) completed four hypothetical outcome delay-discounting tasks: a gain of $500, a loss of $500, a temporary boost in health, and temporary cure from a debilitating disease. Participants reported the duration of each health outcome that would be equivalent to $500; these durations were then used in the respective discounting tasks. Delays ranged from 1 week to 25 years. Smokers’ indifference points for monetary gains, boosts in health, and temporary cures were lower than indifference points from non-smokers. Indifference points of one outcome were correlated with indifference points of other outcomes. Smokers demonstrate steeper discounting across a range of delayed outcomes. How a person discounts one outcome predicts how they will discount other outcomes. These two findings support our assertion that delay discounting is in part a trait. PMID:26691848

  16. Development and Applications of an Outcomes Assessment Framework for Care Management Programs in Learning Health Systems

    PubMed Central

    Wang, Lin; Kuntz-Melcavage, Kara; Forrest, Christopher B.; Lu, Yanyan; Piet, Leslie; Evans, Kathy; Uriyo, Maria; Sherry, Melissa; Richardson, Regina; Hawkins, Michelle; Neale, Donna

    2015-01-01

    Purpose: To develop and apply an outcomes assessment framework (OAF) for care management programs in health care delivery settings. Background: Care management (CM) refers to a regimen of organized activities that are designed to promote health in a population with particular chronic conditions or risk profiles, with focus on the triple aim for populations: improving the quality of care, advancing health outcomes, and lowering health care costs. CM has become an integral part of a care continuum for population-based health care management. To sustain a CM program, it is essential to assure and improve CM effectiveness through rigorous outcomes assessment. To this end, we constructed the OAF as the foundation of a systematic approach to CM outcomes assessment. Innovations: To construct the OAF, we first systematically analyzed the operation process of a CM program; then, based on the operation analysis, we identified causal relationships between interventions and outcomes at various implementation stages of the program. This set of causal relationships established a roadmap for the rest of the outcomes assessment. Built upon knowledge from multiple disciplines, we (1) formalized a systematic approach to CM outcomes assessment, and (2) integrated proven analytics methodologies and industrial best practices into operation-oriented CM outcomes assessment. Conclusion: This systematic approach to OAF for assessing the outcomes of CM programs offers an opportunity to advance evidence-based care management. In addition, formalized CM outcomes assessment methodologies will enable us to compare CM effectiveness across health delivery settings. PMID:25992387

  17. mHealthMon: toward energy-efficient and distributed mobile health monitoring using parallel offloading.

    PubMed

    Ahnn, Jong Hoon; Potkonjak, Miodrag

    2013-10-01

    Although mobile health monitoring where mobile sensors continuously gather, process, and update sensor readings (e.g. vital signals) from patient's sensors is emerging, little effort has been investigated in an energy-efficient management of sensor information gathering and processing. Mobile health monitoring with the focus of energy consumption may instead be holistically analyzed and systematically designed as a global solution to optimization subproblems. This paper presents an attempt to decompose the very complex mobile health monitoring system whose layer in the system corresponds to decomposed subproblems, and interfaces between them are quantified as functions of the optimization variables in order to orchestrate the subproblems. We propose a distributed and energy-saving mobile health platform, called mHealthMon where mobile users publish/access sensor data via a cloud computing-based distributed P2P overlay network. The key objective is to satisfy the mobile health monitoring application's quality of service requirements by modeling each subsystem: mobile clients with medical sensors, wireless network medium, and distributed cloud services. By simulations based on experimental data, we present the proposed system can achieve up to 10.1 times more energy-efficient and 20.2 times faster compared to a standalone mobile health monitoring application, in various mobile health monitoring scenarios applying a realistic mobility model. PMID:23897403

  18. I35W collapse, rebuild, and structural health monitoring - challenges associated with structural health monitoring of bridge systems

    SciTech Connect

    French, C. E.; Hedegaard, B.; Shield, C. K.; Stolarski, H.

    2011-06-23

    During evening rush hour traffic on August 1, 2007, the major interstate highway bridge carrying I35W over the Mississippi River in Minneapolis catastrophically failed, tragically taking the lives of thirteen people and injuring many more. The steel truss bridge, constructed in 1967, was undergoing deck reconstruction during the collapse, and was estimated to carry more than 140,000 vehicles daily. This tragedy generated great interest in employment of structural health monitoring systems. The I35W St. Anthony Falls Bridge, a post-tensioned concrete box bridge constructed to replace the collapsed steel truss bridge, contains over 500 instruments to monitor the structural behavior. Numerical models of the bridge are being developed and calibrated to the collected data obtained from truck load tests and thermal effects. The data obtained over the first few years of monitoring are being correlated with the calibrated models and used to develop the baseline bridge behavior. This information is being used to develop a system to monitor and interpret the long-term behavior of the bridge. This paper describes the instrumentation, preliminary results from the data and model calibration, the plan for developing long-term monitoring capabilities, and the challenges associated with structural health monitoring of bridge systems. In addition, opportunities and directions for future research required to fully realize the objectives of structural health monitoring are described.

  19. Behavioral, health, and cost outcomes of an HMO-based prenatal health education program.

    PubMed Central

    Ershoff, D H; Aaronson, N K; Danaher, B G; Wasserman, F W

    1983-01-01

    This report presents the results of an evaluation of a prenatal health education program conducted within a health maintenance organization (HMO) setting. Specifically, the behavioral, birth, and treatment-cost outcomes for 57 women in an experimental group who received individual nutrition counseling and a home-correspondence smoking cessation program were evaluated against the outcomes for 72 women in a control group who received standard prenatal care. In comparison with the controls, a greater percentage of women in the experimental group quit smoking during pregnancy (49.1 percent versus 37.5 percent). Of those who smoked throughout their pregnancy, women in the experimental group had a greater reduction in their mean rate of daily smoking. A significantly greater percentage of experimental group women adjusted their diets during the prenatal period (91 percent versus 68 percent), and particular success was achieved in increased consumption of dairy products and vegetables, decreased consumption of coffee, and adequate weight gain during pregnancy. Analysis of birth outcome data revealed that infants born to the experimental group had a significantly higher mean birth weight than infants born to the controls (121.34 oz versus 113.64 oz). The experimental group also had fewer low birth weight infants (7.0 percent versus 9.7 percent for controls). Hospital treatment cost savings associated with the reduced incidence of low birth weight infants among experimental group women yielded an overall benefit-cost ratio for the prenatal program of approximately 2:1. PMID:6419268

  20. P.Re.Val.E.: outcome research program for the evaluation of health care quality in Lazio, Italy

    PubMed Central

    2012-01-01

    Background P.Re.Val.E. is the most comprehensive comparative evaluation program of healthcare outcomes in Lazio, an Italian region, and the first Italian study to make health provider performance data available to the public. The aim of this study is to describe the P.Re.Val.E. and the impact of releasing performance data to the public. Methods P.Re.Val.E. included 54 outcome/process indicators encompassing many different clinical areas. Crude and adjusted rates were estimated for the 2006-2009 period. Multivariate regression models and direct standardization procedures were used to control for potential confounding due to individual characteristics. Variable life-adjusted display charts were developed, and 2008-2009 results were compared with those from 2006-2007. Results Results of 54 outcome indicators were published online at http://www.epidemiologia.lazio.it/prevale10/index.php. Public disclosure of the indicators' results caused mixed reactions but finally promoted discussion and refinement of some indicators. Based on the P.Re.Val.E. experience, the Italian National Agency for Regional Health Services has launched a National Outcome Program aimed at systematically comparing outcomes in hospitals and local health units in Italy. Conclusions P.Re.Val.E. highlighted aspects of patient care that merit further investigation and monitoring to improve healthcare services and equity. PMID:22283880

  1. An integrated FBG sensing system for bridge health monitoring

    NASA Astrophysics Data System (ADS)

    Sun, Ru-Jiao; Sun, Zhi; Dan, Dan-Hui; Sun, Li-Min

    2006-03-01

    Thanking to its distinguishing advantages including wavelength multiplexing capability, miniature size, high sensitivity, immunity from electro-magnetic interference and etc, the fiber Bragg grating (FBG) sensing technologies are regarded as a competent candidate for the bridge long-term health monitoring. According to the shifted Bragg wavelength of the light reflected by a fiber grating, the FBG sensors can accurately measure various physical properties such as strain, temperature, displacement, acceleration and corrosion. One special advantage of the FBG sensing technology is that only one demodulation device is required to acquire various physical properties simultaneously. Compared with the bridge health monitoring system using conventional sensors, this advantage makes the quasi-distributed sensing possible and data transmission more convenient because many FBG sensors can be connected in series by a single fiber. In this paper, an integrated FBG sensing system is presented for monitoring the physical state of a real bridge, the main-navigation channel cable-stayed bridge of the Donghai Bridge. The strain variation of two selected sections in the construction stage and during the load trial test are continuously monitored. The results of this study will supply a good guidance for the use of FBG sensors on the health monitoring of real bridges. Finally, the paper present the design and fabrication of an accelerometer based on the FBG technology for structure vibration monitoring.

  2. Psycho-social aspects of personal health monitoring: a descriptive literature review.

    PubMed

    Muehlan, Holger; Schmidt, Silke

    2013-01-01

    We aimed at providing a short review on already published studies addressing psycho-social issues of personal health monitoring (PHM). Both core questions addressed within this review are: What is the impact of PHM on intended psycho-social and health-related outcomes? And which psycho-social issues affected by or related to PHM have already been investigated? This descriptive review based on a literature search using various databases (Psycinfo, Psyndex, Pubmed, SSCI). Resulting 428 abstracts were coded regarding their psycho-social content. Inspection of results was carried out along the relevance of the papers regarding psycho-social issues. Research in PHM focuses on telemonitoring and smart home applications: Tele-monitoring studies are directed to outcome-related questions, smart home studies to feasibility issues. Despite of technological matters, comparability of both systems in psycho-social issues is lacking. Tele-monitoring has been proven for impact on patient groups with chronic diseases, yet smart home still lacks evidence in health-related and psycho-social matters. Smart home applications have been investigated with respect to attitudes, perceptions and concerns of end-users, telemonitoring regarding acceptance and adherence. PMID:23920455

  3. Sensing platforms for structural health monitoring

    NASA Astrophysics Data System (ADS)

    Zheng, Shijie; Naik, Gautam; Chen, Zhongbi; Zhu, Yinian; Krishnaswamy, Sridhar

    2013-04-01

    The emerging concept of structural health management relies on extensive onboard diagnostic sensors that can provide near real-time information about the state of a structure so that informed prognostic assessment can be made of the continuing reliability of the structure. In this paper, we will discuss two types of sensing platforms that can provide valuable information about the state of a structure: 1D fiber-optic sensors and 2D thin-film sensors. Both fiber-optic and thin film sensors are easily integrated with structures, and can offer local and/or distributed sensing capabilities. Parameters that can be sensed include: static and dynamic strain, acoustic emission, vibration, corrosion products, moisture ingression etc. We will first describe some recent developments in dynamic strain sensing using optical fiber Bragg grating (FBG) sensors. Applications to detection of acoustic emission and impact will be described. In the area of chemical sensing, we will describe a nanofilm-coated photonic crystal fiber (PCF) long-period grating (LPG) sensing platform. PCF-LPG sensors can be designed to provide greater interaction between the analyte of interest and the light propagating in the fiber, thereby increasing the sensitivity of detection. Applications to humidity sensing will be described. Finally, 2D thin-film sensors on polymer substrates will be discussed. One type of sensor we have been fabricating is based on reduced graphene oxide for large-area chemical sensing applications. It is expected that these 1D and 2D sensing platforms will form part of a suite of sensors that can provide diagnostic structural health information.

  4. Structural Health Monitoring of AN Aircraft Joint

    NASA Astrophysics Data System (ADS)

    Mickens, T.; Schulz, M.; Sundaresan, M.; Ghoshal, A.; Naser, A. S.; Reichmeider, R.

    2003-03-01

    A major concern with ageing aircraft is the deterioration of structural components in the form of fatigue cracks at fastener holes, loose rivets and debonding of joints. These faults in conjunction with corrosion can lead to multiple-site damage and pose a hazard to flight. Developing a simple vibration-based method of damage detection for monitoring ageing structures is considered in this paper. The method is intended to detect damage during operation of the vehicle before the damage can propagate and cause catastrophic failure of aircraft components. It is typical that only a limited number of sensors could be used on the structure and damage can occur anywhere on the surface or inside the structure. The research performed was to investigate use of the chirp vibration responses of an aircraft wing tip to detect, locate and approximately quantify damage. The technique uses four piezoelectric patches alternatively as actuators and sensors to send and receive vibration diagnostic signals.Loosening of selected screws simulated damage to the wing tip. The results obtained from the testing led to the concept of a sensor tape to detect damage at joints in an aircraft structure.

  5. Does home blood pressure monitoring improve patient outcomes? A systematic review comparing home and ambulatory blood pressure monitoring on blood pressure control and patient outcomes

    PubMed Central

    Breaux-Shropshire, Tonya L; Judd, Eric; Vucovich, Lee A; Shropshire, Toneyell S; Singh, Sonal

    2015-01-01

    Objective Our objective was to compare the clinical effectiveness of home blood pressure monitoring (HBPM) and 24-hour ambulatory blood pressure monitoring (ABPM) on blood pressure (BP) control and patient outcomes. Design A systematic review was conducted. We also appraised the methodological quality of studies. Data sources PubMed, Scopus, CINAHL, and the Cochrane Central Register of Control Trials (CENTRAL). Inclusion criteria Randomized control trials, prospective and retrospective cohort studies, observational studies, and case-control studies published in English from any year to present that describe HBPM and 24-hour ABPM and report on systolic and/or diastolic BP and/or heart attack, stroke, kidney failure and/or all-cause mortality for adult patients. Due to the nature of the question, studies with only untreated patients were not considered. Results Of 1,742 titles and abstractions independently reviewed by two reviewers, 137 studies met predetermined criteria for evaluation. Nineteen studies were identified as relevant and included in the paper. The common themes were that HBPM and ABPM correlated with cardiovascular events and mortality, and targeting HBPM or ABPM resulted in similar outcomes. Associations between BP measurement type and mortality differed by study population. Both the low sensitivity of office blood pressure monitoring (OBPM) to detect optimal BP control by ABPM and the added association of HBPM with cardiovascular mortality supported the routine use of HBPM in clinical practice. There was insufficient data to determine the benefit of using HBPM as a measurement standard for BP control. Conclusion HBPM encourages patient-centered care and improves BP control and patient outcomes. Given the limited number of studies with both HBPM and ABPM, these measurement types should be incorporated into the design of randomized clinical trials within hypertensive populations. PMID:26170715

  6. Structural Health Monitoring Analysis for the Orbiter Wing Leading Edge

    NASA Technical Reports Server (NTRS)

    Yap, Keng C.

    2010-01-01

    This viewgraph presentation reviews Structural Health Monitoring Analysis for the Orbiter Wing Leading Edge. The Wing Leading Edge Impact Detection System (WLE IDS) and the Impact Analysis Process are also described to monitor WLE debris threats. The contents include: 1) Risk Management via SHM; 2) Hardware Overview; 3) Instrumentation; 4) Sensor Configuration; 5) Debris Hazard Monitoring; 6) Ascent Response Summary; 7) Response Signal; 8) Distribution of Flight Indications; 9) Probabilistic Risk Analysis (PRA); 10) Model Correlation; 11) Impact Tests; 12) Wing Leading Edge Modeling; 13) Ascent Debris PRA Results; and 14) MM/OD PRA Results.

  7. Conformal and embedded IDT microsensors for health monitoring of structures

    NASA Astrophysics Data System (ADS)

    Varadan, Vijay K.; Varadan, Vasundara V.

    2000-06-01

    MEMS are currently being applied to the structural health monitoring of critical aircraft components and composites. The approach integrates acoustic emission, strain gauges, MEMS accelerometers and vibration monitoring aircraft components with a known history of catastrophic failure due to fracture. Recently a combination of the need for safety in the air and the desire to control costs is encouraging the use of in-flight monitoring of aircraft components and systems using light-weight, wireless and cost effective microsensors and MEMS. An in-situ aircraft structural health monitoring system, with sensors embedded in the composite structure or surface-mounted on the structure, would permit the timely detection of damage in aircraft. Micromachining offers the potential for fabricating a range of microsensor and MEMS for structural applications including load, vibration and acoustics characterization and monitoring. Such microsensors are extremely small; they can be embedded into structural materials, can be mass-produced and are therefore potentially cheap. The smart sensors are being developed using the standard microelectronics and micromachining in conjunction with novel Penn State wireless communication systems suitable for condition monitoring of aircraft structures in-flight. The main application areas of this investigation include continuos monitoring of a) structural integrity of aging aircraft, b) fatigue cracking, c) corrosion, d) deflection and strain of aircraft structures, wings, and rotorblades, e) impact damage, f) delamination and g) location and propagation of cracks. In this paper we give an overview of wireless programmable microsensors and MEMS and their associated driving electronics for such applications.

  8. Monitoring Rangeland Health With MODIS Vegetation Index Data

    NASA Astrophysics Data System (ADS)

    Brown, J. F.

    2004-12-01

    Rangelands cover approximately one third of the land area of the conterminous U.S. These lands supply much of the forage for the U.S. cattle industry. Large area monitoring of these vast expanses of range has proved challenging since most of these lands are in the western U.S., are relatively sparsely populated, and are not well covered by meteorological weather stations. Improvements in the spatial and temporal precision of rangeland health information would be useful both for the cattle industry and for scientific studies of soil erosion, water runoff, ecosystem health, and carbon cycling. Optical multispectral remote sensing data from satellites are an objective source of synoptic, timely information for monitoring rangeland health. The objective of this study is to develop and evaluate a method for measuring and monitoring rangeland health over large areas. In the past, data collected by the Advanced Very High Resolution Radiometer has proved useful for this purpose, however the basic 1 km spatial resolution is not ideal when scaling up from ground observations. This study assesses MODIS 250 meter resolution vegetation index data for this purpose. MODIS data not only have finer spatial resolution and improved geolocation, but they also exhibit enhanced vegetation sensitivity and minimized variations associated with external atmospheric and non-atmospheric effects. Ground data collected over 51 sites in western South Dakota over four years are used as training for regression tree models of range health. Range health maps for the growing season derived from the models are presented and evaluated.

  9. Iatrogenic risks and maternal health: Issues and outcomes

    PubMed Central

    Khaskheli, Meharun-nissa; Baloch, Shahla; Sheeba, Aneela

    2014-01-01

    Objective: To observe acute maternal morbidity and mortality due to iatrogenic factors and outcomes. Methods: This observational cross sectional study was conducted at intensive care unit of Liaquat University of Medical and Health sciences Jamshoro from 1-January-2011 to 31-December-2012. In this study all the delivered or undelivered women who needed intensive care unit (ICU) admission due to management related life threatening complication referred from periphery or within this hospital were included, while those women who had pregnancy complicated by medical conditions were excluded. These women were registered on the predesigned proforma containing variables like Demographic characteristics, various iatrogenic risk factors, complications and management out comes. The data was collected and analyzed on SPSS version 20. Results: During these study period 51 women needed ICU care for different complications due to adverse effects of medical treatments. Majority of these women were between 20-40 years of age 41(80.39%), multiparous 29(56.86%), unbooked 38(74.50%), referred from periphery 39(76.47%), common iatrogenic factors were misuse of oxytocin 16(31.37%), fluid overload/cardiac failure 8(15.68%), blood reaction 7(13.72%), anesthesia related problems were delayed recovery 3(5.88%), cardiac arrest 2(3.92%), spinal shock 2(3.92%), surgical problems were bladder injury 5(9.8%), post operative internal haemorrhage 3(5.88%), 37(72.54%) women recovered and 14(27.45%) expired. Conclusion: The maternal morbidity and mortality rate with iatrogenic factors was high and majority of these factors were avoidable. PMID:24639842

  10. Comparing the performance of English mental health providers in achieving patient outcomes.

    PubMed

    Moran, Valerie; Jacobs, Rowena

    2015-09-01

    Evidence on provider payment systems that incorporate patient outcomes is limited for mental health care. In England, funding for mental health care services is changing to a prospective payment system with a future objective of linking some part of provider payment to outcomes. This research examines performance of mental health providers offering hospital and community services, in order to investigate if some are delivering better outcomes. Outcomes are measured using the Health of the Nation Outcome Scales (HoNOS) - a clinician-rated routine outcome measure (CROM) mandated for national use. We use data from the Mental Health Minimum Data Set (MHMDS) - a dataset on specialist mental health care with national coverage - for the years 2011/12 and 2012/13 with a final estimation sample of 305,960 observations with follow-up HoNOS scores. A hierarchical ordered probit model is used and outcomes are risk adjusted with independent variables reflecting demographic, need, severity and social indicators. A hierarchical linear model is also estimated with the follow-up total HoNOS score as the dependent variable and the baseline total HoNOS score included as a risk-adjuster. Provider performance is captured by a random effect that is quantified using Empirical Bayes methods. We find that worse outcomes are associated with severity and better outcomes with older age and social support. After adjusting outcomes for various risk factors, variations in performance are still evident across providers. This suggests that if the intention to link some element of provider payment to outcomes becomes a reality, some providers may gain financially whilst others may lose. The paper contributes to the limited literature on risk adjustment of outcomes and performance assessment of providers in mental health in the context of prospective activity-based payment systems. PMID:26218853

  11. PILOT VOLUNTEER TRAINING FOR WETLAND MONITORING AND HEALTH ASSESSMENT

    EPA Science Inventory

    Massachusetts Bays Estuary Program expressed a need to better assess and monitor the health of their saltmarshes. By training citizen volunteers in the methodologies of saltmarsh bioassessment, Mass Bays saw the additional opportunity to engage the public in their estuary protec...

  12. Course Modules on Structural Health Monitoring with Smart Materials

    ERIC Educational Resources Information Center

    Shih, Hui-Ru; Walters, Wilbur L.; Zheng, Wei; Everett, Jessica

    2009-01-01

    Structural Health Monitoring (SHM) is an emerging technology that has multiple applications. SHM emerged from the wide field of smart structures, and it also encompasses disciplines such as structural dynamics, materials and structures, nondestructive testing, sensors and actuators, data acquisition, signal processing, and possibly much more. To…

  13. STRUCTURAL HEALTH MONITORING OF COMPOSITE LAMINATES WITH EMBEDDED PIEZOELECTRIC FIBERS

    SciTech Connect

    Lissenden, Cliff J.; Puthillath, Padma K.; Blackshire, James L.

    2009-03-03

    The actuation of ultrasonic guided waves in a carbon fiber reinforced polymer plate from embedded metal core piezoelectric fibers is studied for structural health monitoring applications. A linear array of fibers embedded at the midplane can generate guided waves transverse to the fiber direction. Finite element simulations show that a significant source influence is associated with the small diameter piezoelectric fibers.

  14. Nonlinear feature identification of impedance-based structural health monitoring

    SciTech Connect

    Rutherford, A. C.; Park, G. H.; Sohn, H.; Farrar, C. R.

    2004-01-01

    The impedance-based structural health monitoring technique, which utilizes electromechanical coupling properties of piezoelectric materials, has shown feasibility for use in a variety of structural health monitoring applications. Relying on high frequency local excitations (typically > 30 kHz), this technique is very sensitive to minor changes in structural integrity in the near field of piezoelectric sensors. Several damage sensitive features have been identified and used coupled with the impedance methods. Most of these methods are, however, limited to linearity assumptions of a structure. This paper presents the use of experimentally identified nonlinear features, combined with impedance methods, for structural health monitoring. Their applicability to damage detection in various frequency ranges is demonstrated using actual impedance signals measured from a portal frame structure. The performance of the nonlinear feature is compared with those of conventional impedance methods. This paper reinforces the utility of nonlinear features in structural health monitoring and suggests that their varying sensitivity in different frequency ranges may be leveraged for certain applications.

  15. Dynamic Structural Health Monitoring of Slender Structures Using Optical Sensors

    PubMed Central

    Antunes, Paulo; Travanca, Rui; Rodrigues, Hugo; Melo, José; Jara, José; Varum, Humberto; André, Paulo

    2012-01-01

    In this paper we summarize the research activities at the Instituto de Telecomunicações—Pólo de Aveiro and University of Aveiro, in the field of fiber Bragg grating based sensors and their applications in dynamic measurements for Structural Health Monitoring of slender structures such as towers. In this work we describe the implementation of an optical biaxial accelerometer based on fiber Bragg gratings inscribed on optical fibers. The proof-of-concept was done with the dynamic monitoring of a reinforced concrete structure and a slender metallic telecommunication tower. Those structures were found to be suitable to demonstrate the feasibility of FBG accelerometers to obtain the structures' natural frequencies, which are the key parameters in Structural Health Monitoring and in the calibration of numerical models used to simulate the structure behavior. PMID:22778661

  16. A Survey of Current Rotorcraft Propulsion Health Monitoring Technologies

    NASA Technical Reports Server (NTRS)

    Delgado, Irebert R.; Dempsey, Paula J.; Simon, Donald L.

    2012-01-01

    A brief review is presented on the state-of-the-art in rotorcraft engine health monitoring technologies including summaries on current practices in the area of sensors, data acquisition, monitoring and analysis. Also, presented are guidelines for verification and validation of Health Usage Monitoring System (HUMS) and specifically for maintenance credits to extend part life. Finally, a number of new efforts in HUMS are summarized as well as lessons learned and future challenges. In particular, gaps are identified to supporting maintenance credits to extend rotorcraft engine part life. A number of data sources were consulted and include results from a survey from the HUMS community, Society of Automotive Engineers (SAE) documents, American Helicopter Society (AHS) papers, as well as references from Defence Science & Technology Organization (DSTO), Civil Aviation Authority (CAA), and Federal Aviation Administration (FAA).

  17. [Use of routine data from statutory health insurances for federal health monitoring purposes].

    PubMed

    Ohlmeier, C; Frick, J; Prütz, F; Lampert, T; Ziese, T; Mikolajczyk, R; Garbe, E

    2014-04-01

    Federal health monitoring deals with the state of health and the health-related behavior of populations and is used to inform politics. To date, the routine data from statutory health insurances (SHI) have rarely been used for federal health monitoring purposes. SHI routine data enable analyses of disease frequency, risk factors, the course of the disease, the utilization of medical services, and mortality rates. The advantages offered by SHI routine data regarding federal health monitoring are the intersectoral perspective and the nearly complete absence of recall and selection bias in the respective population. Further, the large sample sizes and the continuous collection of the data allow reliable descriptions of the state of health of the insurants, even in cases of multiple stratification. These advantages have to be weighed against disadvantages linked to the claims nature of the data and the high administrative hurdles when requesting the use of SHI routine data. Particularly in view of the improved availability of data from all SHI insurants for research institutions in the context of the "health-care structure law", SHI routine data are an interesting data source for federal health monitoring purposes. PMID:24658676

  18. Special Statement: Program Objectives and Student Outcomes in Health Education

    ERIC Educational Resources Information Center

    Hurster, Madeline M.; Whitmore, Robert M.

    1976-01-01

    A survey of members of the Health Education Section, American College Health Association, indicates that they feel the major object of health education programs is to make the student aware that his health is primarily his responsibility and that colleges aid the student in assuming this responsibility. (MB)

  19. Clustering of health-related behaviors, health outcomes and demographics in Dutch adolescents: a cross-sectional study

    PubMed Central

    2013-01-01

    Background Recent studies show several health-related behaviors to cluster in adolescents. This has important implications for public health. Interrelated behaviors have been shown to be most effectively targeted by multimodal interventions addressing wider-ranging improvements in lifestyle instead of via separate interventions targeting individual behaviors. However, few previous studies have taken into account a broad, multi-disciplinary range of health-related behaviors and connected these behavioral patterns to health-related outcomes. This paper presents an analysis of the clustering of a broad range of health-related behaviors with relevant demographic factors and several health-related outcomes in adolescents. Methods Self-report questionnaire data were collected from a sample of 2,690 Dutch high school adolescents. Behavioral patterns were deducted via Principal Components Analysis. Subsequently a Two-Step Cluster Analysis was used to identify groups of adolescents with similar behavioral patterns and health-related outcomes. Results Four distinct behavioral patterns describe the analyzed individual behaviors: 1- risk-prone behavior, 2- bully behavior, 3- problematic screen time use, and 4- sedentary behavior. Subsequent cluster analysis identified four clusters of adolescents. Multi-problem behavior was associated with problematic physical and psychosocial health outcomes, as opposed to those exerting relatively few unhealthy behaviors. These associations were relatively independent of demographics such as ethnicity, gender and socio-economic status. Conclusions The results show that health-related behaviors tend to cluster, indicating that specific behavioral patterns underlie individual health behaviors. In addition, specific patterns of health-related behaviors were associated with specific health outcomes and demographic factors. In general, unhealthy behavior on account of multiple health-related behaviors was associated with both poor psychosocial

  20. Assessment of Factors Contributing to Health Outcomes in the Eight States of the Mississippi Delta Region

    PubMed Central

    Jovaag, Amanda; Catlin, Bridget B.; Rodock, Matthew; Park, Hyojun

    2016-01-01

    Introduction The objective of this observational study was to examine the key contributors to health outcomes and to better understand the health disparities between Delta and non-Delta counties in 8 states in the Mississippi River Delta Region. We hypothesized that a unique set of contributors to health outcomes in the Delta counties could explain the disparities between Delta and non-Delta counties. Methods Data were from the 2014 County Health Rankings for counties in 8 states (Alabama, Arkansas, Illinois, Kentucky, Louisiana, Mississippi, Missouri, and Tennessee). We used the Delta Regional Authority definition to identify the 252 Delta counties and 468 non-Delta counties or county equivalents. Information on health factors (eg, health behaviors, clinical care) and outcomes (eg, mortality) were derived from 38 measures from the 2014 County Health Rankings. The contributions of health factors to health outcomes in Delta and non-Delta counties were examined using path analysis. Results We found similarities between Delta counties and non-Delta counties in the health factors (eg, tobacco use, diet and exercise) that significantly predicted the health outcomes of self-rated health and low birthweight. The most variation was seen in predictors of mortality; however, Delta counties shared 2 of the 3 significant predictors (ie, community safety and income) of mortality with non-Delta counties. On average across all measures, values in the Delta were 16% worse than in the non-Delta and 22% worse than in the rest of the United States. Conclusion The health status of Delta counties is poorer than that of non-Delta counties because the health factors that contribute to health outcomes in the entire region are worse in the Delta counties, not because of a unique set of health predictors. PMID:26940300

  1. The Association of Changes in Local Health Department Resources With Changes in State-Level Health Outcomes

    PubMed Central

    Greene, Sandra B.; Mays, Glen P.; Ricketts, Thomas C.; Davis, Mary V.

    2011-01-01

    We explored the association between changes in local health department (LHD) resource levels with changes in health outcomes via a retrospective cohort study. We measured changes in expenditures and staffing reported by LHDs on the 1997 and 2005 National Association of County and City Health Officials surveys and assessed changes in state-level health outcomes with the America's Health Rankings reports for those years. We used pairwise correlation and multivariate regression to analyze the association of changes in LHD resources with changes in health outcomes. Increases in LHD expenditures were significantly associated with decreases in infectious disease morbidity at the state level (P = .037), and increases in staffing were significantly associated with decreases in cardiovascular disease mortality (P = .014), controlling for other factors. PMID:20558799

  2. Augmented Fish Health Monitoring, 1987-1988 Annual Report.

    SciTech Connect

    Warren, James W.

    1988-08-01

    Augmented Fish Health Monitoring Contract DE-AI79-87BP35585 was implemented on July 20, 1987. First year highlights included remodeling of the Olympia (WA) Fish Health Center to provide laboratory space for histopathological support services to participating state agencies, acquisition of gas monitoring equipment for hatchery water systems, expanded disease detection work for bacterial kidney disease and erythrocytic inclusion body syndrome in fish stocks at 13 Columbia River Basin National Fish Hatcheries and advancements in computerized case history data storage and analysis. This report summarizes the health status of fish reared at Service facilities in the Columbia River basin, briefly describes work being done to meet contract requirements for fish disease surveillance at those hatcheries and provides a summary of case history data for calendar years 1984, 1985, 1986 and 1987. 1 ref.

  3. A Battery Health Monitoring Framework for Planetary Rovers

    NASA Technical Reports Server (NTRS)

    Daigle, Matthew J.; Kulkarni, Chetan Shrikant

    2014-01-01

    Batteries have seen an increased use in electric ground and air vehicles for commercial, military, and space applications as the primary energy source. An important aspect of using batteries in such contexts is battery health monitoring. Batteries must be carefully monitored such that the battery health can be determined, and end of discharge and end of usable life events may be accurately predicted. For planetary rovers, battery health estimation and prediction is critical to mission planning and decision-making. We develop a model-based approach utilizing computaitonally efficient and accurate electrochemistry models of batteries. An unscented Kalman filter yields state estimates, which are then used to predict the future behavior of the batteries and, specifically, end of discharge. The prediction algorithm accounts for possible future power demands on the rover batteries in order to provide meaningful results and an accurate representation of prediction uncertainty. The framework is demonstrated on a set of lithium-ion batteries powering a rover at NASA.

  4. Forest health monitoring 1992 annual statistical summary. Project report

    SciTech Connect

    Aalexander, S.A.; Barnard, J.E.

    1994-04-01

    In 1990, the U.S. Department of Agriculture (USDA) Forest Service (FS) and the U.S. Environmental Protection Agency (EPA) initiated a cooperative national program to monitor the condition of the nation's forests. This multi-agency effort, within EPA's Environmental Monitoring and Assessment Program (EMAP), is called the Forest Health Monitoring (FHM) program. In 1992, Detection Monitoring activities were conducted in twelve states: Alabama; Connecticut; Delaware; Georgia; Maine; Maryland; Massachusetts; New Hampshire; New Jersey; Rhode Island; Vermont; and Virginia. Data analysis results for the following indicators are presented; tree species and stand density (mensuration); tree crown condition; tree species diversity; and air pollution bioindicator plants. The cumulative distribution function methods used in the analysis provide a statistical summary of most measurements. Tabular summaries were also prepared in some cases.

  5. Multi-metric model-based structural health monitoring

    NASA Astrophysics Data System (ADS)

    Jo, Hongki; Spencer, B. F.

    2014-04-01

    ABSTRACT The inspection and maintenance of bridges of all types is critical to the public safety and often critical to the economy of a region. Recent advanced sensor technologies provide accurate and easy-to-deploy means for structural health monitoring and, if the critical locations are known a priori, can be monitored by direct measurements. However, for today's complex civil infrastructure, the critical locations are numerous and often difficult to identify. This paper presents an innovative framework for structural monitoring at arbitrary locations on the structure combining computational models and limited physical sensor information. The use of multi-metric measurements is advocated to improve the accuracy of the approach. A numerical example is provided to illustrate the proposed hybrid monitoring framework, particularly focusing on fatigue life assessment of steel structures.

  6. Adaptable System for Vehicle Health and Usage Monitoring

    NASA Technical Reports Server (NTRS)

    Woodart, Stanley E.; Woodman, Keith L.; Coffey, Neil C.; Taylor, Bryant D.

    2005-01-01

    Aircraft and other vehicles are often kept in service beyond their original design lives. As they age, they become susceptible to system malfunctions and fatigue. Unlike future aircraft that will include health-monitoring capabilities as integral parts in their designs, older aircraft have not been so equipped. The Adaptable Vehicle Health and Usage Monitoring System is designed to be retrofitted into a preexisting fleet of military and commercial aircraft, ships, or ground vehicles to provide them with state-of-the-art health- and usage-monitoring capabilities. The monitoring system is self-contained, and the integration of it into existing systems entails limited intrusion. In essence, it has bolt-on/ bolt-off simplicity that makes it easy to install on any preexisting vehicle or structure. Because the system is completely independent of the vehicle, it can be certified for airworthiness as an independent system. The purpose served by the health-monitoring system is to reduce vehicle operating costs and to increase safety and reliability. The monitoring system is a means to identify damage to, or deterioration of, vehicle subsystems, before such damage or deterioration becomes costly and/or disastrous. Frequent monitoring of a vehicle enables identification of the embryonic stages of damage or deterioration. The knowledge thus gained can be used to correct anomalies while they are still somewhat minor. Maintenance can be performed as needed, instead of having the need for maintenance identified during cyclic inspections that take vehicles off duty even when there are no maintenance problems. Measurements and analyses acquired by the health-monitoring system also can be used to analyze mishaps. Overall, vehicles can be made more reliable and kept on duty for longer times. Figure 1 schematically depicts the system as applied to a fleet of n vehicles. The system has three operational levels. All communication between system components is by use of wireless

  7. Engagement with eHealth Self-Monitoring in a Primary Care-Based Weight Management Intervention

    PubMed Central

    Wolin, Kathleen Y.; Steinberg, Dori M.; Lane, Ilana B.; Askew, Sandy; Greaney, Mary L.; Colditz, Graham A.; Bennett, Gary G.

    2015-01-01

    Background While eHealth approaches hold promise for improving the reach and cost-effectiveness of behavior change interventions, they have been challenged by declining participant engagement over time, particularly for self-monitoring behaviors. These are significant concerns in the context of chronic disease prevention and management where durable effects are important for driving meaningful changes. Purpose “Be Fit, Be Well” was an eHealth weight loss intervention that allowed participants to self-select a self-monitoring modality (web or interactive voice response (IVR)). Participants could change their modality. As such, this study provides a unique opportunity to examine the effects of intervention modality choice and changing modalities on intervention engagement and outcomes. Methods Intervention participants, who were recruited from community health centers, (n = 180) were expected to self-monitor health behaviors weekly over the course of the 24-month intervention. We examined trends in intervention engagement by modality (web, IVR, or changed modality) among participants in the intervention arm. Results The majority (61%) of participants chose IVR self-monitoring, while 39% chose web. 56% of those who selected web monitoring changed to IVR during the study versus no change in those who initially selected IVR. Self-monitoring declined in both modalities, but completion rates were higher in those who selected IVR. There were no associations between self-monitoring modality and weight or blood pressure outcomes. Conclusions This is the first study to compare web and IVR self-monitoring in an eHealth intervention where participants could select and change their self-monitoring modality. IVR shows promise for achieving consistent engagement. PMID:26469065

  8. Nutritionists’ Health Study cohort: a web-based approach of life events, habits and health outcomes

    PubMed Central

    da Silva, Isis Tande; de Almeida-Pititto, Bianca; Ferreira, Sandra Roberta G

    2016-01-01

    Introduction Non-communicable chronic diseases (NCCDs) represent a burden for public health. Alongside the established cardiometabolic risk factors such as high blood pressure and disorders of glucose and lipid metabolism, living habits and nutritional status at different stages of life are seen as contributors to this scenario. Gut microbiota composition and subclinical inflammation have been pointed out as underlying mechanisms of NCCDs. Studies involving health professionals have brought relevant contributions to the knowledge about risk factors. Technological advances facilitate data collection and analysis for big samples. A web-based survey addressed to collect data from a cohort study, which is able to identify NCCDs risk factors, is highly desirable. The objective of the Brazilian Nutritionists’ Health Study (NutriHS) is to gather online information on early life events, daily habits, emergent cardiometabolic risk factors and health outcomes of a specific subset of the Brazilian population. Methods and analysis NutriHS, developed at the School of Public Health—University of Sao Paulo, Brazil, is a research initiative that enrols undergraduates of nutrition courses from Brazilian universities and graduated volunteers. A web-based self-administered system was designed to collect health-related data. After fulfilling online questionnaires (socioeconomic, early life events and lifestyle data), participants are invited to a clinical visit for physical examination and laboratory procedures (blood sampling, faeces collection and body composition). At a 3-year interval, they will be invited to repeat similar procedures. Ethics and dissemination The NutriHS research protocol was approved by the Institutional Ethics Committee and is providing promising data which contribute to the understanding of pathophysiological links between early life events, body composition, gut microbiota, and inflammatory and metabolic risk profile. The combination of a friendly tool

  9. Labour market outcomes of public health graduates: evidence from Australia.

    PubMed

    Li, Ian W; Awofeso, Niyi

    2014-09-01

    Little information is available on the public health workforce. This study contributes to the gap in the literature and examines the demographic characteristics, career destinations and earnings of Masters in Public Health (MPH) graduates in Australia, using data from the 1999-2009 waves of the Graduate Destination Survey. It was found that public health graduates had a high amount of female representation and very low proportions of indigenous representation. Public health graduates experienced a relatively low unemployment rate and 85% were employed within 120 days of graduation. However, close to half of the graduates did not work in the health industry or in health-related roles. The mean salaries of public health graduates working in public health roles were relatively low compared to those in other occupations, but they had a range comparable to that observed for public health professionals in the USA and were higher than those of other Masters graduates in some other health fields. The results indicate strong demand and positive employment prospects for public health graduates in Australia. Strategies to target recruitment and/or retention of female or indigenous graduates in the public health workforce should be a priority. Mapping of public health graduate destinations and employment prospects should might be prioritised, given its strong potential to facilitate workforce planning and provide potential public health workers with more comprehensive career trajectories. PMID:23782503

  10. Corneal foreign bodies--first aid, treatment, and outcomes. Skills review for an occupational health setting.

    PubMed

    Owens, J K; Scibilia, J; Hezoucky, N

    2001-05-01

    actively seeking collaboration with safety departments to continuously monitor and improve eye injury and outcome statistics and use of protective eye-wear. By consistently wearing proper safety eyewear, such as approved goggles or prescription safety glasses with side sheilds, during each and every venture into the work area, occupational health nurses provide a strong role model and have the opportunity to educate employees and encourage safe work practices. It is important to encourage shared responsibility and awareness between workers and management for prevention of foreign body incidents and prompt, accurate treatment when necessary to promote optimal outcome. PMID:11760304

  11. Health Insurance, Medical Care, and Health Outcomes: A Model of Elderly Health Dynamics

    ERIC Educational Resources Information Center

    Yang, Zhou; Gilleskie, Donna B.; Norton, Edward C.

    2009-01-01

    Prescription drug coverage creates a change in medical care consumption, beyond standard moral hazard, arising both from the differential cost-sharing and the relative effectiveness of different types of care. We model the dynamic supplemental health insurance decisions of Medicare beneficiaries, their medical care demand, and subsequent health…

  12. The relationship between general health and lifestyle factors and oral health outcomes.

    PubMed

    Sharma, P; Busby, M; Chapple, L; Matthews, R; Chapple, I

    2016-07-22

    .Conclusion The current study has demonstrated that patient reported general health and risk factors were negatively associated with an overall composite oral health score outcome in a large population of over 37,000 patients examined by 493 dentists. While the clinical significance of some of the reported associations is unknown, the data lend support to the growing body of evidence linking the oral and systemic health of individuals. Therefore, GDPs may be in a unique position to influence the lifestyle and general health of patients as part of their specific remit to attain and maintain optimal oral health. PMID:27444597

  13. Challenges in Data Quality Assurance in Pervasive Health Monitoring Systems

    NASA Astrophysics Data System (ADS)

    Sriram, Janani; Shin, Minho; Kotz, David; Rajan, Anand; Sastry, Manoj; Yarvis, Mark

    Wearable, portable, and implantable medical sensors have ushered in a new paradigm for healthcare in which patients can take greater responsibility and caregivers can make well-informed, timely decisions. Health-monitoring systems built on such sensors have huge potential benefit to the quality of healthcare and quality of life for many people, such as patients with chronic medical conditions (such as blood-sugar sensors for diabetics), people seeking to change unhealthy behavior (such as losing weight or quitting smoking), or athletes wishing to monitor their condition and performance. To be effective, however, these systems must provide assurances about the quality of the sensor data. The sensors must be applied to the patient by a human, and the sensor data may be transported across multiple networks and devices before it is presented to the medical team. While no system can guarantee data quality, we anticipate that it will help for the system to annotate data with some measure of confidence. In this paper, we take a deeper look at potential health-monitoring usage scenarios and highlight research challenges required to ensure and assess quality of sensor data in health-monitoring systems.

  14. Systematic review of employer-sponsored wellness strategies and their economic and health-related outcomes.

    PubMed

    Kaspin, Lisa C; Gorman, Kathleen M; Miller, Ross M

    2013-02-01

    This review determines the characteristics and health-related and economic outcomes of employer-sponsored wellness programs and identifies possible reasons for their success. PubMed, ABI/Inform, and Business Source Premier databases, and Corporate Wellness Magazine were searched. English-language articles published from 2005 to 2011 that reported characteristics of employer-sponsored wellness programs and their impact on health-related and economic outcomes among US employees were accepted. Data were abstracted, synthesized, and interpreted. Twenty references were accepted. Wellness interventions were classified into health assessments, lifestyle management, and behavioral health. Improved economic outcomes were reported (health care costs, return on investment, absenteeism, productivity, workers' compensation, utilization) as well as decreased health risks. Programs associated with favorable outcomes had several characteristics in common. First, the corporate culture encouraged wellness to improve employees' lives, not only to reduce costs. Second, employees and leadership were strongly motivated to support the wellness programs and to improve their health in general. Third, employees were motivated by a participation-friendly corporate policy and physical environment. Fourth, successful programs adapted to the changing needs of the employees. Fifth, community health organizations provided support, education, and treatment. Sixth, successful wellness programs utilized technology to facilitate health risk assessments and wellness education. Improved health-related and economic outcomes were associated with employer-sponsored wellness programs. Companies with successful programs tended to include wellness as part of their corporate culture and supported employee participation in several key ways. PMID:23113636

  15. Magnetic resonance imaging: opportunities for rheumatoid arthritis disease assessment and monitoring long-term treatment outcomes

    PubMed Central

    2002-01-01

    Early diagnosis of rheumatoid arthritis (RA) combined with early initiation of an appropriate treatment regimen is acknowledged as an important factor in improving clinical outcomes in patients with RA. Early diagnosis allows treatment intervention to occur sooner in order to inhibit the progression of structural joint damage as well as providing improved patient quality of life. Unfortunately, early diagnosis has been challenging due to the non-specific signs and symptoms associated with many polyarthropathies and the lack of accurate definitive diagnostic tests that can accurately classify RA at presentation. The emphasis on early diagnosis has fueled the need for powerful, sensitive, non-invasive imaging techniques that not only accurately define RA and give an indication of prognosis, but can also serve as a tool to monitor long-term treatment outcomes. This article reviews the potential uses of magnetic resonance imaging as a tool for the classification, documentation, and clinical monitoring of RA. PMID:12110151

  16. The National Health Educator Job Analysis 2010: Process and Outcomes

    ERIC Educational Resources Information Center

    Doyle, Eva I.; Caro, Carla M.; Lysoby, Linda; Auld, M. Elaine; Smith, Becky J.; Muenzen, Patricia M.

    2012-01-01

    The National Health Educator Job Analysis 2010 was conducted to update the competencies model for entry- and advanced-level health educators. Qualitative and quantitative methods were used. Structured interviews, focus groups, and a modified Delphi technique were implemented to engage 59 health educators from diverse work settings and experience…

  17. Development of structural health monitoring techniques using dynamics testing

    SciTech Connect

    James, G.H. III

    1996-03-01

    Today`s society depends upon many structures (such as aircraft, bridges, wind turbines, offshore platforms, buildings, and nuclear weapons) which are nearing the end of their design lifetime. Since these structures cannot be economically replaced, techniques for structural health monitoring must be developed and implemented. Modal and structural dynamics measurements hold promise for the global non-destructive inspection of a variety of structures since surface measurements of a vibrating structure can provide information about the health of the internal members without costly (or impossible) dismantling of the structure. In order to develop structural health monitoring for application to operational structures, developments in four areas have been undertaken within this project: operational evaluation, diagnostic measurements, information condensation, and damage identification. The developments in each of these four aspects of structural health monitoring have been exercised on a broad range of experimental data. This experimental data has been extracted from structures from several application areas which include aging aircraft, wind energy, aging bridges, offshore structures, structural supports, and mechanical parts. As a result of these advances, Sandia National Laboratories is in a position to perform further advanced development, operational implementation, and technical consulting for a broad class of the nation`s aging infrastructure problems.

  18. PRISM: A DATA-DRIVEN PLATFORM FOR MONITORING MENTAL HEALTH.

    PubMed

    Kamdar, Maulik R; Wu, Michelle J

    2016-01-01

    Neuropsychiatric disorders are the leading cause of disability worldwide and there is no gold standard currently available for the measurement of mental health. This issue is exacerbated by the fact that the information physicians use to diagnose these disorders is episodic and often subjective. Current methods to monitor mental health involve the use of subjective DSM-5 guidelines, and advances in EEG and video monitoring technologies have not been widely adopted due to invasiveness and inconvenience. Wearable technologies have surfaced as a ubiquitous and unobtrusive method for providing continuous, quantitative data about a patient. Here, we introduce PRISM-Passive, Real-time Information for Sensing Mental Health. This platform integrates motion, light and heart rate data from a smart watch application with user interactions and text entries from a web application. We have demonstrated a proof of concept by collecting preliminary data through a pilot study of 13 subjects. We have engineered appropriate features and applied both unsupervised and supervised learning to develop models that are predictive of user-reported ratings of their emotional state, demonstrating that the data has the potential to be useful for evaluating mental health. This platform could allow patients and clinicians to leverage continuous streams of passive data for early and accurate diagnosis as well as constant monitoring of patients suffering from mental disorders. PMID:26776198

  19. Willingness of Patients to Use Computers for Health Communication and Monitoring Following Myocardial Infarction.

    PubMed

    Shaw, Ryan J; Zullig, Leah L; Crowley, Matthew J; Grambow, Steven C; Lindquist, Jennifer H; Shah, Bimal R; Peterson, Eric; Bosworth, Hayden B

    2015-09-01

    We describe the computer use characteristics of 406 post-myocardial infarction (MI) patients and their willingness to engage online for health communication and monitoring. Most participants were computer users (n = 259; 63.8%) and half (n = 209; 51.5%) read health information online at least monthly. However, most participants did not go online to track health conditions (n = 283; 69.7%), look at medical records (n = 287; 70.7%), or e-mail doctors (n = 351; 86.5%). Most participants would consider using a Web site to e-mail doctors (n = 275; 67.7%), share medical information with doctors (n = 302; 74.4%), send biological data to their doctor (n = 308; 75.9%), look at medical records (n = 321; 79.1%), track health conditions (n = 331; 81.5%), and read about health conditions (n = 332; 81.8%). Sharing health information online with family members (n = 181; 44.6%) or for support groups (n = 223; 54.9%) was not of much interest. Most post-MI participants reported they were interested in communicating with their provider and tracking their health conditions online. Because patients with a history of MI tend to be older and are disproportionately minority, researchers and clinicians must be careful to design interventions that embrace post-MI patients of diverse backgrounds that both improve their access to care and health outcomes. PMID:26176640

  20. Integrated controls and health monitoring for chemical transfer propulsion

    NASA Technical Reports Server (NTRS)

    Millis, Marc G.; Binder, Michael P.

    1990-01-01

    NASA is reviewing various propulsion technologies for exploring space. The requirements are examined for one enabling propulsion technology: Integrated Controls and Health Monitoring (ICHM) for Chemical Transfer Propulsion (CTP). Functional requirements for a CTP-ICHM system are proposed from tentative mission scenarios, vehicle configurations, CTP specifications, and technical feasibility. These CTP-ICHM requirements go beyond traditional reliable operation and emergency shutoff control to include: (1) enhanced mission flexibility; (2) continuously variable throttling; (3) tank-head start control; (4) automated prestart and post-shutoff engine check; (5) monitoring of space exposure degradation; and (6) product evolution flexibility. Technology development plans are also discussed.

  1. Fail-safe sensor for structural health monitoring

    NASA Astrophysics Data System (ADS)

    Dethlefsen, Annelene F.; Li, Henry C. H.; Davis, Claire E.; Stoddart, Paul R.

    2008-04-01

    This paper introduces the concept of a fail-safe sensor to monitor the structural health of a composite repair. The low-cost fiber Bragg grating (FBG) sensor system consists of a light source, two specially designed fiber Bragg gratings and a photodiode detector. This system is applied to a typical bonded composite scarf joint often employed in aerospace structures. A finite element model is developed to assess the change in strain distribution as the result of a structural debond. The proposed monitoring system will be validated through an experimental investigation.

  2. Smart antenna technology for structural health monitoring applications

    NASA Astrophysics Data System (ADS)

    Özdemir, Tayfun; Goykhman, Yuriy; Oberdier, Larry; Lynch, Jerome

    2010-04-01

    A smart antenna has been developed for structural health monitoring. The antenna is based on Monarch's GEN 2 selfstructuring antenna (SSA) technology and provides polarization and beam-diversity for improving signal-to-noise ratio (SNR). The antenna works with University of Michigan's Narada platform, where a microcontroller monitors the RSSI and selects the best beam to maintain reliable RF link. Antenna has two wide beams for each polarization and the beams are selected by applying appropriate DC voltages to the RF switches on the antenna aperture. Paper presents the GEN C antenna, which is a smaller version of the GEN 2B with comparable performance features.

  3. FBG sensor for physiologic monitoring in M-health application

    NASA Astrophysics Data System (ADS)

    Lee, Chi Chung; Hung, Kevin; Chan, Wai-Man; Wu, Y. K.; Choy, Sheung-On; Kwok, Paul

    2011-12-01

    In this paper, a wearable physiologic monitoring system using FBG sensors is investigated. The FBG sensors with the capability of sensing temperature, movement, and respiration are connected to the wireless transceiver, microcontroller and server for wireless and long distance physiologic monitoring and analysis. Biosignals recorded experimentally are analyzed and compared with the data obtained in the traditional medical data acquisition system. The system investigated in this paper can be used in an m-health shirt, which has the capability to measure and wirelessly transmit electrocardiogram, respiration, movement, and body temperature signal to a remote station, with other plug-in modules.

  4. A Simplified Method for Routine Outcome Monitoring after Drug Abuse Treatment

    PubMed Central

    Lennox, Richard D.; Sternquist, Marie A.; Paredes, Alfonso

    2013-01-01

    The routine collection of drug treatment outcomes to manage quality of care, improve patient satisfaction, and allocate treatment resources is currently hampered by two key difficulties: (1) problems locating clients once they leave treatment; and (2) the prohibitive cost of obtaining meaningful and reliable post-treatment data. This pilot describes precise methods for an economical staff-based routine outcome monitoring (ROM) system using an 18-item core measure telephone survey. As implemented at Narconon™ of Oklahoma, a behavioral and social skills based, residential drug rehabilitation program, the system was psychometrically adequate for aggregate reporting while providing clinically useful information. Standardized procedures for staff training, collecting client contact information, structuring exit interviews and maintaining post-treatment telephone contact produced follow-up rates that improved from 57.6% to 100% over the course of the project. Aggregate data was used to improve program delivery and thereby post-treatment substance use and social outcomes. These methods and use of data may contribute to the discussion on how to best monitor outcomes. PMID:24092985

  5. Key Findings on Alcohol Consumption and a Variety of Health Outcomes From the Nurses’ Health Study

    PubMed Central

    Mostofsky, Elizabeth; Mukamal, Kenneth J.; Giovannucci, Ed L.; Stampfer, Meir J.

    2016-01-01

    Objectives. To review critical contributions from the Nurses’ Health Study (NHS) on alcohol consumption and health outcomes. Methods. We performed a narrative review of NHS (1980–2012) and NHS II (1989–2011) publications. Results. Using detailed information on self-reported alcohol drinking patterns obtained approximately every 4 years combined with extensive information on diet, lifestyle habits, and physician-diagnosed health conditions, NHS investigators have prospectively examined the risks and benefits associated with alcohol consumption. Moderate intake, defined as up to 1 drink a day, is associated with a lower risk of hypertension, myocardial infarction, stroke, sudden cardiac death, gallstones, cognitive decline, and all-cause mortality. However, even moderate intake places women at higher risk for breast cancer and bone fractures, and higher intake increases risk for colon polyps and colon cancer. Conclusions. Regular alcohol intake has both risks and benefits. In analyses using repeated assessments of alcohol over time and deaths from all causes, women with low to moderate intake and regular frequency (> 3 days/week) had the lowest risk of mortality compared with abstainers and women who consumed substantially more than 1 drink per day. PMID:27459455

  6. Health system and community level interventions for improving antenatal care coverage and health outcomes

    PubMed Central

    Mbuagbaw, Lawrence; Medley, Nancy; Darzi, Andrea J; Richardson, Marty; Habiba Garga, Kesso; Ongolo-Zogo, Pierre

    2015-01-01

    Background The World Health Organization (WHO) recommends at least four antenatal care (ANC) visits for all pregnant women. Almost half of pregnant women worldwide, and especially in developing countries do not receive this amount of care. Poor attendance of ANC is associated with delivery of low birthweight babies and more neonatal deaths. ANC may include education on nutrition, potential problems with pregnancy or childbirth, child care and prevention or detection of disease during pregnancy. This review focused on community-based interventions and health systems-related interventions. Objectives To assess the effects of health system and community interventions for improving coverage of antenatal care and other perinatal health outcomes. Search methods We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (7 June 2015) and reference lists of retrieved studies. Selection criteria We included randomised controlled trials (RCTs), quasi-randomised trials and cluster-randomised trials. Trials of any interventions to improve ANC coverage were eligible for inclusion. Trials were also eligible if they targeted specific and related outcomes, such as maternal or perinatal death, but also reported ANC coverage. Data collection and analysis Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. Main results We included 34 trials involving approximately 400,000 women. Some trials tested community-based interventions to improve uptake of antenatal care (media campaigns, education or financial incentives for pregnant women), while other trials looked at health systems interventions (home visits for pregnant women or equipment for clinics). Most trials took place in low- and middle-income countries, and 29 of the 34 trials used a cluster-randomised design. We assessed 30 of the 34 trials as of low or unclear overall risk of bias. Comparison 1: One intervention versus no intervention We

  7. Efficacy of monitoring and empirical predictive modeling at improving public health protection at Chicago beaches

    USGS Publications Warehouse

    Nevers, Meredith B.; Whitman, Richard L.

    2011-01-01

    Efforts to improve public health protection in recreational swimming waters have focused on obtaining real-time estimates of water quality. Current monitoring techniques rely on the time-intensive culturing of fecal indicator bacteria (FIB) from water samples, but rapidly changing FIB concentrations result in management errors that lead to the public being exposed to high FIB concentrations (type II error) or beaches being closed despite acceptable water quality (type I error). Empirical predictive models may provide a rapid solution, but their effectiveness at improving health protection has not been adequately assessed. We sought to determine if emerging monitoring approaches could effectively reduce risk of illness exposure by minimizing management errors. We examined four monitoring approaches (inactive, current protocol, a single predictive model for all beaches, and individual models for each beach) with increasing refinement at 14 Chicago beaches using historical monitoring and hydrometeorological data and compared management outcomes using different standards for decision-making. Predictability (R2) of FIB concentration improved with model refinement at all beaches but one. Predictive models did not always reduce the number of management errors and therefore the overall illness burden. Use of a Chicago-specific single-sample standard-rather than the default 235 E. coli CFU/100 ml widely used-together with predictive modeling resulted in the greatest number of open beach days without any increase in public health risk. These results emphasize that emerging monitoring approaches such as empirical models are not equally applicable at all beaches, and combining monitoring approaches may expand beach access.

  8. Personal health monitoring - exploiting the power of the personal telephone.

    PubMed

    Hannan, Amir

    2015-11-01

    Many health issues that we currently face are related to our lifestyle choices. Educating patients can help them to make better informed health decisions. The internet and smartphones, mobile telephones that perform many of the functions of a computer, are becoming more accessible to the majority of the population. Applications on smartphones and professional health websites can signpost patients to trusted information and allow them to co-produce records. Empowering patients, staff and organizations through enabling access to records and understanding, building a partnership trust and the use of social media can enable people to do more and hopefully improve outcomes. In this article, I describe the steps we have taken to facilitate such interactions within our own primary care practice and the response of patients to these initiatives. PMID:26376672

  9. Structural Health Monitoring of Stiffened Plates Using Guided Ultrasonic Waves

    NASA Astrophysics Data System (ADS)

    Fromme, P.

    2009-03-01

    The concept of using distributed arrays of permanently attached sensors for the long-term structural health monitoring of large plates has previously been demonstrated under laboratory conditions. Based on the scattering characteristics of the employed guided ultrasonic wave mode at typical defects, the influence of the signal processing parameters on the damage detection and localization accuracy is discussed. Problems employing this structural health monitoring concept can occur due to additional changes in the signal reflected at undamaged parts of the structure. For real technical structures reflections occur at structural features, which have been identified as safety-critical areas for the development of fatigue and corrosion damage. Results from laboratory experiments are presented for the detection of crack-like defects (notch) at a welded stiffener on a large steel plate structure.

  10. TPS In-Flight Health Monitoring Project Progress Report

    NASA Technical Reports Server (NTRS)

    Kostyk, Chris; Richards, Lance; Hudston, Larry; Prosser, William

    2007-01-01

    Progress in the development of new thermal protection systems (TPS) is reported. New approaches use embedded lightweight, sensitive, fiber optic strain and temperature sensors within the TPS. Goals of the program are to develop and demonstrate a prototype TPS health monitoring system, develop a thermal-based damage detection algorithm, characterize limits of sensor/system performance, and develop ea methodology transferable to new designs of TPS health monitoring systems. Tasks completed during the project helped establish confidence in understanding of both test setup and the model and validated system/sensor performance in a simple TPS structure. Other progress included complete initial system testing, commencement of the algorithm development effort, generation of a damaged thermal response characteristics database, initial development of a test plan for integration testing of proven FBG sensors in simple TPS structure, and development of partnerships to apply the technology.

  11. Space Station Environmental Health System water quality monitoring

    NASA Technical Reports Server (NTRS)

    Vincze, Johanna E.; Sauer, Richard L.

    1990-01-01

    One of the unique aspects of the Space Station is that it will be a totally encapsulated environment and the air and water supplies will be reclaimed for reuse. The Environmental Health System, a subsystem of CHeCS (Crew Health Care System), must monitor the air and water on board the Space Station Freedom to verify that the quality is adequate for crew safety. Specifically, the Water Quality Subsystem will analyze the potable and hygiene water supplies regularly for organic, inorganic, particulate, and microbial contamination. The equipment selected to perform these analyses will be commercially available instruments which will be converted for use on board the Space Station Freedom. Therefore, the commercial hardware will be analyzed to identify the gravity dependent functions and modified to eliminate them. The selection, analysis, and conversion of the off-the-shelf equipment for monitoring the Space Station reclaimed water creates a challenging project for the Water Quality engineers and scientists.

  12. Monitoring and Evaluating the Transition of Large-Scale Programs in Global Health

    PubMed Central

    Bao, James; Rodriguez, Daniela C; Paina, Ligia; Ozawa, Sachiko; Bennett, Sara

    2015-01-01

    Purpose: Donors are increasingly interested in the transition and sustainability of global health programs as priorities shift and external funding declines. Systematic and high-quality monitoring and evaluation (M&E) of such processes is rare. We propose a framework and related guiding questions to systematize the M&E of global health program transitions. Methods: We conducted stakeholder interviews, searched the peer-reviewed and gray literature, gathered feedback from key informants, and reflected on author experiences to build a framework on M&E of transition and to develop guiding questions. Findings: The conceptual framework models transition as a process spanning pre-transition and transition itself and extending into sustained services and outcomes. Key transition domains include leadership, financing, programming, and service delivery, and relevant activities that drive the transition in these domains forward include sustaining a supportive policy environment, creating financial sustainability, developing local stakeholder capacity, communicating to all stakeholders, and aligning programs. Ideally transition monitoring would begin prior to transition processes being implemented and continue for some time after transition has been completed. As no set of indicators will be applicable across all types of health program transitions, we instead propose guiding questions and illustrative quantitative and qualitative indicators to be considered and adapted based on the transition domains identified as most important to the particular health program transition. The M&E of transition faces new and unique challenges, requiring measuring constructs to which evaluators may not be accustomed. Many domains hinge on measuring “intangibles” such as the management of relationships. Monitoring these constructs may require a compromise between rigorous data collection and the involvement of key stakeholders. Conclusion: Monitoring and evaluating transitions in global

  13. ART and health: clinical outcomes and insights on molecular mechanisms from rodent studies

    PubMed Central

    Feuer, S.K.; Camarano, L.; Rinaudo, P.F.

    2013-01-01

    Since the birth of the first IVF-conceived child in 1978, the use of assisted reproductive technologies (ART) has grown dramatically, contributing to the successful birth of 5 million individuals worldwide. However, there are several reported associations of ART with pregnancy complications, such as low birthweight (LBW), preterm birth, birth defects, epigenetic disorders, cancer and poor metabolic health. Whether this is attributed to ART procedures or to the subset of the population seeking ART remains a controversy, but the most relevant question today concerns the potential long-term implications of assisted conception. Recent evidence has emerged suggesting that ART-conceived children have distinct metabolic profiles that may predispose to cardiovascular pathologies in adulthood. Because the eldest IVF individuals are still too young to exhibit components of chronic middle-aged syndromes, the use of animal models has become particularly useful in describing the effects of unusual or stressful preimplantation experiences on adult fitness. Elucidating the molecular mechanisms by which embryos integrate environmental signals into development and metabolic gene expression programs will be essential for optimizing ART procedures such as in vitro culture conditions, embryo selection and transfer. In the future, additional animal studies to identify mechanisms underlying unfavorable ART outcomes, as well as more epidemiological reviews to monitor the long-term health of ART children are required, given that ART procedures have become routine medical practice. PMID:23264495

  14. Optimized Radar Remote Sensing for Levee Health Monitoring

    NASA Technical Reports Server (NTRS)

    Jones, Cathleen E.

    2013-01-01

    Radar remote sensing offers great potential for high resolution monitoring of ground surface changes over large areas at one time to detect movement on and near levees and for location of seepage through levees. Our NASA-funded projects to monitor levees in the Sacramento Delta and the Mississippi River have developed and demonstrated methods to use radar remote sensing to measure quantities relevant to levee health and of great value to emergency response. The DHS-funded project will enable us is to define how to optimally monitor levees in this new way and set the stage for transition to using satellite SAR (synthetic aperture radar) imaging for better temporal and spatial coverage at lower cost to the end users.

  15. Health monitoring in composite materials via peak strain sensing

    NASA Astrophysics Data System (ADS)

    Thompson, Larry D.; Westermo, Bruce D.

    1996-11-01

    Fiber-reinforced composite materials are beginning to be employed in applications related to retrofit and repair of large-scale civil structures. This paper discusses the utilization of a passive, pea, strain monitoring technology to the damage and health assessment of composite structures. Applications considered include epoxy-matrix composite materials reinforced with chopped glass, continuous glass fibers, carbon-fiber mat as well as continuous carbon-fiber. The advantages of the various material applications are discussed as they apply to large civil structures with peak strain monitoring data presented to illustrate how the systems can be field monitored. Full-scale structural component testing as well as subscale laboratory testing results will be presented and discussed. Recommendations are provided to guide the engineering community in such composite applications and to provide a design framework for the inclusion of simple and reliable sensor systems to detect both short-term and long-term damage.

  16. Prescription drug insurance coverage and patient health outcomes: a systematic review.

    PubMed

    Kesselheim, Aaron S; Huybrechts, Krista F; Choudhry, Niteesh K; Fulchino, Lisa A; Isaman, Danielle L; Kowal, Mary K; Brennan, Troyen A

    2015-02-01

    Previous reviews have shown that changes in prescription drug insurance benefits can affect medication use and adherence. We conducted a systematic review of the literature to identify studies addressing the association between prescription drug coverage and health outcomes. Studies were included if they collected empirical data on expansions or restrictions of prescription drug coverage and if they reported clinical outcomes. We found 23 studies demonstrating that broader prescription drug insurance reduces use of other health care services and has a positive impact on patient outcomes. Coverage gaps or caps on drug insurance generally led to worse outcomes. States should consider implementing the Affordable Care Act expansions in drug coverage to improve the health of low-income patients receiving state-based health insurance. PMID:25521879

  17. Equality of what in health? Distinguishing between outcome egalitarianism and gain egalitarianism.

    PubMed

    Tsuchiya, Aki; Dolan, Paul

    2009-02-01

    When deciding how to weigh benefits to different groups, standard economic models assume that people focus on the final distribution of utility, health or whatever. Thus, an egalitarian is assumed to be an egalitarian in the outcome space. But what about egalitarianism in the gains space, such that people focus instead on how equally benefits are distributed? This paper reports on a study in which members of the public were asked to rank a number of health programmes that differed in the distribution of benefits and final outcomes in ways that enabled us to distinguish between different types of egalitarianism. The results suggest that outcome egalitarianism dominates, particularly for differences in health by social class, but a sizeable minority of respondents appear to be gain egalitarians, especially when the health differences are by sex. These results have important implications for how we think about outcome-based social welfare functions in economics. PMID:18484571

  18. Challenges in measuring outcomes for caregivers of people with mental health problems

    PubMed Central

    Zendjidjian, Xavier Y.; Boyer, Laurent

    2014-01-01

    Patient-reported outcomes (PROs) are increasingly important in health care and mental health research. Furthermore, caregivers become partners in care for patients with mental disorders, and health workers are more attentive to the expectations and needs of caregivers. A number of outcomes for caregivers are measured and used in daily practice in order to promote actions to improve health care systems and progress in research on the impact of mental disorders on their caregivers. This paper proposes an inventory of the different outcomes and different measurement tools used to assess the impact of disorders, raising a number of methodological and conceptual issues that limit the relevance of measurement tools and complicate their use. Finally, we propose some recommendations promoting the development of relevant outcome measures for caregivers and their integration into current systems of care. PMID:25152655

  19. Mental Health Pathways from Interpersonal Violence to Health-Related Outcomes in HIV-Positive Sexual Minority Men

    ERIC Educational Resources Information Center

    Pantalone, David W.; Hessler, Danielle M.; Simoni, Jane M.

    2010-01-01

    Objective: We examined mental health pathways between interpersonal violence (IPV) and health-related outcomes in HIV-positive sexual minority men engaged with medical care. Method: HIV-positive gay and bisexual men (N = 178) were recruited for this cross-sectional study from 2 public HIV primary care clinics that treated outpatients in an urban…

  20. Mental health predicts better academic outcomes: a longitudinal study of elementary school students in Chile.

    PubMed

    Murphy, J Michael; Guzmán, Javier; McCarthy, Alyssa E; Squicciarini, Ana María; George, Myriam; Canenguez, Katia M; Dunn, Erin C; Baer, Lee; Simonsohn, Ariela; Smoller, Jordan W; Jellinek, Michael S

    2015-04-01

    The world's largest school-based mental health program, Habilidades para la Vida [Skills for Life (SFL)], has been operating on a national scale in Chile for 15 years. SFL's activities include using standardized measures to screen elementary school students and providing preventive workshops to students at risk for mental health problems. This paper used SFL's data on 37,397 students who were in first grade in 2009 and third grade in 2011 to ascertain whether first grade mental health predicted subsequent academic achievement and whether remission of mental health problems predicted improved academic outcomes. Results showed that mental health was a significant predictor of future academic performance and that, overall, students whose mental health improved between first and third grade made better academic progress than students whose mental health did not improve or worsened. Our findings suggest that school-based mental health programs like SFL may help improve students' academic outcomes. PMID:24771270

  1. Mental health predicts better academic outcomes: A longitudinal study of elementary school students in Chile

    PubMed Central

    Murphy, J. Michael; Guzmán, Javier; McCarthy, Alyssa; Squicciarini, Ana María; George, Myriam; Canenguez, Katia; Dunn, Erin C.; Baer, Lee; Simonsohn, Ariela; Smoller, Jordan W.; Jellinek, Michael

    2015-01-01

    The world’s largest school-based mental health program, Habilidades para la Vida [Skills for Life, SFL], has been operating at a national scale in Chile for fifteen years. SFL’s activities include using standardized measures to screen elementary school students and providing preventive workshops to students at risk for mental health problems. This paper used SFL’s data on 37,397 students who were in first grade in 2009 and third grade in 2011 to ascertain whether first grade mental health predicted subsequent academic achievement and whether remission of mental health problems predicted improved academic outcomes. Results showed that mental health was a significant predictor of future academic performance and that, overall, students whose mental health improved between first and third grade made better academic progress than students whose mental health did not improve or worsened. Our findings suggest that school-based mental health programs like SFL may help improve students’ academic outcomes. PMID:24771270

  2. Signature Optical Cues: Emerging Technologies for Monitoring Plant Health

    PubMed Central

    Liew, Oi Wah; Chong, Pek Ching Jenny; Li, Bingqing; Asundi, Anand K.

    2008-01-01

    Optical technologies can be developed as practical tools for monitoring plant health by providing unique spectral signatures that can be related to specific plant stresses. Signatures from thermal and fluorescence imaging have been used successfully to track pathogen invasion before visual symptoms are observed. Another approach for non-invasive plant health monitoring involves elucidating the manner with which light interacts with the plant leaf and being able to identify changes in spectral characteristics in response to specific stresses. To achieve this, an important step is to understand the biochemical and anatomical features governing leaf reflectance, transmission and absorption. Many studies have opened up possibilities that subtle changes in leaf reflectance spectra can be analyzed in a plethora of ways for discriminating nutrient and water stress, but with limited success. There has also been interest in developing transgenic phytosensors to elucidate plant status in relation to environmental conditions. This approach involves unambiguous signal creation whereby genetic modification to generate reporter plants has resulted in distinct optical signals emitted in response to specific stressors. Most of these studies are limited to laboratory or controlled greenhouse environments at leaf level. The practical translation of spectral cues for application under field conditions at canopy and regional levels by remote aerial sensing remains a challenge. The movement towards technology development is well exemplified by the Controlled Ecological Life Support System under development by NASA which brings together technologies for monitoring plant status concomitantly with instrumentation for environmental monitoring and feedback control.

  3. Piezoelectric based sensing in wireless steel bridge health monitoring

    NASA Astrophysics Data System (ADS)

    Yu, Lingyu; Giurgiutiu, Victor; Ziehl, Paul; Ozevin, Didem

    2009-03-01

    rent routine inspection practices for bridge health monitoring are not sufficient for the timely identification of areas of concern or to provide enough information to bridge owners to make informed decisions for maintenance prioritization. Continuous monitoring is needed for long term evaluation from an integrated sensing system that would act as a monitoring and early warning alarm system and be able to communicate the information from the bridge directly to the bridge owners for potential and immediate action. To address this urgent highway bridge health monitoring need, a joint venture research has been initiated by incorporating novel and promising sensing approach based on piezoelectricity together with energy harvesting to reduce the dramatic uncertainty inherent into any inspection and maintenance plan. In the system, the damage detection and classification is focused on the use of piezoelectric wafer active sensors (PWAS) at both active (Lamb wave interrogation) mode and passive (acoustic emission) mode on steel bridge. For efficient energy usage, the active mode will be triggered when acoustic emission caused by the structural change is detected. In the active sensing mode, computed array imaging will be used to detect the presence of crack and to track its growth. To further quantify the crack growth, damage physics based damage indicator will be defined and used to trace the crack growth as well.

  4. Fiber Optic Sensors for Health Monitoring of Morphing Aircraft

    NASA Technical Reports Server (NTRS)

    Brown, Timothy; Wood, Karen; Childers, Brooks; Cano, Roberto; Jensen, Brian; Rogowski, Robert

    2001-01-01

    Fiber optic sensors are being developed for health monitoring of future aircraft. Aircraft health monitoring involves the use of strain, temperature, vibration and chemical sensors. These sensors will measure load and vibration signatures that will be used to infer structural integrity. Sine the aircraft morphing program assumes that future aircraft will be aerodynamically reconfigurable there is also a requirement for pressure, flow and shape sensors. In some cases a single fiber may be used for measuring several different parameters. The objective of the current program is to develop techniques for using optical fibers to monitor composite cure in real time during manufacture and to monitor in-service structural integrity of the composite structure. Graphite-epoxy panels were fabricated with integrated optical fibers of various types. The panels were mechanically and thermally tested to evaluate composite strength and sensor durability. Finally the performance of the fiber optic sensors was determined. Experimental results are presented evaluating the performance of embedded and surface mounted optical fibers for measuring strain, temperature and chemical composition. The performance of the fiber optic sensors was determined by direct comparison with results from more conventional instrumentation. The facilities for fabricating optical fiber and associated sensors and methods of demodulating Bragg gratings for strain measurement will be described.

  5. Ultra low power signal oriented approach for wireless health monitoring.

    PubMed

    Marinkovic, Stevan; Popovici, Emanuel

    2012-01-01

    In recent years there is growing pressure on the medical sector to reduce costs while maintaining or even improving the quality of care. A potential solution to this problem is real time and/or remote patient monitoring by using mobile devices. To achieve this, medical sensors with wireless communication, computational and energy harvesting capabilities are networked on, or in, the human body forming what is commonly called a Wireless Body Area Network (WBAN). We present the implementation of a novel Wake Up Receiver (WUR) in the context of standardised wireless protocols, in a signal-oriented WBAN environment and present a novel protocol intended for wireless health monitoring (WhMAC). WhMAC is a TDMA-based protocol with very low power consumption. It utilises WBAN-specific features and a novel ultra low power wake up receiver technology, to achieve flexible and at the same time very low power wireless data transfer of physiological signals. As the main application is in the medical domain, or personal health monitoring, the protocol caters for different types of medical sensors. We define four sensor modes, in which the sensors can transmit data, depending on the sensor type and emergency level. A full power dissipation model is provided for the protocol, with individual hardware and application parameters. Finally, an example application shows the reduction in the power consumption for different data monitoring scenarios. PMID:22969379

  6. Ultra Low Power Signal Oriented Approach for Wireless Health Monitoring

    PubMed Central

    Marinkovic, Stevan; Popovici, Emanuel

    2012-01-01

    In recent years there is growing pressure on the medical sector to reduce costs while maintaining or even improving the quality of care. A potential solution to this problem is real time and/or remote patient monitoring by using mobile devices. To achieve this, medical sensors with wireless communication, computational and energy harvesting capabilities are networked on, or in, the human body forming what is commonly called a Wireless Body Area Network (WBAN). We present the implementation of a novel Wake Up Receiver (WUR) in the context of standardised wireless protocols, in a signal-oriented WBAN environment and present a novel protocol intended for wireless health monitoring (WhMAC). WhMAC is a TDMA-based protocol with very low power consumption. It utilises WBAN-specific features and a novel ultra low power wake up receiver technology, to achieve flexible and at the same time very low power wireless data transfer of physiological signals. As the main application is in the medical domain, or personal health monitoring, the protocol caters for different types of medical sensors. We define four sensor modes, in which the sensors can transmit data, depending on the sensor type and emergency level. A full power dissipation model is provided for the protocol, with individual hardware and application parameters. Finally, an example application shows the reduction in the power consumption for different data monitoring scenarios. PMID:22969379

  7. Some practical issues in remote structural health monitoring

    NASA Astrophysics Data System (ADS)

    Han, L.; Newhook, J. P.; Mufti, A. A.

    2005-05-01

    Structural health monitoring (SHM) activities in civil engineering grow at a rapid pace and mature in both research and field applications. Internet technology was successfully incorporated into structural health monitoring, which makes it possible to manage real-time sensing data and centralize the remote structural monitoring systems. With the increase in size and complexity of the monitored structures, more sensors and data acquisition equipment is involved. This paper addresses some specific issues related to long distance small signal transmission and Ethernet IP sharing between different devices. The issue of data volume versus storage space and communication bandwidth is discussed especially in the application of web camera image transfer and recording. The approaches are illustrated through reference to two current case studies, which include a bridge and a statue. It can be seen that these practical solutions employed by ISIS Canada are easy to implement and reduce the cost for the maintenance of SHM systems. The paper also discusses future activities and research needs related to the reliability and security of the SHM system.

  8. Health monitoring of composite structures throughout the life cycle

    NASA Astrophysics Data System (ADS)

    Chilles, James; Croxford, Anthony; Bond, Ian

    2016-04-01

    This study demonstrates the capability of inductively coupled piezoelectric sensors to monitor the state of health throughout the lifetime of composite structures. A single sensor which generated guided elastic waves was embedded into the stacking sequence of a large glass fiber reinforced plastic plate. The progress of cure was monitored by measuring variations in the amplitude and velocity of the waveforms reflected from the plate's edges. Baseline subtraction techniques were then implemented to detect barely visible impact damage (BVID) created by a 10 Joule impact, at a distance of 350 mm from the sensor embedded in the cured plate. To investigate the influence of mechanical loading on sensor performance, a single sensor was embedded within a glass fiber panel and subjected to tensile load. The panel was loaded up to a maximum strain of 1%, in increments of 0.1% strain. Guided wave measurements were recorded by the embedded sensor before testing, when the panel was under load, and after testing. The ultrasonic measurements showed a strong dependence on the applied load. Upon removal of the mechanical load the guided wave measurements returned to their original values recorded before testing. The results in this work show that embedded piezoelectric sensors can be used to monitor the state of health throughout the life-cycle of composite parts, even when subjected to relatively large strains. However the influence of load on guided wave measurements has implications for online monitoring using embedded piezoelectric transducers.

  9. Neighborhood conditions are associated with maternal health behaviors and pregnancy outcomes.

    PubMed

    Vinikoor-Imler, L C; Messer, L C; Evenson, K R; Laraia, B A

    2011-11-01

    Women residing in neighborhoods of low socioeconomic status are more likely to experience adverse reproductive outcomes; however, few studies explore which specific neighborhood features are associated with poor maternal health behaviors and pregnancy outcomes. Based upon our conceptual model, directly observed street-level data from four North Carolina US counties were used to create five neighborhood indices: physical incivilities (neighborhood degradation), social spaces (public space for socializing), walkability (walkable neighborhoods), borders (property boundaries), and arterial features (traffic safety). Singleton birth records (2001-2005) were obtained from the North Carolina State Center for Vital Statistics and maternal health behavior information (smoking, inadequate or excessive weight gain) and pregnancy outcomes (pregnancy-induced hypertension/pre-eclampsia, low birthweight, preterm birth) were abstracted. Race-stratified random effect models were used to estimate associations between neighborhood indices and women's reproductive behaviors and outcomes. In adjusted models, higher amounts of physical incivilities were positively associated with maternal smoking and inadequate weight gain, while walkability was associated with lower odds of these maternal health behaviors. Social spaces were also associated with inadequate weight gain during pregnancy. Among pregnancy outcomes, high levels of physical incivilities were consistently associated with all adverse pregnancy outcomes, and high levels of walkability were inversely associated with pregnancy-induced hypertension and preterm birth for Non-Hispanic white women only. None of the indices were associated with adverse birth outcomes for Non-Hispanic black women. In conclusion, certain neighborhood conditions were associated with maternal health behaviors and pregnancy outcomes. PMID:21920650

  10. Availability of Reproductive Health Care Services at Schools and Subsequent Birth Outcomes among Adolescent Mothers

    ERIC Educational Resources Information Center

    Madkour, Aubrey S.; Xie, Yiqiong; Harville, Emily W.

    2016-01-01

    Background: Adverse birth outcomes are more common among adolescent versus adult mothers, but little is known about school-based services that may improve birth outcomes in this group. Methods: Data from Waves I and IV of the National Longitudinal Study of Adolescent Health were analyzed. Girls and women who gave birth to singleton live infants…

  11. Design and Analysis of Architectures for Structural Health Monitoring Systems

    NASA Technical Reports Server (NTRS)

    Mukkamala, Ravi; Sixto, S. L. (Technical Monitor)

    2002-01-01

    During the two-year project period, we have worked on several aspects of Health Usage and Monitoring Systems for structural health monitoring. In particular, we have made contributions in the following areas. 1. Reference HUMS architecture: We developed a high-level architecture for health monitoring and usage systems (HUMS). The proposed reference architecture is shown. It is compatible with the Generic Open Architecture (GOA) proposed as a standard for avionics systems. 2. HUMS kernel: One of the critical layers of HUMS reference architecture is the HUMS kernel. We developed a detailed design of a kernel to implement the high level architecture.3. Prototype implementation of HUMS kernel: We have implemented a preliminary version of the HUMS kernel on a Unix platform.We have implemented both a centralized system version and a distributed version. 4. SCRAMNet and HUMS: SCRAMNet (Shared Common Random Access Memory Network) is a system that is found to be suitable to implement HUMS. For this reason, we have conducted a simulation study to determine its stability in handling the input data rates in HUMS. 5. Architectural specification.

  12. Evaluation of NOC standardized outcome of "health seeking behavior" in nurse-managed clinics.

    PubMed

    Macnee, Carol L; Edwards, Joellen; Kaplan, Amy; Reed, Sue; Bradford, Susanne; Walls, Jennie; Schaller-Ayers, Jennifer M

    2006-01-01

    This study evaluated the accomplishment of the Nursing Outcomes Classification (NOC) outcome "Health Seeking Behavior" in 5 nurse-managed clinics. Nurse practitioners and registered nurses rated patients on 11 indicators of health seeking behaviors, and recorded their level of knowledge of the patient. A total of 556 evaluations were collected. Health seeking behavior scores were lowest in a rural county school-based clinic and highest in a federally qualified health center. Ratings increased with nurses' knowledge of patients and for older patients. PMID:16816605

  13. Measuring the impact and outcomes of maternal child health federal programs.

    PubMed

    Taylor, Yhenneko J; Nies, Mary A

    2013-07-01

    Improving maternal and child health is a key objective of the United Nations' Millennium Development Goals and the Healthy People goals for improving the health of Americans. Government initiatives are important particularly for reducing disparities that affect disadvantaged populations. Head Start, Healthy Start, WIC and Medicaid are four federal programs that target disparities in maternal and child health outcomes. This paper reviews recent evaluations of these programs to identify outcomes assessed and opportunities for further evaluation of these programs. We conducted a review of recent evaluation studies assessing the impact of four maternal and child health programs on a health or healthcare outcome. Sources for published literature included the PubMed, Academic Search Complete, CINAHL and PsycInfo databases. Titles and abstracts of studies were examined to determine if they met inclusion criteria. Included studies were categorized by type of outcome examined. Twenty peer-reviewed studies published between January 2006 and June 2011 met inclusion criteria. The majority of studies examined infant outcomes (11), followed by breastfeeding/nutrition (4), maternal health (3), and unintended pregnancy (2). Measures used were consistent across studies; however, findings on the impact of programs were mixed reflecting differences in selection of comparison group, data source and statistical methods. The impact of maternal and child health programs may vary by setting and population served, but inconclusive findings remain. Health service researchers can build upon current evaluations to increase our understanding of what works, help target resources, and improve evaluation of programs in the future. PMID:22729661

  14. Province-Level Income Inequality and Health Outcomes in Canadian Adolescents

    PubMed Central

    McGrath, Jennifer J.

    2015-01-01

    Objective To examine the effects of provincial income inequality (disparity between rich and poor), independent of provincial income and family socioeconomic status, on multiple adolescent health outcomes. Methods Participants (aged 12–17 years; N = 11,899) were from the Canadian National Longitudinal Survey of Children and Youth. Parental education, household income, province income inequality, and province mean income were measured. Health outcomes were measured across a number of domains, including self-rated health, mental health, health behaviors, substance use behaviors, and physical health. Results Income inequality was associated with injuries, general physical symptoms, and limiting conditions, but not associated with most adolescent health outcomes and behaviors. Income inequality had a moderating effect on family socioeconomic status for limiting conditions, hyperactivity/inattention, and conduct problems, but not for other outcomes. Conclusions Province-level income inequality was associated with some physical and mental health outcomes in adolescents, which has research and policy implications for this age-group. PMID:25324533

  15. Incorporating Patient-Reported Outcomes Into Health Care To Engage Patients And Enhance Care.

    PubMed

    Lavallee, Danielle C; Chenok, Kate E; Love, Rebecca M; Petersen, Carolyn; Holve, Erin; Segal, Courtney D; Franklin, Patricia D

    2016-04-01

    The provision of patient-centered care requires a health care environment that fosters engagement between patients and their health care team. One way to encourage patient-centered care is to incorporate patient-reported outcomes into clinical settings. Collecting these outcomes in routine care ensures that important information only the patient can provide is captured. This provides insights into patients' experiences of symptoms, quality of life, and functioning; values and preferences; and goals for health care. Previously embraced in the research realm, patient-reported outcomes have started to play a role in successful shared decision making, which can enhance the safe and effective delivery of health care. We examine the opportunities for using patient-reported outcomes to enhance care delivery and outcomes as health care information needs and technology platforms change. We highlight emerging practices in which patient-reported outcomes provide value to patients and clinicians and improve care delivery. Finally, we examine present and future challenges to maximizing the use of patient-reported outcomes in the clinic. PMID:27044954

  16. Cusp Catastrophe Model: A Nonlinear Model for Health Outcomes in Nursing Research

    PubMed Central

    Chen, Ding-Geng(Din); Lin, Feng; Chen, Xinguang (Jim); Tang, Wan; Kitzman, Harriet

    2014-01-01

    Background Although health outcomes may have fundamentally nonlinearly relationships with relevant behavioral, psychological, cognitively, or biological predictors, most analytical models assume a linear relationship. Further, some health outcomes may have multimodal distributions but most statistical models in commun use assume a unimodal, normal distribution. Suitable nonlinear models should be developed to explain health outcomes. Objective The aim of this study is to provide an overview of a cusp catastrophe model for examining health outcomes, and to present an example using grip strength as an indicator of a physical functioning outcome to illustrate how the technique may be used. Results using linear regression, nonlinear logistic model and the cusp catastrophe model were compared. Methods Data from 935 participants from the Survey of Midlife Development in the United States (MIDUS) were analyzed. The outcome was grip strength; executive function (EF) and the inflammatory cytokine interleukin-6 (IL-6) were predictor variables. Results Grip strength was bimodally distributed. Based on fit and model selection criteria, the cusp model was superior to the linear model and the nonlinear logistic regression model. The cusp catastrophe model identified IL-6 as a significant asymmetry factor and EF as a significant bifurcation factor. Conclusion The cusp catastrophe model is a useful alternative for for explaining the nonlinear relationships commonly seen between health outcome and its predictors. Considerations for the use of cusp catastrophe model in nursing research are discussed and recommended. PMID:24785249

  17. Environmental Volunteering and Health Outcomes over a 20-Year Period

    ERIC Educational Resources Information Center

    Pillemer, Karl; Fuller-Rowell, Thomas E.; Reid, M. C.; Wells, Nancy M.

    2010-01-01

    Purpose: This study tested the hypothesis that volunteering in environmental organizations in midlife is associated with greater physical activity and improved mental and physical health over a 20-year period. Design and Methods: The study used data from two waves (1974 and 1994) of the Alameda County Study, a longitudinal study of health and…

  18. Mental health outcomes at the Jersey Shore after Hurricane Sandy.

    PubMed

    Boscarino, Joseph A; Hoffman, Stuart N; Kirchner, H Lester; Erlich, Porat M; Adams, Richard E; Figley, Charles R; Solhkhah, Ramon

    2013-01-01

    On October 29, 2012, Hurricane Sandy made landfall in the most densely populated region in the US. In New Jersey, thousands of families were made homeless and entire communities were destroyed in the worst disaster in the history of the state. The economic impact of Sandy was huge, comparable to Hurricane Katrina. The areas that sustained the most damage were the small- to medium-sized beach communities along New Jersey's Atlantic coastline. Six months following the hurricane, we conducted a random telephone survey of 200 adults residing in 18 beach communities located in Monmouth County. We found that 14.5% (95% CI = 9.9-20.2) of these residents screened positive for PTSD and 6.0% (95% CI = 3.1-10.2) met criteria for major depression. Altogether 13.5% (95% CI = 9.1-19.0) received mental health counseling and 20.5% (95% CI = 15.1-26.8) sought some type of mental health support in person or online, rates similar to those reported in New York after the World Trade Center disaster In multivariate analyses, the best predictors of mental health status and service use were having high hurricane exposure levels, having physical health limitations, and having environmental health concerns. Research is needed to assess the mental health status and service use of Jersey Shore residents over time, to evaluate environmental health concerns, and to better understand the storm's impact among those with physical health limitations. PMID:24558743

  19. Health outcomes during the 2008 financial crisis in Europe: systematic literature review

    PubMed Central

    Parmar, Divya; Ioannidis, John P A

    2016-01-01

    Objective To systematically identify, critically appraise, and synthesise empirical studies about the impact of the 2008 financial crisis in Europe on health outcomes. Design Systematic literature review. Data sources Structural searches of key databases, healthcare journals, and organisation based websites. Review methods Empirical studies reporting on the impact of the financial crisis on health outcomes in Europe, published from January 2008 to December 2015, were included. All selected studies were assessed for risk of bias. Owing to the heterogeneity of studies in terms of study design and analysis and the use of overlapping datasets across studies, studies were analysed thematically per outcome, and the evidence was synthesised on different health outcomes without formal meta-analysis. Results 41 studies met the inclusion criteria, and focused on suicide, mental health, self rated health, mortality, and other health outcomes. Of those studies, 30 (73%) were deemed to be at high risk of bias, nine (22%) at moderate risk of bias, and only two (5%) at low risk of bias, limiting the conclusions that can be drawn. Although there were differences across countries and groups, there was some indication that suicides increased and mental health deteriorated during the crisis. The crisis did not seem to reverse the trend of decreasing overall mortality. Evidence on self rated health and other indicators was mixed. Conclusions Most published studies on the impact of financial crisis on health in Europe had a substantial risk of bias; therefore, results need to be cautiously interpreted. Overall, the financial crisis in Europe seemed to have had heterogeneous effects on health outcomes, with the evidence being most consistent for suicides and mental health. There is a need for better empirical studies, especially those focused on identifying mechanisms that can mitigate the adverse effects of the crisis. PMID:27601477

  20. Urban community health workers: selection, training, practice and outcomes.

    PubMed

    Ramontja, R M; Wagstaff, L A; Khomo, N E

    1998-09-01

    The role, desirability and success of community health workers is debated. Conflicting reports have highlighted important concerns and provided guidelines. Particular issues identified are the necessity for both community and health professional input to determine needs and to ensure an acceptable selection process, training, support and accountability. Such steps were followed in the Greater Soweto Maternal Child Project. These are described together with the results achieved. Eight trained Soweto community health workers centered at Chiawelo Clinic and providing home based and neighbourhood health care undertake supervised Tuberculosis treatment, tracing of immunisation defaulters, and health education based on GOBI FFF (Grant JP, UNICEF:1985;94) and "Facts for Life" (UNICEF 1989-1993). They form a link between the community and government health care services and also other available resources. Over a period of 26 months, working from their own homes, they provided 14,254 health related services and in addition undertook 14,501 neighbourhood home visits. They were responsible for 8,710 referrals to the clinic or other relevant agencies for assistance. Incremental training has included HIV/AIDS counselling, advice on family planning with regular report back sessions and discussions. Participatory management involves all major role players. The community health workers have the approval and support of the Local Soweto Health Authority, the Civic Association and the communities they serve. On completion of the project, all were redeployed into local health service posts where it is intended that they form the nucleus of an expanding service. Delegation of selected tasks allows for cost effective functioning of more highly trained staff, an improved service and better use of available resources. PMID:11040587

  1. HRM and its effect on employee, organizational and financial outcomes in health care organizations

    PubMed Central

    2014-01-01

    Background One of the main goals of Human Resource Management (HRM) is to increase the performance of organizations. However, few studies have explicitly addressed the multidimensional character of performance and linked HR practices to various outcome dimensions. This study therefore adds to the literature by relating HR practices to three outcome dimensions: financial, organizational and employee (HR) outcomes. Furthermore, we will analyze how HR practices influence these outcome dimensions, focusing on the mediating role of job satisfaction. Methods This study uses a unique dataset, based on the ‘ActiZ Benchmark in Healthcare’, a benchmark study conducted in Dutch home care, nursing care and care homes. Data from autumn 2010 to autumn 2011 were analyzed. In total, 162 organizations participated during this period (approximately 35% of all Dutch care organizations). Employee data were collected using a questionnaire (61,061 individuals, response rate 42%). Clients were surveyed using the Client Quality Index for long-term care, via stratified sampling. Financial outcomes were collected using annual reports. SEM analyses were conducted to test the hypotheses. Results It was found that HR practices are - directly or indirectly - linked to all three outcomes. The use of HR practices is related to improved financial outcomes (measure: net margin), organizational outcomes (measure: client satisfaction) and HR outcomes (measure: sickness absence). The impact of HR practices on HR outcomes and organizational outcomes proved substantially larger than their impact on financial outcomes. Furthermore, with respect to HR and organizational outcomes, the hypotheses concerning the full mediating effect of job satisfaction are confirmed. This is in line with the view that employee attitudes are an important element in the ‘black box’ between HRM and performance. Conclusion The results underscore the importance of HRM in the health care sector, especially for HR and

  2. Wireless microsensors for health monitoring of aircraft structures

    NASA Astrophysics Data System (ADS)

    Varadan, Vijay K.

    2003-01-01

    The integration of MEMS, IDTs (interdigital transducers) and required microelectronics and conformal antennas to realize programmable, robust and low cost passive microsensors suitable for many military structures and systems including aircraft, missiles and munitions is presented in this paper. The technology is currently being applied to the structural health monitoring of critical aircraft components. The approach integrates acoustic emission, strain gauges, MEMS accelerometers, gyroscopes and vibration monitoring devices with signal processing electronics to provide real-time indicators of incipient failure of aircraft components with a known history of catastrophic failure due to fracture. Recently a combination of the need for safety in the air and the desire to control costs is encouraging the use of in-flight monitoring of aircraft components and systems using light-weight, wireless and cost effective microsensors and MEMS. An in-situ Aircraft structural health monitoring (ASHM) system, with sensors embedded in the composite structure or surface-mounted on the structure, would permit the timely detection of damage in aircraft. Micromachining offers the potential for fabricating a range of microsensors and MEMS for structural applications including load, vibration and acoustics characterization and monitoring. Such microsensors are extremely small; they can be embedded into structural materials, can be mass-produced and are therefore potentially cheap. Additionally a range of sensor types can be integrated onto a single chip with built-in electronics and ASIC (Application Specific Integrated Circuit), providing a low power Microsystems. The smart sensors are being developed using the standard microelectronics and micromachining in conjunction with novel Penn State smart electronics or wireless communication systems suitable for condition monitoring of aircraft structures in-flight. A hybrid accelerometer and gyroscope in a single chip suitable for inertial

  3. Effective Coverage: A Metric for Monitoring Universal Health Coverage

    PubMed Central

    Ng, Marie; Fullman, Nancy; Dieleman, Joseph L.; Flaxman, Abraham D.; Murray, Christopher J. L.; Lim, Stephen S.

    2014-01-01

    A major challenge in monitoring universal health coverage (UHC) is identifying an indicator that can adequately capture the multiple components underlying the UHC initiative. Effective coverage, which unites individual and intervention characteristics into a single metric, offers a direct and flexible means to measure health system performance at different levels. We view effective coverage as a relevant and actionable metric for tracking progress towards achieving UHC. In this paper, we review the concept of effective coverage and delineate the three components of the metric — need, use, and quality — using several examples. Further, we explain how the metric can be used for monitoring interventions at both local and global levels. We also discuss the ways that current health information systems can support generating estimates of effective coverage. We conclude by recognizing some of the challenges associated with producing estimates of effective coverage. Despite these challenges, effective coverage is a powerful metric that can provide a more nuanced understanding of whether, and how well, a health system is delivering services to its populations. PMID:25243780

  4. Continuous health monitoring of graphite epoxy motorcases (GEM)

    NASA Astrophysics Data System (ADS)

    Finlayson, Richard D.; Luzio, Marco A.; Miller, Ronnie K.; Pollock, Adrian A.

    2003-08-01

    With the increasing use of advanced composite materials in aircraft, automobiles, military hardware, and aerospace composites (such as rocket motorcases) a sizable need for composite health assessment measures exist, particularly where there is risk of failure due to high mechanical and thermal stresses. For most epoxy-based laminate composites, even low-momentum impacts can lead to "barely visible impact damage" (BVD), corresponding to a significant weakening of the composite. This weakening can lead to sudden and catastrophic failure when the material is subjected to normal operating loads. Following the explosion of Delta 241 (IIR-1) on Jaunary 17th, 1997, the failure investigation board concluded that an entire fleet of Graphite Epoxy Motorcases (GEMs) should be instrumented with a health monitoring system. This system would provide continuous structural health data on the GEM from initial acceptance testing through final erection on the launch pad. The result presented here contribute significantly to the understanding of the acoustic properties of the GEM casing, and make a substantial advancement in the theoretical phase of the source location algorithm development. When the system is complete it will continuously monitor the structural health of the GEMs, communicate wirelessly with base stations, operate autonomously for extended periods, and fit unobtrusively on the GEM itself.

  5. Male facial masculinity as a cue to health outcomes.

    PubMed

    Boothroyd, Lynda G; Scott, Isabel; Gray, Alan W; Coombes, Claire I; Pound, Nicholas

    2013-01-01

    Evolutionary theories of human attraction draw heavily upon nonhuman literature, and currently the Immunocompetence Handicap Hypothesis dominates research into female attraction to male facial masculinity. Although some studies have shown links between masculinity and some measures of health, other data have failed to support the Immunocompetence Hypothesis as applied to human face preferences. Here we summarize that literature and present new data regarding links between masculinity and multiple measures of health condition in human males. Undergraduate males were photographed and their faces were assessed for sexual dimorphism using multiple methods and rated for apparent healthiness and attractiveness. Participants also reported recent health experiences both prior to being photographed and then again 10 weeks later. Although both attractiveness and rated health were associated with better actual health in the past and future (mainly indexed by lower antibiotic use), results were mixed for masculinity. With respect to respiratory illnesses, facial masculinity (assessed using morphometric techniques) was associated with better past health but with worse future health. Possible reasons for the complex and inconsistent findings are discussed and some potentially fruitful avenues of future research are outlined. PMID:24252513

  6. Engine health monitoring systems: Tools for improved maintenance management in the 1980's

    NASA Technical Reports Server (NTRS)

    Kimball, J. C.

    1981-01-01

    The performance monitoring aspect of maintenance, characteristic of the engine health monitoring system are discussed. An overview of the system activities is presented and a summary of programs for improved monitoring in the 1980's are discussed.

  7. TRANSFoRm eHealth solution for quality of life monitoring.

    PubMed Central

    Saganowski, Stanisław; Misiaszek, Andrzej; Bródka, Piotr; Andreasson, Anna; Curcin, Vasa; Delaney, Brendan; Frączkowski, Kazimierz

    2016-01-01

    Patient Recorded Outcome Measures (PROMs) are an essential part of quality of life monitoring, clinical trials, improvement studies and other medical tasks. Recently, web and mobile technologies have been explored as means of improving the response rates and quality of data collected. Despite the potential benefit of this approach, there are currently no widely accepted standards for developing or implementing PROMs in CER (Comparative Effectiveness Research). Within the European Union project Transform (Translational Research and Patient Safety in Europe) an eHealth solution for quality of life monitoring has been developed and validated. This paper presents the overall architecture of the system as well as a detailed description of the mobile and web applications. PMID:27570677

  8. How can health literacy influence outcomes in heart failure patients? Mechanisms and interventions.

    PubMed

    Westlake, Cheryl; Sethares, Kristen; Davidson, Patricia

    2013-09-01

    Health literacy is discussed in papers from 25 countries where findings suggest that approximately a third up to one half of the people in developed countries have low health literacy. Specifically, health literacy is the mechanism by which individuals obtain and use health information to make health decisions about individual treatments in the home, access care in the community, promote provider-patient interactions, structure self-care, and navigate health care programs both locally and nationally. Further, health literacy is a key determinant of health and a critical dimension for assessing individuals' needs, and, importantly, their capacity for self-care. Poorer health knowledge/status, more medication errors, costs, and higher rates of morbidity, readmissions, emergency room visits, and mortality among patients with health illiteracy have been demonstrated. Individuals at high risk for low health literacy include the elderly, disabled, Blacks, those with a poverty-level income, some or less high school education, either no insurance or Medicare or Medicaid, and those for whom English is a second language. As a consequence, health literacy is a complex, multifaceted, and evolving construct including aspects of social, psychological, cultural and economic circumstances. The purpose of this paper is to describe the mechanisms and consequences of health illiteracy. Specifically, the prevalence, associated demographics, and models of health literacy are described. The mechanism of health illiteracy's influence on outcomes in heart failure is proposed. Tools for health literacy assessment are described and compared. Finally, the health outcomes and general interventions to enhance the health outcomes in heart failure are discussed. PMID:23873404

  9. Impact of mHealth Chronic Disease Management on Treatment Adherence and Patient Outcomes: A Systematic Review

    PubMed Central

    Hamine, Saee; Faulx, Dunia; Green, Beverly B; Ginsburg, Amy Sarah

    2015-01-01

    Background Adherence to chronic disease management is critical to achieving improved health outcomes, quality of life, and cost-effective health care. As the burden of chronic diseases continues to grow globally, so does the impact of non-adherence. Mobile technologies are increasingly being used in health care and public health practice (mHealth) for patient communication, monitoring, and education, and to facilitate adherence to chronic diseases management. Objective We conducted a systematic review of the literature to evaluate the effectiveness of mHealth in supporting the adherence of patients to chronic diseases management (“mAdherence”), and the usability, feasibility, and acceptability of mAdherence tools and platforms in chronic disease management among patients and health care providers. Methods We searched PubMed, Embase, and EBSCO databases for studies that assessed the role of mAdherence in chronic disease management of diabetes mellitus, cardiovascular disease, and chronic lung diseases from 1980 through May 2014. Outcomes of interest included effect of mHealth on patient adherence to chronic diseases management, disease-specific clinical outcomes after intervention, and the usability, feasibility, and acceptability of mAdherence tools and platforms in chronic disease management among target end-users. Results In all, 107 articles met all inclusion criteria. Short message service was the most commonly used mAdherence tool in 40.2% (43/107) of studies. Usability, feasibility, and acceptability or patient preferences for mAdherence interventions were assessed in 57.9% (62/107) of studies and found to be generally high. A total of 27 studies employed randomized controlled trial (RCT) methods to assess impact on adherence behaviors, and significant improvements were observed in 15 of those studies (56%). Of the 41 RCTs that measured effects on disease-specific clinical outcomes, significant improvements between groups were reported in 16 studies (39

  10. Progress Monitoring in an Integrated Health Care System: Tracking Behavioral Health Vital Signs.

    PubMed

    Steinfeld, Bradley; Franklin, Allie; Mercer, Brian; Fraynt, Rebecca; Simon, Greg

    2016-05-01

    Progress monitoring implementation in an integrated health care system is a complex process that must address factors such as measurement, technology, delivery system care processes, patient needs and provider requirements. This article will describe how one organization faced these challenges by identifying the key decision points (choice of measure, process for completing rating scale, interface with electronic medical record and clinician engagement) critical to implementation. Qualitative and quantitative data will be presented describing customer and stakeholder satisfaction with the mental health progress monitoring tool (MHPMT) as well as organizational performance with key measurement targets. PMID:25840521

  11. Health Monitoring of Composite Material Structures using a Vibrometry Technique

    NASA Technical Reports Server (NTRS)

    Schulz, Mark J.

    1997-01-01

    Large composite material structures such as aircraft and Reusable Launch Vehicles (RLVS) operate in severe environments comprised of vehicle dynamic loads, aerodynamic loads, engine vibration, foreign object impact, lightning strikes, corrosion, and moisture absorption. These structures are susceptible to damage such as delamination, fiber breaking/pullout, matrix cracking, and hygrothermal strain. To ensure human safety and load-bearing integrity, these structures must be inspected to detect and locate often invisible damage and faults before becoming catastrophic. Moreover, nearly all future structures will need some type of in-service inspection technique to increase their useful life and reduce maintenance and overall costs. Possible techniques for monitoring the health and indicating damage on composite structures include: c-scan, thermography, acoustic emissions using piezoceramic actuators or fiber-optic wires with gratings, laser ultrasound, shearography, holography, x-ray, and others. These techniques have limitations in detecting damage that is beneath the surface of the structure, far away from a sensor location, or during operation of the vehicle. The objective of this project is to develop a more global method for damage detection that is based on structural dynamics principles, and can inspect for damage when the structure is subjected to vibratory loads to expose faults that may not be evident by static inspection. A Transmittance Function Monitoring (TFM) method is being developed in this project for ground-based inspection and operational health monitoring of large composite structures as a RLV. A comparison of the features of existing health monitoring approaches and the proposed TFM method is given.

  12. Ethnic and racial identity in adolescence: implications for psychosocial, academic, and health outcomes.

    PubMed

    Rivas-Drake, Deborah; Seaton, Eleanor K; Markstrom, Carol; Quintana, Stephen; Syed, Moin; Lee, Richard M; Schwartz, Seth J; Umaña-Taylor, Adriana J; French, Sabine; Yip, Tiffany

    2014-01-01

    The construction of an ethnic or racial identity is considered an important developmental milestone for youth of color. This review summarizes research on links between ethnic and racial identity (ERI) with psychosocial, academic, and health risk outcomes among ethnic minority adolescents. With notable exceptions, aspects of ERI are generally associated with adaptive outcomes. ERI are generally beneficial for African American adolescents' adjustment across all three domains, whereas the evidence is somewhat mixed for Latino and American Indian youth. There is a dearth of research for academic and health risk outcomes among Asian American and Pacific Islander adolescents. The review concludes with suggestions for future research on ERI among minority youth. PMID:24490891

  13. Creating an Overall Environmental Quality Index to Examine Health Outcomes

    EPA Science Inventory

    The interaction between environmental conditions and human health transpire from complex processes. Environmental exposures tend to cluster and disamenities such as landfills or industrial plants are often located in areas with high a percentage of minority and poor residents. Wh...

  14. Wireless Zigbee strain gage sensor system for structural health monitoring

    NASA Astrophysics Data System (ADS)

    Ide, Hiroshi; Abdi, Frank; Miraj, Rashid; Dang, Chau; Takahashi, Tatsuya; Sauer, Bruce

    2009-05-01

    A compact cell phone size radio frequency (ZigBee) wireless strain measurement sensor system to measure the structural strain deformation was developed. The developed system provides an accurate strain measurement data stream to the Internet for further Diagnostic and Prognostic (DPS) correlation. Existing methods of structural measurement by strain sensors (gauges) do not completely satisfy problems posed by continuous structural health monitoring. The need for efficient health monitoring methods with real-time requirements to bidirectional data flow from sensors and to a commanding device is becoming critical for keeping our daily life safety. The use of full-field strain measurement techniques could reduce costly experimental programs through better understanding of material behavior. Wireless sensor-network technology is a monitoring method that is estimated to grow rapidly providing potential for cost savings over traditional wired sensors. The many of currently available wireless monitoring methods have: the proactive and constant data rate character of the data streams rather than traditional reactive, event-driven data delivery; mostly static node placement on structures with limited number of nodes. Alpha STAR Electronics' wireless sensor network system, ASWN, addresses some of these deficiencies, making the system easier to operate. The ASWN strain measurement system utilizes off-the-shelf sensors, namely strain gauges, with an analog-to-digital converter/amplifier and ZigBee radio chips to keep cost lower. Strain data is captured by the sensor, converted to digital form and delivered to the ZigBee radio chip, which in turn broadcasts the information using wireless protocols to a Personal Data Assistant (PDA) or Laptop/Desktop computers. From here, data is forwarded to remote computers for higher-level analysis and feedback using traditional cellular and satellite communication or the Ethernet infrastructure. This system offers a compact size, lower cost

  15. Continuous health monitoring of Graphite Epoxy Motorcases (GEM)

    NASA Astrophysics Data System (ADS)

    Finlayson, Richard D.; Schaafsma, David T.; Shen, H. Warren; Carlos, Mark F.; Miller, Ronnie K.; Shepherd, Brent

    2001-07-01

    Following the explosion of Delta 241 (IIR-1) on January 17th, 1997, the failure investigation board concluded that the Graphite Epoxy Motorcases (GEM's) should be inspected for damage just prior to launch. Subsequent investigations and feedback from industry led to an Aerospace Corporation proposal to instrument the entire fleet of GEM's with a continuous health monitoring system. The period of monitoring would extend from the initial acceptance testing through final erection on the launch pad. As this proposal demonstrates, (along with the increasing use of advanced composite materials in aircraft, automobiles, military hardware, and aerospace components such as rocket motorcases) a sizable need for composite health assessment measures exist. Particularly where continuous monitoring is required for the detection of damage from impacts and other sources of high mechanical and thermal stresses. Even low-momentum impacts can lead to barely visible impact damage (BVID), corresponding to a significant weakening of the composite. This damage, undetectable by visual inspection, can in turn lead to sudden and catastrophic failure when the material is subjected to a normal operating load. There is perhaps no system with as much potential for truly catastrophic failure as a rocket motor. We will present an update on our ongoing efforts with the United States Air Force Delta II Program Office, and The Aerospace Corporation. This will cover the development of a local, portable, surface-mounted, fiberoptic sensor based impact damage monitor designed to operate on a Delta II GEM during transport, storage, and handling. This system is designed to continuously monitor the GEMs, to communicate wirelessly with base stations and maintenance personnel, to operate autonomously for extended periods, and to fit unobtrusively on the GEM itself.

  16. Parental monitoring, parental warmth, and minority youths' academic outcomes: exploring the integrative model of parenting.

    PubMed

    Lowe, Katie; Dotterer, Aryn M

    2013-09-01

    Guided by the integrative model of parenting, the present study investigated the relationship between parental monitoring and racial/ethnic minority adolescents' school engagement and academic motivation as a function of parental warmth, and explored whether these associations varied for boys and girls. Participants (60 % female) were 208 sixth through eighth grade students (63 % African American, 19 % Latino, 18 % Multiracial) from an urban middle school in the Midwestern United States. Youth completed an in-school survey with items on parenting (parental monitoring, mothers'/fathers' warmth), cognitive engagement (school self-esteem), behavioral engagement (school trouble), and academic motivation (intrinsic motivation). As hypothesized, mothers' warmth enhanced the association between parental monitoring and youths' engagement and motivation. No gender differences in these associations emerged. Fathers' warmth strengthened the negative association between parental monitoring and school trouble, and this association was stronger for boys. Implications regarding the importance of sustaining a high level of monitoring within the context of warm parent-adolescent relationships to best support academic outcomes among minority youth are discussed. PMID:23456244

  17. Predictors of Criminal Justice Outcomes Among Mental Health Courts Participants: The Role of Perceived Coercion and Subjective Mental Health Recovery

    PubMed Central

    Yanos, Philip T.; Kopelovich, Sarah L.; Koerner, Joshua; Alexander, Mary Jane

    2013-01-01

    Internationally, one effort to reduce the number of people with serious mental illness (SMI) in jails and prisons is the development of Mental Health Courts (MHC). Research on MHCs to date has been disproportionately focused on the study of recidivism and re-incarceration over the potential of these problem-solving courts to facilitate mental health recovery and affect the slope or gradient of opportunity for recovery. Despite the strong conceptual links between the MHC approach and the recovery-orientation in mental health, the capacity for MHCs to facilitate recovery has not been explored. This user-informed mental health and criminal justice (MH/CJ) community based participatory (CBPR) study assesses the extent to which MHC practices align with recovery-oriented principles and may subsequently affect criminal justice outcomes. We report on the experiences and perceptions of 51 MHC participants across four metropolitan Mental Health Courts. Specifically, the current study assesses: 1) how defendants’ perceptions of court practices, particularly with regard to procedural justice and coercion, relate to perceptions of mental health recovery and psychiatric symptoms, and, 2) how perceptions of procedural justice and mental health recovery relate to subsequent criminal justice outcomes. The authors hypothesized that perceived coercion and mental health recovery would be inversely related, that perceived coercion would be associated with worse criminal justice outcomes, and perceptions of mental health recovery would be associated with better criminal justice outcomes. Results suggest that perceived coercion in the MHC experience was negatively associated with perceptions of recovery among MHC participants. Perceptions of “negative pressures,” a component of coercion, were important predictors of criminal justice involvement in the 12 month period following MHC admission, even when controlling for other factors that were related to criminal justice outcomes, and

  18. Health-related outcomes of war in Nicaragua.

    PubMed Central

    Garfield, R M; Frieden, T; Vermund, S H

    1987-01-01

    Since 1983, war in Nicaragua has slowed improvements in health which had developed rapidly from 1979-82. The rate of war-related deaths among Nicaraguans now exceeds that of the United States citizens in either the Vietnam War or World War II. Forty-two of the 84 documented war-related casualties among Nicaraguan health workers have been deaths. This high case fatality rate reflects the targeting of health workers by contra troops. The number of staff and services of the public medical system decreased by approximately 10 per cent from 1983 to 1985. Population movements, the establishment of new settlements, and war-related destruction of the primary health infrastructure are associated with recent epidemics of malaria, dengue, measles, and leishmaniasis. The estimated rate of infant mortality in Nicaragua, which had declined from 120 per 1,000 in 1978 to 76/1,000 live births in 1983, has since shown no further decline. Internationally mandated protections enjoyed by civilians and health workers during times of war do not appear to operate in this so-called "low intensity" conflict. Further declines in infant mortality, prevention of epidemics, and improvement in other health indicators will likely await the cessation of military hostilities. PMID:3565659

  19. The Saskatchewan rural health study: an application of a population health framework to understand respiratory health outcomes

    PubMed Central

    2012-01-01

    Background Respiratory disease can impose a significant burden on the health of rural populations. The Saskatchewan Rural Health Study (SRHS) is a new large prospective cohort study of ages 6 and over currently being conducted in farming and non-farming communities to evaluate potential health determinants associated with respiratory outcomes in rural populations. In this article, we describe the rationale and methodology for the adult component. The study is being conducted over 5 years (2009–15) in two phases, baseline and longitudinal. The baseline survey consists of two components, adults and children. The adult component consists of a questionnaire-based evaluation of individual and contextual factors of importance to respiratory health in two sub populations (a Farm Cohort and a Small Town Cohort) of rural families in Saskatchewan Rural Municipalities (RMs). Clinical studies of lung function and allergy tests are being conducted on selected sub-samples of the two cohorts based on the positive response to the last question on the baseline questionnaire: “Would you be willing to be contacted about having breathing and/or allergy tests at a nearby location?”. We adopted existing population health theory to evaluate individual factors, contextual factors, and principal covariates on the outcomes of chronic bronchitis, chronic obstructive pulmonary disease, asthma and obstructive sleep apnea. Findings Of the RMs selected to participate, 32 (89%) out of 36 RMs and 15 (94%) out of 16 small towns within the RMs agreed to participate. Using the mail out survey method developed by Dillman, we obtained completed questionnaires from 4264 households (8261 individuals). We obtained lung function measurements on 1609 adults, allergy skin test information on 1615 adults; both measurements were available on 1549 adults. We observed differences between farm and non-farm rural residents with respect to individual, contextual factors and covariates. Discussion There are

  20. An Apparatus for Monitoring the Health of Electrical Cables

    NASA Technical Reports Server (NTRS)

    Pai, Devdas M.; Tatum, Paul; Pace, Rachel

    2004-01-01

    As with most elements of infrastructure, electrical wiring is innocuous; usually hidden away and unnoticed until it fails. Failure of infrastructure, however, sometimes leads to serious health and safety hazards. Electrical wiring fails when the polymeric (usually rubber) insulation material that sheathes the conductor gets embrittled with age from exposure to pressure, temperature or radiation cycling or when the insulation gets removed by the chafing of wires against each other. Miles of such wiring can be found in typical aircraft, with significant lengths of the wiring immersed in aviation fuel - a recipe for an explosion if a spark were to occur. Diagnosing the health of wiring is thus an important aspect of monitoring the health of aging aircraft. Stress wave propagation through wiring affords a quick and non-invasive method for health monitoring. The extent to which a stress wave propagating through the cable core gets attenuated depends on the condition of the surrounding insulation. When the insulation is in good condition - supple and pliable, there is more damping or attenuation of the waveform. As the insulation gets embrittled and cracked, the attenuation is likely to reduce and the waveform of the propagating stress wave is likely to change. The monitoring of these changes provides a potential tool to evaluate wiring or cabling in service that is not accessible for visual inspection. This experiment has been designed for use in an introductory mechanical or materials engineering instrumentation lab. Initial setup (after procuring all the materials) should take the lab instructor about 4 hours. A single measurement can be initiated and saved to disk in less than 3 minutes, allowing for all the students in a typical lab section to take their own data rather than share a single set of data for the entire class.

  1. Personal Health Technologies in Employee Health Promotion: Usage Activity, Usefulness, and Health-Related Outcomes in a 1-Year Randomized Controlled Trial

    PubMed Central

    Orsama, Anna-Leena; Ahtinen, Aino; Hopsu, Leila; Leino, Timo; Korhonen, Ilkka

    2013-01-01

    Background Common risk factors such as obesity, poor nutrition, physical inactivity, stress, and sleep deprivation threaten the wellness and work ability of employees. Personal health technologies may help improve engagement in health promotion programs and maintenance of their effect. Objective This study investigated personal health technologies in supporting employee health promotion targeting multiple behavioral health risks. We studied the relations of usage activity to demographic and physiological characteristics, health-related outcomes (weight, aerobic fitness, blood pressure and cholesterol), and the perceived usefulness of technologies in wellness management. Methods We conducted a subgroup analysis of the technology group (114 subjects, 33 males, average age 45 years, average BMI 27.1 kg/m2) of a 3-arm randomized controlled trial (N=352). The trial was organized to study the efficacy of a face-to-face group intervention supported by technologies, including Web services, mobile applications, and personal monitoring devices. Technology usage was investigated based on log files and questionnaires. The associations between sustained usage of Web and mobile technologies and demographic and physiological characteristics were analyzed by comparing the baseline data of sustained and non-sustained users. The associations between sustained usage and changes in health-related outcomes were studied by repeated analysis of variance, using data measured by baseline and end questionnaires, and anthropometric and laboratory measurements. The experienced usability, usefulness, motivation, and barriers to using technologies were investigated by 4 questionnaires and 2 interviews. Results 111 subjects (97.4%) used technologies at some point of the study, and 33 (29.9%) were classified as sustained users of Web or mobile technologies. Simple technologies, weight scales and pedometer, attracted the most users. The sustained users were slightly older 47 years (95% CI 44 to 49

  2. The quiet revolution: reporting of health outcomes in general medical journals.

    PubMed

    Seymour, J; Newell, D; Shiell, A

    1997-01-01

    This study reviews the extent of evaluation of health outcomes in three general medical journals over the past decade by examining papers published in the original research section of the New England Journal of Medicine (NEJM), The Lancet, and the Medical Journal of Australia (MJA) in 1982 and 1992. Evaluations were identified and classified according to the type of comparison group and the type of outcome measures employed. They were divided into three categories: those employing a comparison group; those employing a before-and-after study design (or own comparison group); and those with no comparison group. The categories of outcome measures were mortality, clinical or intermediate measures of health state, and final outcome measures (quality of life). Results show that the proportion of papers evaluating a health services intervention remained stable over the period. However, the MJA published considerably fewer evaluations than the other journals. In the NEJM and The Lancet, 75 per cent of evaluations incorporated comparison groups, in the MJA, less than 40 per cent. Overall, the proportion of papers reporting final outcome measures increased significantly between 1982 and 1992 (p = 0.04) but the change in each journal individually did not reach statistical significance. This study indicates that the reporting of health outcomes evaluations has remained constant but there has been some change in the use of comparison groups and final outcome measures over time. PMID:10165947

  3. Telephone-Based Psychiatric Referral-Care Management Intervention Health Outcomes

    PubMed Central

    Bush, Heather; Oslin, David

    2010-01-01

    Abstract Objective: This study examined the effectiveness of a telephone-based referral-care management (TBR-CM) intervention on psychiatric health outcomes. Materials and Methods: Between September 2005 and May 2006, primary care patients (n = 169) at the Philadelphia Veterans Affairs Medical Center completed a psychiatric interview over the telephone, of which 113 gave consent and were randomized into the TBR-CM usual care or intervention groups (n = 40 [39%] depression, n = 40 [39%] substance abuse, and n = 33 [22%] comorbid condition: depression and substance abuse). Usual care consisted of participants receiving a psychiatric appointment, followed up with standard institutional reminders. The intervention care group received the same, with the addition of brief motivational telephone sessions. Baseline and 6-month interviews were used to obtain study data. Results: Results indicated that there was improvement in mental health functioning (p < 0.0001), depression (p < 0.0001), and binge (p < 0.0332) outcomes over the 6-month interview (78% retention). However, there was no change observed for physical health functioning and drinks per week outcomes. For mental health functioning, depression, and binge rates there were no randomization group assignment effects, indicating that the intervention care group did not show better health outcomes despite showing higher levels of psychiatric appointment attendance. Conclusions: Patients who are exposed to the intervention have similar health outcomes as patients in usual care. In conclusion, the TBR-CM intervention does not lead to relatively improved psychiatric health outcomes. Further research is necessary to examine the efforts needed to extend increased treatment engagement into improved health outcomes for intervention recipients. PMID:20575721

  4. Impact of clinical registries on quality of patient care and health outcomes: protocol for a systematic review

    PubMed Central

    Hoque, Dewan Md Emdadul; Kumari, Varuni; Ruseckaite, Rasa; Romero, Lorena; Evans, Sue M

    2016-01-01

    Introduction Many developed countries have regional and national clinical registries aimed at improving health outcomes of patients diagnosed with particular diseases or cared for in particular healthcare settings. Clinical quality registries (CQRs) are clinical registries established with the purpose of monitoring quality of care and providing feedback to improve health outcomes. The aim of this systematic review is to understand the impact of CQRs on (1) mortality/survival; (2) measures of outcome that reflect a process or outcome of healthcare; (3) healthcare utilisation and (4) costs. Methods and analysis The PRISMA-P methodology, checklist and standard strategy using predefined inclusion and exclusion criteria and structured data abstraction tools will be followed. A search of the electronic databases MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL) and CINAHL will be undertaken, in addition to Google Scholar and grey literature, to identify studies in English covering the period January 1980 to December 2014. Case–control, cohort, randomised controlled trials and controlled clinical trials which describe the registry as an intervention will be eligible for inclusion. Narrative synthesis of study findings will be conducted, guided by a conceptual framework developed to analyse the outcome measure of the registry using defined criteria. If sufficient studies are identified with a similar outcome of interest and measure using the same comparator and time of interval, results will be pooled for random-effects meta-analysis. Test for heterogeneity and sensitivity analysis will be conducted. To identify reporting bias, forest plots and funnel plots will be created and, if required, Egger's test will be conducted. Ethics and dissemination Ethical approval is not required as primary data will not be collected. Review results will be published as a part of thesis, peer-reviewed journal and conferences. Trial registration number CRD

  5. Nurse-sensitive health care outcomes in acute care settings: an integrative analysis of the literature.

    PubMed

    Pierce, S F

    1997-04-01

    With the advent of profit maximization in health care came an increased focus on defining quality through outcomes achieved. The article describes an analysis of the nursing literature from 1974 to 1996 using Donabedian's structure-process-outcome framework and the specific indicators identified by the American Nurses Association report card, the Institute of Medicine, and the nursing-sensitive outcomes classification. Although evidence exists documenting nursing's positive impact on patient outcomes, this analysis suggests a real need to integrate our clinical and administrative studies and to employ a more comprehensive, longitudinal, multifacility approach if we are to answer the scientific question regarding which nursing structures and processes truly produce the best health outcomes. PMID:9097521

  6. Adherence to antihypertensive medications and health outcomes among newly treated hypertensive patients

    PubMed Central

    Esposti, Luca Degli; Saragoni, Stefania; Benemei, Silvia; Batacchi, Paolo; Geppetti, Pierangelo; Di Bari, Mauro; Marchionni, Niccolò; Sturani, Alessandra; Buda, Stefano; Esposti, Ezio Degli

    2011-01-01

    Objective: To evaluate adherence to antihypertensive therapy (AHT) and the association between adherence to AHT, all-cause mortality, and cardiovascular (CV) morbidity in a large cohort of patients newly treated with antihypertensives in a clinical practice setting. Methods: An administrative database kept by the Local Health Unit of Florence (Italy) listing patient baseline characteristics, drug prescription, and hospital admission information was used to perform a population-based retrospective study including patients newly treated with antihypertensives, ≥18 years of age, with a first prescription between January 1, 2004 and December 31, 2006. Patients using antihypertensives for secondary prevention of CV disease, occasional spot users, and patients with early CV events, were excluded from the study cohort. Adherence to AHT was calculated and classified as poor, moderate, good, and excellent. A Cox regression model was conducted to determine the association among adherence to AHT and risk of all-cause mortality, stroke, or acute myocardial infarction. Results: A total of 31,306 patients, 15,031 men (48.0%), and 16,275 women (52.0%), with a mean age of 60.2 ± 14.5 years was included in the study. Adherence to AHT was poor in 8038 patients (25.7% of included patients), moderate in 4640 (14.8%), good in 5651 (18.1%), and excellent in 12,977 (41.5%). Compared with patients with poor adherence (hazard ratio [HR] = 1), the risk of all-cause death, stroke, or acute myocardial infarction was significantly lower in patients with good (HR = 0.69, P < 0.001) and excellent adherence (HR = 0.53, P < 0.001). Conclusions: These findings indicate that suboptimal adherence to AHT occurs in a substantial proportion of patients and is associated with poor health outcomes already in primary prevention of CV diseases. For health authorities, this preliminary evidence underlines the need for monitoring and improving medication adherence in clinical practice. PMID:21935332

  7. A framework for outcome-level evaluation of in-service training of health care workers

    PubMed Central

    2013-01-01

    Background In-service training is a key strategic approach to addressing the severe shortage of health care workers in many countries. However, there is a lack of evidence linking these health care worker trainings to improved health outcomes. In response, the United States President’s Emergency Plan for AIDS Relief’s Human Resources for Health Technical Working Group initiated a project to develop an outcome-focused training evaluation framework. This paper presents the methods and results of that project. Methods A general inductive methodology was used for the conceptualization and development of the framework. Fifteen key informant interviews were conducted to explore contextual factors, perceived needs, barriers and facilitators affecting the evaluation of training outcomes. In addition, a thematic analysis of 70 published articles reporting health care worker training outcomes identified key themes and categories. These were integrated, synthesized and compared to several existing training evaluation models. This formed an overall typology which was used to draft a new framework. Finally, the framework was refined and validated through an iterative process of feedback, pilot testing and revision. Results The inductive process resulted in identification of themes and categories, as well as relationships among several levels and types of outcomes. The resulting framework includes nine distinct types of outcomes that can be evaluated, which are organized within three nested levels: individual, organizational and health system/population. The outcome types are: (1) individual knowledge, attitudes and skills; (2) individual performance; (3) individual patient health; (4) organizational systems; (5) organizational performance; (6) organizational-level patient health; (7) health systems; (8) population-level performance; and (9) population-level health. The framework also addresses contextual factors which may influence the outcomes of training, as well as the

  8. Remote health monitoring for elderly through interactive television

    PubMed Central

    2012-01-01

    Background Providing remote health monitoring to specific groups of patients represents an issue of great relevance for the national health systems, because of the costs related to moving health operators, the time spent to reach remote sites, and the high number of people needing health assistance. At the same time, some assistance activities, like those related to chronical diseases, may be satisfied through a remote interaction with the patient, without a direct medical examination. Methods Moving from this considerations, our paper proposes a system architecture for the provisioning of remote health assistance to older adults, based on a blind management of a network of wireless medical devices, and an interactive TV Set Top Box for accessing health related data. The selection of TV as the interface between the user and the system is specifically targeted to older adults. Due to the private nature of the information exchanged, a certified procedure is implemented for data delivery, through the use of non conditional smart cards. All these functions may be accomplished through a proper design of the system management, and a suitable interactive application. Results The interactive application acting as the interface between the user and the system on the TV monitor has been evaluated able to help readability and clear understanding of the contents and functions proposed. Thanks to the limited amount of data to transfer, even a Set Top Box equipped with a traditional PSTN modem may be used to support the proposed service at a basic level; more advanced features, like audio/video connection, may be activated if the Set Top Box enables a broadband connection (e.g. ADSL). Conclusions The proposed layered architecture for a remote health monitoring system can be tailored to address a wide range of needs, according with each patient’s conditions and capabilities. The system exploits the potentialities offered by Digital Television receivers, a friendly MHP interface

  9. The Effect of Financial Compensation on Health Outcomes following Musculoskeletal Injury: Systematic Review

    PubMed Central

    Murgatroyd, Darnel F.; Casey, Petrina P.; Cameron, Ian D.; Harris, Ian A.

    2015-01-01

    The effect of financial compensation on health outcomes following musculoskeletal injury requires further exploration because results to date are varied and controversial. This systematic review identifies compensation related factors associated with poorer health outcomes following musculoskeletal injury. Searches were conducted using electronic medical journal databases (Medline, CINAHL, Embase, Informit, Web of Science) for prospective studies published up to October 2012. Selection criteria included: prognostic factors associated with validated health outcomes; six or more months follow up; and multivariate statistical analysis. Studies solely measuring return to work outcomes were excluded. Twenty nine articles were synthesised and then assessed using GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology to determine evidence levels. The results were mixed. There was strong evidence of an association between compensation status and poorer psychological function; and legal representation and poorer physical function. There was moderate evidence of an association between compensation status and poorer physical function; and legal representation and poorer psychological function. There was limited evidence of an association between compensation status and increased pain. In seven studies the association depended on the outcome measured. No studies reported an association between compensation related factors and improved health outcomes. Further research is needed to find plausible reasons why compensation related factors are associated with poorer health following musculoskeletal injury. PMID:25680118

  10. Regional health expenditure and health outcomes after out-of-hospital cardiac arrest in Japan: an observational study

    PubMed Central

    Tsugawa, Yusuke; Hasegawa, Kohei; Hiraide, Atsushi; Jha, Ashish K

    2015-01-01

    Objectives Japan is considering policies to set the target health expenditure level for each region, a policy approach that has been considered in many other countries. The objective of this study was to examine the relationship between regional health expenditure and health outcomes after out-of-hospital cardiac arrest (OHCA), which incorporates the qualities of prehospital, in-hospital and posthospital care systems. Design We examined the association between prefecture-level per capita health expenditure and patients’ health outcomes after OHCA. Setting We used a nationwide, population-based registry system of OHCAs that captured all cases with OHCA resuscitated by emergency responders in Japan from 2005 to 2011. Participants All patients with OHCA aged 1–100 years were analysed. Outcome measures The patients’ 1-month survival rate, and favourable neurological outcome (defined as cerebral performance category 1–2) at 1-month. Results Among 618 154 cases with OHCA, the risk-adjusted 1-month survival rate varied from 3.3% (95% CI 2.9% to 3.7%) to 8.4% (95% CI 7.7% to 9.1%) across prefectures. The risk-adjusted probabilities of favourable neurological outcome ranged from 1.6% (95% CI 1.4% to 1.9%) to 3.7% (95% CI 3.4% to 3.9%). Compared with prefectures with lowest tertile health expenditure, 1-month survival rate was significantly higher in medium-spending (adjusted OR 1.31, 95% CI 1.03 to 1.66, p=0.03) and high-spending prefectures (adjusted OR 1.30, 95% CI 1.03 to 1.64, p=0.02), after adjusting for patient characteristics. There was no difference in the survival between medium-spending and high-spending regions. We observed similar patterns for favourable neurological outcome. Additional adjustment for regional per capita income did not affect our overall findings. Conclusions We observed a wide variation in the health outcomes after OHCA across regions. Low-spending regions had significantly worse health outcomes compared with medium-spending or high

  11. Diagnostics in a digital age: an opportunity to strengthen health systems and improve health outcomes.

    PubMed

    Peeling, Rosanna W

    2015-11-01

    Diagnostics play a critical role in clinical decision making, and in disease control and prevention. Rapid point-of-care (POC) tests for infectious diseases can improve access to diagnosis and patient management, but the quality of these tests vary, quality of testing is often not assured and there are few mechanisms to capture test results for surveillance when the testing is so decentralised. A new generation of POC molecular tests that are highly sensitive and specific, robust and easy to use are now available for deployment in low resource settings. Decentralisation of testing outside of the laboratory can put tremendous stress on the healthcare system and presents challenges for training and quality assurance. A feature of many of these POC molecular devices is that they are equipped with data transmission capacities. In a digital age, it is possible to link data from diagnostic laboratories and POC test readers and devices to provide data on testing coverage, disease trends and timely information for early warning of infectious disease outbreaks to inform design or optimisation of disease control and elimination programmes. Data connectivity also allows control programmes to monitor the quality of tests and testing, and optimise supply chain management; thus, increasing the efficiency of healthcare systems and improving patient outcomes. PMID:26553825

  12. Remote health monitoring system for detecting cardiac disorders.

    PubMed

    Bansal, Ayush; Kumar, Sunil; Bajpai, Anurag; Tiwari, Vijay N; Nayak, Mithun; Venkatesan, Shankar; Narayanan, Rangavittal

    2015-12-01

    Remote health monitoring system with clinical decision support system as a key component could potentially quicken the response of medical specialists to critical health emergencies experienced by their patients. A monitoring system, specifically designed for cardiac care with electrocardiogram (ECG) signal analysis as the core diagnostic technique, could play a vital role in early detection of a wide range of cardiac ailments, from a simple arrhythmia to life threatening conditions such as myocardial infarction. The system that the authors have developed consists of three major components, namely, (a) mobile gateway, deployed on patient's mobile device, that receives 12-lead ECG signals from any ECG sensor, (b) remote server component that hosts algorithms for accurate annotation and analysis of the ECG signal and (c) point of care device of the doctor to receive a diagnostic report from the server based on the analysis of ECG signals. In the present study, their focus has been toward developing a system capable of detecting critical cardiac events well in advance using an advanced remote monitoring system. A system of this kind is expected to have applications ranging from tracking wellness/fitness to detection of symptoms leading to fatal cardiac events. PMID:26577166

  13. Ultrasonic wave-based structural health monitoring embedded instrument

    SciTech Connect

    Aranguren, G.; Monje, P. M.; Cokonaj, Valerijan; Barrera, Eduardo; Ruiz, Mariano

    2013-12-15

    Piezoelectric sensors and actuators are the bridge between electronic and mechanical systems in structures. This type of sensor is a key element in the integrity monitoring of aeronautic structures, bridges, pressure vessels, wind turbine blades, and gas pipelines. In this paper, an all-in-one system for Structural Health Monitoring (SHM) based on ultrasonic waves is presented, called Phased Array Monitoring for Enhanced Life Assessment. This integrated instrument is able to generate excitation signals that are sent through piezoelectric actuators, acquire the received signals in the piezoelectric sensors, and carry out signal processing to check the health of structures. To accomplish this task, the instrument uses a piezoelectric phased-array transducer that performs the actuation and sensing of the signals. The flexibility and strength of the instrument allow the user to develop and implement a substantial part of the SHM technique using Lamb waves. The entire system is controlled using configuration software and has been validated through functional, electrical loading, mechanical loading, and thermal loading resistance tests.

  14. A qualitative review for wireless health monitoring system

    NASA Astrophysics Data System (ADS)

    Arshad, Atika; Fadzil Ismail, Ahmad; Khan, Sheroz; Zahirul Alam, A. H. M.; Tasnim, Rumana; Samnan Haider, Syed; Shobaki, Mohammed M.; Shahid, Zeeshan

    2013-12-01

    A proliferating interest has been being observed over the past years in accurate wireless system development in order to monitor incessant human activities in health care centres. Furthermore because of the swelling number of elderly population and the inadequate number of competent staffs for nursing homes there is a big market petition for health care monitoring system. In order to detect human researchers developed different methods namely which include Field Identification technique, Visual Sensor Network, radar detection, e-mobile techniques and so on. An all-encompassing overview of the non-wired human detection application advancement is presented in this paper. Inductive links are used for human detection application while wiring an electronic system has become impractical in recent times. Keeping in mind the shortcomings, an Inductive Intelligent Sensor (IIS) has been proposed as a novel human monitoring system for future implementation. The proposed sensor works towards exploring the signature signals of human body movement and size. This proposed sensor is fundamentally based on inductive loop that senses the presence and a passing human resulting an inductive change.

  15. Ultrasonic wave-based structural health monitoring embedded instrument

    NASA Astrophysics Data System (ADS)

    Aranguren, G.; Monje, P. M.; Cokonaj, Valerijan; Barrera, Eduardo; Ruiz, Mariano

    2013-12-01

    Piezoelectric sensors and actuators are the bridge between electronic and mechanical systems in structures. This type of sensor is a key element in the integrity monitoring of aeronautic structures, bridges, pressure vessels, wind turbine blades, and gas pipelines. In this paper, an all-in-one system for Structural Health Monitoring (SHM) based on ultrasonic waves is presented, called Phased Array Monitoring for Enhanced Life Assessment. This integrated instrument is able to generate excitation signals that are sent through piezoelectric actuators, acquire the received signals in the piezoelectric sensors, and carry out signal processing to check the health of structures. To accomplish this task, the instrument uses a piezoelectric phased-array transducer that performs the actuation and sensing of the signals. The flexibility and strength of the instrument allow the user to develop and implement a substantial part of the SHM technique using Lamb waves. The entire system is controlled using configuration software and has been validated through functional, electrical loading, mechanical loading, and thermal loading resistance tests.

  16. Ultrasonic wave-based structural health monitoring embedded instrument.

    PubMed

    Aranguren, G; Monje, P M; Cokonaj, Valerijan; Barrera, Eduardo; Ruiz, Mariano

    2013-12-01

    Piezoelectric sensors and actuators are the bridge between electronic and mechanical systems in structures. This type of sensor is a key element in the integrity monitoring of aeronautic structures, bridges, pressure vessels, wind turbine blades, and gas pipelines. In this paper, an all-in-one system for Structural Health Monitoring (SHM) based on ultrasonic waves is presented, called Phased Array Monitoring for Enhanced Life Assessment. This integrated instrument is able to generate excitation signals that are sent through piezoelectric actuators, acquire the received signals in the piezoelectric sensors, and carry out signal processing to check the health of structures. To accomplish this task, the instrument uses a piezoelectric phased-array transducer that performs the actuation and sensing of the signals. The flexibility and strength of the instrument allow the user to develop and implement a substantial part of the SHM technique using Lamb waves. The entire system is controlled using configuration software and has been validated through functional, electrical loading, mechanical loading, and thermal loading resistance tests. PMID:24387467

  17. A Microwave Blade Tip Clearance Sensor for Propulsion Health Monitoring

    NASA Technical Reports Server (NTRS)

    Woike, Mark R.; Abdul-Aziz, Ali; Bencic, Timothy J.

    2010-01-01

    Microwave sensor technology is being investigated by the NASA Glenn Research Center as a means of making non-contact structural health measurements in the hot sections of gas turbine engines. This type of sensor technology is beneficial in that it is accurate, it has the ability to operate at extremely high temperatures, and is unaffected by contaminants that are present in turbine engines. It is specifically being targeted for use in the High Pressure Turbine (HPT) and High Pressure Compressor (HPC) sections to monitor the structural health of the rotating components. It is intended to use blade tip clearance to monitor blade growth and wear and blade tip timing to monitor blade vibration and deflection. The use of microwave sensors for this application is an emerging concept. Techniques on their use and calibration needed to be developed. As a means of better understanding the issues associated with the microwave sensors, a series of experiments have been conducted to evaluate their performance for aero engine applications. This paper presents the results of these experiments.

  18. Development and evaluation of an Individualized Outcome Measure (IOM) for randomized controlled trials in mental health.

    PubMed

    Pesola, Francesca; Williams, Julie; Bird, Victoria; Freidl, Marion; Le Boutillier, Clair; Leamy, Mary; Macpherson, Rob; Slade, Mike

    2015-12-01

    Pre-defined, researcher-selected outcomes are routinely used as the clinical end-point in randomized controlled trials (RCTs); however, individualized approaches may be an effective way to assess outcome in mental health research. The present study describes the development and evaluation of the Individualized Outcome Measure (IOM), which is a patient-specific outcome measure to be used for RCTs of complex interventions. IOM was developed using a narrative review, expert consultation and piloting with mental health service users (n = 20). The final version of IOM comprises two components: Goal Attainment (GA) and Personalized Primary Outcome (PPO). For GA, patients identify one relevant goal at baseline and rate its attainment at follow-up. For PPO, patients choose an outcome domain related to their goal from a pre-defined list at baseline, and complete a standardized questionnaire assessing the chosen outcome domain at baseline and follow-up. A feasibility study indicated that IOM had adequate completion (89%) and acceptability (96%) rates in a clinical sample (n = 84). IOM was then evaluated in a RCT (ISRCTN02507940). GA and PPO components were associated with each other and with the trial primary outcome. The use of the PPO component of IOM as the primary outcome could be considered in future RCTs. Copyright © 2015 John Wiley & Sons, Ltd. PMID:26184686

  19. Roles of the Lateral Habenula and Anterior Cingulate Cortex in Negative Outcome Monitoring and Behavioral Adjustment in Nonhuman Primates.

    PubMed

    Kawai, Takashi; Yamada, Hiroshi; Sato, Nobuya; Takada, Masahiko; Matsumoto, Masayuki

    2015-11-18

    Animals monitor the outcome of their choice and adjust subsequent choice behavior using the outcome information. Together with the anterior cingulate cortex (ACC), the lateral habenula (LHb) has recently attracted attention for its crucial role in monitoring negative outcome. To investigate their contributions to subsequent behavioral adjustment, we recorded single-unit activity from the LHb and ACC in monkeys performing a reversal learning task. The monkey was required to shift a previous choice to the alternative if the choice had been repeatedly unrewarded in past trials. We found that ACC neurons stored outcome information from several past trials, whereas LHb neurons detected the ongoing negative outcome with shorter latencies. ACC neurons, but not LHb neurons, signaled a behavioral shift in the next trial. Our findings suggest that, although both the LHb and the ACC represent signals associated with negative outcome, these structures contribute to subsequent behavioral adjustment in different ways. PMID:26481035

  20. Fundamental resource dis/advantages, youth health and adult educational outcomes.

    PubMed

    Elman, Cheryl; Wray, Linda A; Xi, Juan

    2014-01-01

    Recent studies find lasting effects of poor youth health on educational attainment but use young samples and narrow life course windows of observation to explore outcomes. We apply a life course framework to three sets of Health and Retirement Study birth cohorts to examine early health status effects on education and skills attainment measured late in life. The older cohorts that we study were the earliest recipients of U.S. policies promoting continuing education through the GI Bill, community college expansions and new credentials such as the GED. We examine a wide range of outcomes but focus on GEDs, postsecondary school entry and adult human capital as job-related training. We find that older U.S. cohorts had considerable exposure to these forms of attainment and that the effects of youth health on them vary by outcome: health selection and ascription group effects are weak or fade, respectively, in outcomes associated with delayed or adult attainment. However, poorer health and social disadvantage in youth and barriers associated with ascription carry forward to limit attainment of key credentials such as diplomas and college degrees. We find that the human capital - health gradient is dynamic and that narrow windows of observation in existing studies miss much of it. National context also matters for studying health-education linkages over the life course. PMID:24267756

  1. Perspectives on differing health outcomes by city: accounting for Glasgow's excess mortality.

    PubMed

    Fraser, Simon Ds; George, Steve

    2015-01-01

    Several health outcomes (including mortality) and health-related behaviors are known to be worse in Scotland than in comparable areas of Europe and the United Kingdom. Within Scotland, Greater Glasgow (in West Central Scotland) experiences disproportionately poorer outcomes independent of measurable variation in socioeconomic status and other important determinants. Many reasons for this have been proposed, particularly related to deprivation, inequalities, and variation in health behaviors. The use of models (such as the application of Bradford Hill's viewpoints on causality to the different hypotheses) has provided useful insights on potentially causal mechanisms, with health behaviors and inequalities likely to represent the strongest individual candidates. This review describes the evolution of our understanding of Glasgow's excess mortality, summarizes some of the key work in this area, and provides some suggestions for future areas of exploration. In the context of demographic change, the experience in Glasgow is an important example of the complexity that frequently lies behind observed variations in health outcomes within and between populations. A comprehensive explanation of Glasgow's excess mortality may continue to remain elusive, but is likely to lie in a complex and difficult-to-measure interplay of health determinants acting at different levels in society throughout the life course. Lessons learned from the detailed examination of different potentially causative determinants in Scotland may provide useful methodological insights that may be applied in other settings. Ongoing efforts to unravel the causal mechanisms are needed to inform public health efforts to reduce health inequalities and improve outcomes in Scotland. PMID:26124684

  2. Modified Therapeutic Community Treatment for Offenders with Co-Occurring Disorders: Mental Health Outcomes

    ERIC Educational Resources Information Center

    Sullivan, Christopher J.; Sacks, Stanley; McKendrick, Karen; Banks, Steven; Sacks, Joann Y.; Stommel, Joseph

    2007-01-01

    This paper examines outcomes 12 months post-prison release for offenders with co-occurring disorders (n = 185) randomly assigned to either a mental health control treatment (C) or a modified therapeutic community (E). Significant between-group differences were not found for mental health measures, although improvements were observed for each…

  3. Evaluating Health Outcomes of Criminal Justice Populations Using Record Linkage: The Importance of Aliases

    ERIC Educational Resources Information Center

    Larney, Sarah; Burns, Lucy

    2011-01-01

    Individuals in contact with the criminal justice system are a key population of concern to public health. Record linkage studies can be useful for studying health outcomes for this group, but the use of aliases complicates the process of linking records across databases. This study was undertaken to determine the impact of aliases on sensitivity…

  4. School Nurse Case Management for Children with Chronic Illness: Health, Academic, and Quality of Life Outcomes

    ERIC Educational Resources Information Center

    Engelke, Martha Keehner; Guttu, Martha; Warren, Michelle B.; Swanson, Melvin

    2008-01-01

    More children with chronic illnesses are attending school, and some of them struggle academically because of issues related to their health. School-based case management has been suggested as one strategy to improve the academic success of these children. This study tracked the academic, health, and quality of life outcomes for 114 children with…

  5. QUALITY OF LIFE, FAMILY BEHAVIOR, AND HEALTH OUTCOMES IN CHILDREN WITH TYPE 2 DIABETES

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Quality of life of youth and disease-specific family behavior have both been shown to be important in the study of health outcomes across a broad range of chronic physical conditions of childhood. Very few studies have addressed quality of life, the family’s role in diabetes management, and health o...

  6. Influence of School Organizational Characteristics on the Outcomes of a School Health Promotion Program.

    ERIC Educational Resources Information Center

    Cullen, Karen Weber; Baranowski, Tom; Baranowski, Janice; Hebert, David; deMoor, Carl; Hearn, Marsha Davis; Resnicow, Ken

    1999-01-01

    Assessed the impact of school organizational characteristics on outcomes of a teacher health behavior change program. Organizational, dietary, and psychologic data from intervention and control schools indicated that teachers at intervention schools with high organizational climate, organizational health, and job satisfaction reported better…

  7. School as a Determinant for Health Outcomes--A Structural Equation Model Analysis

    ERIC Educational Resources Information Center

    Ravens-Sieberer, Ulrike; Freeman, John; Kokonyei, Gyongyi; Thomas, Christiane A.; Erhart, Michael

    2009-01-01

    Purpose: The purpose of this paper is to investigate whether students' perceptions of their school environment and their adjustment to school are associated with health outcomes across gender and age groups. Design/methodology/approach: Data from the cross-sectional international Health Behavior in School-aged Children Survey of the year 2002…

  8. Health outcomes among women trafficked for sex in the United States: a closer look.

    PubMed

    Muftic, Lisa R; Finn, Mary A

    2013-06-01

    Human trafficking is recognized as a major public health problem and a tragic transnational crime. Little is known about the health outcomes of victims of human trafficking. This study identifies the relationship of risk factors to physical, sexual, and mental health outcomes in three groups of women (N = 38) exploited for sex in the United States: international trafficking victims, domestic trafficking victims, and nontrafficked sex workers. To date this is the first study to examine the impact of risk factors on health outcomes using a sample of women trafficked for sex in the United States that includes both domestic and international victims. Overall, findings suggest that the experiences in sex work of domestic trafficking victims were dissimilar to those of international trafficking victims. Moreover, domestic trafficking victims displayed poorer health outcomes compared to international trafficking victims. In terms of risk factors, a higher percentage of women involved in street prostitution reported sexual health problems, co-occurring health issues, and addiction. Childhood physical/sexual victimization was related to poor physical health. PMID:23295378

  9. Partnership working and outcomes: do health and social care partnerships deliver for users and carers?

    PubMed

    Petch, Alison; Cook, Ailsa; Miller, Emma

    2013-11-01

    Working in partnership, both across social care and health and with service users, has been a persistent theme of the health and social care modernisation agenda in the United Kingdom. Despite a relatively underdeveloped evidence base, the development of health and social care partnerships has continued to feature in recent policy and legislative initiatives in the United Kingdom. At the same time there has been a major shift in focus towards the outcomes that support services deliver. A central question remaining is whether the policy initiatives driving the development of health and social care partnerships are delivering improved outcomes, particularly the outcomes valued by people who use services. This article outlines research designed to explore this issue across 15 health and social care partnerships in England and Scotland, building from previous research by the Social Policy Research Unit based at the University of York. It sought to assess the extent to which health and social care partnerships deliver the outcomes that people who use services value, and to determine the features of partnership working associated with the delivery of these outcomes. A robust outcomes framework was defined, which provided the basis for interviews with those receiving support from partnerships. Working with three user-researcher organisations, interviews were completed with 230 individuals in 2006. On the basis of this, some service users were able to identify features of partnership that particularly contributed to improved outcomes. These included continuity of staff and sufficient staff and a range of resources, including the availability of long-term and preventative services. Given the definitional and methodological complexity surrounding partnership working, and the challenges of attribution, the study faced some limitations in its ability to make wider inferences about partnership and outcomes. A theory of change should be employed in future studies of this type

  10. Health outcome after total knee replacement in the very elderly.

    PubMed

    Birdsall, P D; Hayes, J H; Cleary, R; Pinder, I M; Moran, C G; Sher, J L

    1999-07-01

    Between 1992 and 1994 we performed a prospective study of the effect of total knee replacement (TKR) on the health status of 119 patients over the age of 80 years who had had a primary unilateral TKR. The Nottingham Health Profile was used to assess this before and at three and 12 months after operation. We found a significant improvement in the scores for pain, emotional reaction, sleep and physical mobility at three months. After 12 months, the scores for pain and sleep were well maintained. The other factors had deteriorated slightly but remained better than before operation. Our findings show that TKR leads to a significant improvement in the general health status of the very elderly. PMID:10463740

  11. In-service health monitoring of composite structures

    NASA Technical Reports Server (NTRS)

    Pinto, Gino A.; Ventres, C. S.; Ginty, Carol A.; Chamis, Christos C.

    1990-01-01

    The aerospace industry is witnessing a vast utilization of composites in critical structural applications and anticipates even more use of them in future aircraft. Therefore, a definite need exists for a composite health monitoring expert system to meet today's current needs and tomorrow's future demands. The primary goal for this conceptual health monitoring system is functional reliably for in-service operation in the environments of various composite structures. The underlying philosophy of this system is to utilize proven vibration techniques to assess the structural integrity of a fibrous composite. Statistical methods are used to determine if the variances in the measured data are acceptable for making a reliable decision on the health status of the composite. The flexible system allows for algorithms describing any composite fatigue or damage behavior characteristic to be provided as an input to the system. Alert thresholds and variances can also be provided as an input to this system and may be updated to allow for future changes/refinements in the composite's structural integrity behavior.

  12. A Simple Demonstration of Concrete Structural Health Monitoring Framework

    SciTech Connect

    Mahadevan, Sankaran; Agarwal, Vivek; Cai, Guowei; Nath, Paromita; Bao, Yanqing; Bru Brea, Jose Maria; Koester, David; Adams, Douglas; Kosson, David

    2015-03-01

    Assessment and management of aging concrete structures in nuclear power plants require a more systematic approach than simple reliance on existing code margins of safety. Structural health monitoring of concrete structures aims to understand the current health condition of a structure based on heterogeneous measurements to produce high confidence actionable information regarding structural integrity that supports operational and maintenance decisions. This ongoing research project is seeking to develop a probabilistic framework for health diagnosis and prognosis of aging concrete structures in a nuclear power plant subjected to physical, chemical, environment, and mechanical degradation. The proposed framework consists of four elements—damage modeling, monitoring, data analytics, and uncertainty quantification. This report describes a proof-of-concept example on a small concrete slab subjected to a freeze-thaw experiment that explores techniques in each of the four elements of the framework and their integration. An experimental set-up at Vanderbilt University’s Laboratory for Systems Integrity and Reliability is used to research effective combination of full-field techniques that include infrared thermography, digital image correlation, and ultrasonic measurement. The measured data are linked to the probabilistic framework: the thermography, digital image correlation data, and ultrasonic measurement data are used for Bayesian calibration of model parameters, for diagnosis of damage, and for prognosis of future damage. The proof-of-concept demonstration presented in this report highlights the significance of each element of the framework and their integration.

  13. A Low Cost Sensor Controller for Health Monitoring

    NASA Astrophysics Data System (ADS)

    Birbas, M.; Petrellis, N.; Gioulekas, F.

    2015-09-01

    Aging population can benefit from health care systems that allow their health and daily life to be monitored by expert medical staff. Blood pressure, temperature measurements or more advanced tests like Electrocardiograms (ECG) can be ordered through such a healthcare system while urgent situations can be detected and alleviated on time. The results of these tests can be stored with security in a remote cloud or database. Such systems are often used to monitor non-life threatening patient health problems and their advantage in lowering the cost of the healthcare services is obvious. A low cost commercial medical sensor kit has been used in the present work, trying to improve the accuracy and stability of the sensor measurements, the power consumption, etc. This Sensor Controller communicates with a Gateway installed in the patient's residence and a tablet or smart phone used for giving instructions to the patient through a comprehensive user interface. A flexible communication protocol has been defined supporting any short or long term sensor sampling scenario. The experimental results show that it is possible to achieve low power consumption by applying apropriate sleep intervals to the Sensor Controller and by deactivating periodically some of its functionality.

  14. A bio-inspired memory model for structural health monitoring

    NASA Astrophysics Data System (ADS)

    Zheng, Wei; Zhu, Yong

    2009-04-01

    Long-term structural health monitoring (SHM) systems need intelligent management of the monitoring data. By analogy with the way the human brain processes memories, we present a bio-inspired memory model (BIMM) that does not require prior knowledge of the structure parameters. The model contains three time-domain areas: a sensory memory area, a short-term memory area and a long-term memory area. First, the initial parameters of the structural state are specified to establish safety criteria. Then the large amount of monitoring data that falls within the safety limits is filtered while the data outside the safety limits are captured instantly in the sensory memory area. Second, disturbance signals are distinguished from danger signals in the short-term memory area. Finally, the stable data of the structural balance state are preserved in the long-term memory area. A strategy for priority scheduling via fuzzy c-means for the proposed model is then introduced. An experiment on bridge tower deformation demonstrates that the proposed model can be applied for real-time acquisition, limited-space storage and intelligent mining of the monitoring data in a long-term SHM system.

  15. Dynamic structural health monitoring of Saint Torcato church

    NASA Astrophysics Data System (ADS)

    Ramos, Luís F.; Aguilar, Rafael; Lourenço, Paulo B.; Moreira, Susana

    2013-02-01

    The paper presents the dynamic structural health monitoring activities on Saint Torcato church, in Guimarães, Portugal, which has significant structural problems due to soil settlements. Cracks can be observed on the main and the lateral façades, the bell-towers are leaning, and the arches in the nave exhibit a failure mechanism with cracks and vertical deformations. These phenomena are progressing and a structural intervention is planned. A monitoring system has been installed to control the current condition and to assess the success of the future intervention. The paper shows the monitoring results with an emphasis in the dynamic analysis carried out before the structural strengthening, namely with respect to: experimental tests with output-only techniques for frequencies, damping and mode shapes estimation, FE model updating analysis and dynamic monitoring. The automatic system identification process uses ambient vibration signatures in combination with cluster analysis and rule-based approach for the interpretation of the results of the Stochastic Subspace Identification method.

  16. Examining the Relationship between Choice, Therapeutic Alliance and Outcomes in Mental Health Services

    PubMed Central

    Stanhope, Victoria; Barrenger, Stacey L.; Salzer, Mark S.; Marcus, Stephen C.

    2013-01-01

    Background: Self-determination within mental health services is increasingly recognized as an ethical imperative, but we still know little about the impact of choice on outcomes among people with severe mental illnesses. This study examines whether choice predicts outcomes and whether this relationship is mediated by therapeutic alliance. Method: The study sample of 396 participants completed a survey measuring choice, therapeutic alliance, recovery, quality of life and functioning. Multivariate analyses examined choice as a predictor of outcomes, and Sobel tests assessed alliance as a mediator. Results: Choice variables predicted recovery, quality of life and perceived outcomes. Sobel tests indicated that the relationship between choice and outcome variables was mediated by therapeutic alliance. Implications: The study demonstrates that providing more choice and opportunities for collaboration within services does improve consumer outcomes. The results also show that collaboration is dependent on the quality of the relationship between the provider and consumer. PMID:25562652

  17. Psychosocial and Health Behavior Outcomes of Young Adults with Asthma or Diabetes

    PubMed Central

    Berge, Jerica M.; Bauer, Katherine W.; Eisenberg, Marla E.; Denny, Kara; Neumark-Sztainer, Dianne

    2013-01-01

    Purpose Previous research has shown a relationship between childhood/adolescent chronic conditions and negative health behaviors, psychological outcomes, and social outcomes. Less is known about whether these negative outcomes are experienced by young adults with chronic health conditions. The purpose of this paper is to investigate how young adults’ BMI, health behaviors, and psychological and social outcomes differ depending on whether they have diabetes, asthma, or neither of these chronic conditions. Methods Data were drawn from the third wave of Project EAT-III: Eating and Activity in Young Adults, a population-based study of 2287 young adults (mean age = 25.3; range 19.8 – 31.2). General linear models were used to test differences in BMI, health behaviors (e.g., fast food intake) and psychosocial outcomes (e.g. depressive symptoms) by young adults’ chronic disease status. Results Young adults with diabetes had higher BMIs, engaged in less physical activity and more unhealthy weight control behaviors and binge eating, had lower self-esteem and lower body satisfaction, and experienced more depressive symptoms and appearance-based teasing compared to young adults with asthma or no chronic conditions, after adjusting for age, race/ethnicity, socio-economic status (SES) and, when relevant, for BMI. There were no significant differences between young adults with asthma and young adults with no chronic condition on all of the psychosocial and health behavior outcomes. Conclusions Young adults with diabetes reported higher prevalence of negative health behaviors and psychosocial outcomes. Providers may find it useful to assess for negative health behaviors and psychosocial variables with young adults with diabetes in order to improve treatment and quality of life for these individuals. PMID:24298429

  18. The impact of Brazil’s Bolsa Família conditional cash transfer program on children’s health care utilization and health outcomes

    PubMed Central

    2014-01-01

    Background Conditional cash transfer (CCT) programs provide poor families with cash conditional on investments in health and education. Brazil’s Bolsa Família program began in 2003 and is currently the largest CCT program in the world. This community-based study examines the impact of Bolsa Família on child health in a slum community in a large urban center. Methods In 2010, detailed household surveys were conducted with randomly selected Bolsa Família beneficiaries and non-beneficiaries in a Brazilian slum community of approximately 14,000 inhabitants in a large urban center. 567 families (with 1,266 children) were interviewed. Propensity score methods were used to control for differences between beneficiary and non-beneficiary children to estimate program impacts on health care utilization and health outcomes. Results Bolsa Família has increased the odds of children’s visits to the health post for preventive services. In children under age seven, Bolsa Família was associated with increased odds for growth monitoring (OR = 3.1; 95% CI 1.9-5.1), vaccinations (OR = 2.8; 95% CI 1.4-5.4), and checkups (OR = 1.6; 95% CI 0.98-2.5), and with the number of growth monitoring visits (β = 0.6; p = 0.049) and checkups (β = 0.2; p = 0.068). There were positive spillover effects on older siblings (ages 7-17) no longer required to meet the health conditionalities. Bolsa Família increased their odds for growth monitoring (OR = 2.5; 95% CI 1.3-4.9) and checkups (OR = 1.7; 95% CI 0.9-3.2) and improved psychosocial health (β = 2.6; p = 0.007). Conclusions Bolsa Família has improved health care utilization, especially for services related to the health conditionalites, and there were positive spillover effects on older siblings. The findings of this study are promising, but they also suggest that further improvements in health may depend on the quality of health care services provided, the scope of services linked to the

  19. The performance of automated case-mix adjustment regression model building methods in a health outcome prediction setting.

    PubMed

    Jen, Min-Hua; Bottle, Alex; Kirkwood, Graham; Johnston, Ron; Aylin, Paul

    2011-09-01

    We have previously described a system for monitoring a number of healthcare outcomes using case-mix adjustment models. It is desirable to automate the model fitting process in such a system if monitoring covers a large number of outcome measures or subgroup analyses. Our aim was to compare the performance of three different variable selection strategies: "manual", "automated" backward elimination and re-categorisation, and including all variables at once, irrespective of their apparent importance, with automated re-categorisation. Logistic regression models for predicting in-hospital mortality and emergency readmission within 28 days were fitted to an administrative database for 78 diagnosis groups and 126 procedures from 1996 to 2006 for National Health Services hospital trusts in England. The performance of models was assessed with Receiver Operating Characteristic (ROC) c statistics, (measuring discrimination) and Brier score (assessing the average of the predictive accuracy). Overall, discrimination was similar for diagnoses and procedures and consistently better for mortality than for emergency readmission. Brier scores were generally low overall (showing higher accuracy) and were lower for procedures than diagnoses, with a few exceptions for emergency readmission within 28 days. Among the three variable selection strategies, the automated procedure had similar performance to the manual method in almost all cases except low-risk groups with few outcome events. For the rapid generation of multiple case-mix models we suggest applying automated modelling to reduce the time required, in particular when examining different outcomes of large numbers of procedures and diseases in routinely collected administrative health data. PMID:21556848

  20. Optical Fiber Sensors for Aircraft Structural Health Monitoring.

    PubMed

    García, Iker; Zubia, Joseba; Durana, Gaizka; Aldabaldetreku, Gotzon; Illarramendi, María Asunción; Villatoro, Joel

    2015-01-01

    Aircraft structures require periodic and scheduled inspection and maintenance operations due to their special operating conditions and the principles of design employed to develop them. Therefore, structural health monitoring has a great potential to reduce the costs related to these operations. Optical fiber sensors applied to the monitoring of aircraft structures provide some advantages over traditional sensors. Several practical applications for structures and engines we have been working on are reported in this article. Fiber Bragg gratings have been analyzed in detail, because they have proved to constitute the most promising technology in this field, and two different alternatives for strain measurements are also described. With regard to engine condition evaluation, we present some results obtained with a reflected intensity-modulated optical fiber sensor for tip clearance and tip timing measurements in a turbine assembled in a wind tunnel. PMID:26134107

  1. Fiber optic sensors for structural health monitoring of air platforms.

    PubMed

    Guo, Honglei; Xiao, Gaozhi; Mrad, Nezih; Yao, Jianping

    2011-01-01

    Aircraft operators are faced with increasing requirements to extend the service life of air platforms beyond their designed life cycles, resulting in heavy maintenance and inspection burdens as well as economic pressure. Structural health monitoring (SHM) based on advanced sensor technology is potentially a cost-effective approach to meet operational requirements, and to reduce maintenance costs. Fiber optic sensor technology is being developed to provide existing and future aircrafts with SHM capability due to its unique superior characteristics. This review paper covers the aerospace SHM requirements and an overview of the fiber optic sensor technologies. In particular, fiber Bragg grating (FBG) sensor technology is evaluated as the most promising tool for load monitoring and damage detection, the two critical SHM aspects of air platforms. At last, recommendations on the implementation and integration of FBG sensors into an SHM system are provided. PMID:22163816

  2. Development of High Temperature Ultrasonic Transducer for Structural Health Monitoring

    NASA Astrophysics Data System (ADS)

    Baba, A.; Searfass, C. T.; Tittmann, B. R.

    2011-06-01

    Structural health monitoring (SHM) techniques are needed to maintain the reliability of aging power plants for long term operation. The high temperature transducers are necessary to realize SHM (monitor wall thickness of the pipings, crack growth in the materials and material evaluation) under the working condition of power plants. We have developed high temperature transducer using lithium niobate (LiNbO3) single crystal which is well known as a high Curie temperature piezoelectric material. The LiNbO3 was bonded onto a stainless steel substrate. The transducer was heated in an electric furnace while measuring the bottom echoes from the substrate. We confirmed that the high temperature transducer could work up to 1000 °C.

  3. Performance Health Monitoring of Large-Scale Systems

    SciTech Connect

    Rajamony, Ram

    2014-11-20

    This report details the progress made on the ASCR funded project Performance Health Monitoring for Large Scale Systems. A large-­‐scale application may not achieve its full performance potential due to degraded performance of even a single subsystem. Detecting performance faults, isolating them, and taking remedial action is critical for the scale of systems on the horizon. PHM aims to develop techniques and tools that can be used to identify and mitigate such performance problems. We accomplish this through two main aspects. The PHM framework encompasses diagnostics, system monitoring, fault isolation, and performance evaluation capabilities that indicates when a performance fault has been detected, either due to an anomaly present in the system itself or due to contention for shared resources between concurrently executing jobs. Software components called the PHM Control system then build upon the capabilities provided by the PHM framework to mitigate degradation caused by performance problems.

  4. Advanced active health monitoring system of liquid rocket engines

    NASA Astrophysics Data System (ADS)

    Qing, Xinlin P.; Wu, Zhanjun; Beard, Shawn; Chang, Fu-Kuo

    2008-11-01

    An advanced SMART TAPE system has been developed for real-time in-situ monitoring and long term tracking of structural integrity of pressure vessels in liquid rocket engines. The practical implementation of the structural health monitoring (SHM) system including distributed sensor network, portable diagnostic hardware and dedicated data analysis software is addressed based on the harsh operating environment. Extensive tests were conducted on a simulated large booster LOX-H2 engine propellant duct to evaluate the survivability and functionality of the system under the operating conditions of typical liquid rocket engines such as cryogenic temperature, vibration loads. The test results demonstrated that the developed SHM system could survive the combined cryogenic temperature and vibration environments and effectively detect cracks as small as 2 mm.

  5. Fiber Optic Sensors for Structural Health Monitoring of Air Platforms

    PubMed Central

    Guo, Honglei; Xiao, Gaozhi; Mrad, Nezih; Yao, Jianping

    2011-01-01

    Aircraft operators are faced with increasing requirements to extend the service life of air platforms beyond their designed life cycles, resulting in heavy maintenance and inspection burdens as well as economic pressure. Structural health monitoring (SHM) based on advanced sensor technology is potentially a cost-effective approach to meet operational requirements, and to reduce maintenance costs. Fiber optic sensor technology is being developed to provide existing and future aircrafts with SHM capability due to its unique superior characteristics. This review paper covers the aerospace SHM requirements and an overview of the fiber optic sensor technologies. In particular, fiber Bragg grating (FBG) sensor technology is evaluated as the most promising tool for load monitoring and damage detection, the two critical SHM aspects of air platforms. At last, recommendations on the implementation and integration of FBG sensors into an SHM system are provided. PMID:22163816

  6. Health Monitoring System for the SSME-fault detection algorithms

    NASA Technical Reports Server (NTRS)

    Tulpule, S.; Galinaitis, W. S.

    1990-01-01

    A Health Monitoring System (HMS) Framework for the Space Shuttle Main Engine (SSME) has been developed by United Technologies Corporation (UTC) for the NASA Lewis Research Center. As part of this effort, fault detection algorithms have been developed to detect the SSME faults with sufficient time to shutdown the engine. These algorithms have been designed to provide monitoring coverage during the startup, mainstage and shutdown phases of the SSME operation. The algorithms have the capability to detect multiple SSME faults, and are based on time series, regression and clustering techniques. This paper presents a discussion of candidate algorithms suitable for fault detection followed by a description of the algorithms selected for implementation in the HMS and the results of testing these algorithms with the SSME test stand data.

  7. Probabilistic Structural Health Monitoring of the Orbiter Wing Leading Edge

    NASA Technical Reports Server (NTRS)

    Yap, Keng C.; Macias, Jesus; Kaouk, Mohamed; Gafka, Tammy L.; Kerr, Justin H.

    2011-01-01

    A structural health monitoring (SHM) system can contribute to the risk management of a structure operating under hazardous conditions. An example is the Wing Leading Edge Impact Detection System (WLEIDS) that monitors the debris hazards to the Space Shuttle Orbiter s Reinforced Carbon-Carbon (RCC) panels. Since Return-to-Flight (RTF) after the Columbia accident, WLEIDS was developed and subsequently deployed on board the Orbiter to detect ascent and on-orbit debris impacts, so as to support the assessment of wing leading edge structural integrity prior to Orbiter re-entry. As SHM is inherently an inverse problem, the analyses involved, including those performed for WLEIDS, tend to be associated with significant uncertainty. The use of probabilistic approaches to handle the uncertainty has resulted in the successful implementation of many development and application milestones.

  8. Optical Fiber Sensors for Aircraft Structural Health Monitoring

    PubMed Central

    García, Iker; Zubia, Joseba; Durana, Gaizka; Aldabaldetreku, Gotzon; Illarramendi, María Asunción; Villatoro, Joel

    2015-01-01

    Aircraft structures require periodic and scheduled inspection and maintenance operations due to their special operating conditions and the principles of design employed to develop them. Therefore, structural health monitoring has a great potential to reduce the costs related to these operations. Optical fiber sensors applied to the monitoring of aircraft structures provide some advantages over traditional sensors. Several practical applications for structures and engines we have been working on are reported in this article. Fiber Bragg gratings have been analyzed in detail, because they have proved to constitute the most promising technology in this field, and two different alternatives for strain measurements are also described. With regard to engine condition evaluation, we present some results obtained with a reflected intensity-modulated optical fiber sensor for tip clearance and tip timing measurements in a turbine assembled in a wind tunnel. PMID:26134107

  9. Structural Health Monitoring with Fiber Bragg Grating and Piezo Arrays

    NASA Technical Reports Server (NTRS)

    Black, Richard J.; Faridian, Ferey; Moslehi, Behzad; Sotoudeh, Vahid

    2012-01-01

    Structural health monitoring (SHM) is one of the most important tools available for the maintenance, safety, and integrity of aerospace structural systems. Lightweight, electromagnetic-interference- immune, fiber-optic sensor-based SHM will play an increasing role in more secure air transportation systems. Manufacturers and maintenance personnel have pressing needs for significantly improving safety and reliability while providing for lower inspection and maintenance costs. Undetected or untreated damage may grow and lead to catastrophic structural failure. Damage can originate from the strain/stress history of the material, imperfections of domain boundaries in metals, delamination in multi-layer materials, or the impact of machine tools in the manufacturing process. Damage can likewise develop during service life from wear and tear, or under extraordinary circumstances such as with unusual forces, temperature cycling, or impact of flying objects. Monitoring and early detection are key to preventing a catastrophic failure of structures, especially when these are expected to perform near their limit conditions.

  10. Wake-up transceivers for structural health monitoring of bridges

    NASA Astrophysics Data System (ADS)

    Kumberg, T.; Kokert, J.; Younesi, V.; Koenig, S.; Reindl, L. M.

    2016-04-01

    In this article we present a wireless sensor network to monitor the structural health of a large-scale highway bridge in Germany. The wireless sensor network consists of several sensor nodes that use wake-up receivers to realize latency free and low-power communication. The sensor nodes are either equipped with very accurate tilt sensor developed by Northrop Grumman LITEF GmbH or with a Novatel OEM615 GNSS receiver. Relay nodes are required to forward measurement data to a base station located on the bridge. The base station is a gateway that transmits the local measurement data to a remote server where it can be further analyzed and processed. Further on, we present an energy harvesting system to supply the energy demanding GNSS sensor nodes to realize long term monitoring.

  11. Relations of Behavioral Autonomy to Health Outcomes Among Emerging Adults With and Without Type 1 Diabetes

    PubMed Central

    Reynolds, Kerry A.; Becker, Dorothy; Escobar, Oscar; Siminerio, Linda

    2014-01-01

    Objective To examine the relation of behavioral autonomy to psychological, behavioral, and physical health among emerging adults with and without type 1 diabetes. Methods High school seniors with (n = 118) and without type 1 diabetes (n = 122) completed online questionnaires for three consecutive years. Behavioral autonomy, psychological health, risk behaviors, and diabetes outcomes were assessed. Regression analyses were conducted to predict Time 2 and 3 outcomes, controlling for Time 1 outcomes. Results There were no group differences in behavioral autonomy. Behavioral autonomy predicted better psychological health but only for emerging adults without diabetes. Behavioral autonomy was related to increased risk behavior for both groups. Behavioral autonomy was unrelated to self-care but predicted better glycemic control for females. Conclusions Behavioral autonomy may be beneficial for psychological health, but is related to increased risk behavior. The implications of behavioral autonomy for emerging adults with type 1 diabetes require careful consideration. PMID:25157070

  12. Elementary School Nurse Interventions: Attendance and Health Outcomes

    ERIC Educational Resources Information Center

    Weismuller, Penny C.; Grasska, Merry A.; Alexander, Marilyn; White, Catherine G.; Kramer, Pat

    2007-01-01

    Regular school attendance is a necessary part of the learning process; student absenteeism has a direct association with poor academic performance. School nurses can influence student attendance. This study describes the impact of school nurse interventions on student absenteeism and student health. A retrospective review of 240 randomly selected…

  13. Screening for Childhood Mental Health Problems: Outcomes and Early Identification

    ERIC Educational Resources Information Center

    Essex, Marilyn J.; Kraemer, Helena C.; Slattery, Marcia J.; Burk, Linnea R.; Boyce, W. Thomas; Woodward, Hermi R.; Kupfer, David J.

    2009-01-01

    Background: Many childhood psychiatric problems are transient. Consequently, screening procedures to accurately identify children with problems unlikely to remit and thus, in need of intervention, are of major public health concern. This study aimed to develop a universal school-based screening procedure based on the answers to three questions:…

  14. Attendance at Health Promotion Programs: Baseline Predictors and Program Outcomes.

    ERIC Educational Resources Information Center

    Atkins, Catherine J.; And Others

    1990-01-01

    As part of a family cardiovascular health promotion project, 111 Mexican-American and 95 Anglo-American families with fifth or sixth grade children were assigned to either a primary prevention program involving 18 sessions or to a control condition. Correlates of attendance were low baseline scores on physical activity and cardiovascular fitness…

  15. Monitoring a correctional mental health care system: the role of the mental health expert.

    PubMed

    Metzner, Jeffrey L

    2009-01-01

    Class action litigation has been instrumental in jail and prison reform over the past four decades. This article provides a very brief introduction underlying the legal basis for such litigation. It focuses on the role of the mental health expert in monitoring a correctional mental health care system as a result of class action litigation including issues related to selection of the expert, development of the remedial plan, and monitoring of the implementation of the remedial plan. The importance of policies and procedures and a quality improvement process is emphasized. Essential elements of the monitoring process, prior to and during the site assessment, are described. Inmates and correctional staff alike have benefited substantially from such litigation in the form of increased resources and positive changes in institutional culture. PMID:19544449

  16. Expectations and outcome skills of a generalist health care administrator.

    PubMed

    Jones, V B; Taylor, L C

    1990-01-01

    The question of the degree of technical versus managerial competence to be found in future graduates from health administration programs is not easily resolved. In the HIMSS 1988 survey of CIOs the attributes needed for success are listed in descending rank order as follows: leadership ability, vision/imagination, knowledge of hospital systems, business acumen, decisiveness, and technical competence. CIOs ranked technical competence as less important than other attributes associated with general management success. The expectations for attitudes, knowledge, and skills presented in this article support the greater importance of management abilities relative to pure technical competence. However, it is vital that an appropriate level of technical knowledge and skill be maintained to enable future alumni of health administration programs to function effectively as administrators. Depending on their role in a health care organization, greater or lesser technical knowledge may be needed. Those pursuing a career path toward CIO must, of necessity, have greater technical knowledge and skill. We have discussed necessary and expected attitudes, knowledge, and skills that will be needed by the generalist health administration graduate in the future. It will be important to develop and maintain an attitude that MIS is a strategic tool, that health care technology is a corporate asset, and that information is power. Graduates must recognize the necessity of maintaining and enhancing their knowledge and skills through continuing education. The knowledge base of MIS education should focus on determining information needs to support strategic goals, understanding of general systems theory, principles of systems analysis, design, implementation and maintenance, awareness and exposure to standard application software, and an awareness of external sources of data.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:10106375

  17. Monitoring the health of sugar maple, Acer saccharum

    NASA Astrophysics Data System (ADS)

    Carlson, Martha

    The sugar maple, Acer saccharum, is projected to decline and die in 88 to 100 percent of its current range in the United States. An iconic symbol of the northeastern temperate forest and a dominant species in this forest, the sugar maple is identified as the most sensitive tree in its ecosystem to rising temperatures and a warming climate. This study measures the health of sugar maples on 12 privately owned forests and at three schools in New Hampshire. Laboratory quantitative analyses of leaves, buds and sap as well as qualitative measures of leaf and bud indicate that record high beat in 2012 stressed the sugar maple. The study identifies several laboratory and qualitative tests of health which seem most sensitive and capable of identifying stress early when intervention in forest management or public policy change might counter decline of the species. The study presents evidence of an unusual atmospheric pollution event which defoliated sugar maples in 2010. The study examines the work of citizen scientists in Forest Watch, a K-12 school program in which students monitor the impacts of ozone on white pine, Pinus strobus, another keystone species in New Hampshire's forest. Finally, the study examines three simple measurements of bud, leaf and the tree's acclimation to light. The findings of these tests illuminate findings in the first study. And they present examples of what citizen scientists might contribute to long-term monitoring of maples. A partnership between science and citizens is proposed to begin long-term monitoring and to report on the health of sugar maples.

  18. Structural Health Monitoring Sensor Development at NASA Langley Research Center

    NASA Technical Reports Server (NTRS)

    Prosser, W. H.; Wu, M. C.; Allison, S. G.; DeHaven, S. L.; Ghoshal, A.

    2002-01-01

    NASA is applying considerable effort on the development of sensor technology for structural health monitoring (SHM). This research is targeted toward increasing the safety and reliability of aerospace vehicles, while reducing operating and maintenance costs. Research programs are focused on applications to both aircraft and space vehicles. Sensor technologies under development span a wide range including fiber-optic sensing, active and passive acoustic sensors, electromagnetic sensors, wireless sensing systems, MEMS, and nanosensors. Because of their numerous advantages for aerospace applications, fiber-optic sensors are one of the leading candidates and are the major focus of this presentation. In addition, recent advances in active and passive acoustic sensing will also be discussed.

  19. Aircraft structural health monitoring using on-board BOCDA system

    NASA Astrophysics Data System (ADS)

    Yari, Takashi; Nagai, Kanehiro; Ishioka, Masahito; Hotate, Kazuo; Koshioka, Yasuhiro

    2008-03-01

    We developed the on-board BOCDA system for airplane and verified the flight environmental stability and durability through environmental test. The on-board BOCDA system adopted the polarization diversity technique and temporal gating technique to improve robustness of the BOCDA system. We successfully measured distribution of fiber Brillouin gain spectrum over 500m measurement range with 50mm spatial resolution, 60Hz sampling rate and +/-13μ strain accuracy. Furthermore, we considered flight test to verify the validity of the BOCDA system. From these results, it was confirmed that BOCDA system has potential to be applied to an aircraft structure health monitoring system.

  20. Scoping review: national monitoring frameworks for social determinants of health and health equity

    PubMed Central

    Pedrana, Leo; Pamponet, Marina; Walker, Ruth; Costa, Federico; Rasella, Davide

    2016-01-01

    Background The strategic importance of monitoring social determinants of health (SDH) and health equity and inequity has been a central focus in global discussions around the 2011 Rio Political Declaration on SDH and the Millennium Development Goals. This study is part of the World Health Organization (WHO) equity-oriented analysis of linkages between health and other sectors (EQuAL) project, which aims to define a framework for monitoring SDH and health equity. Objectives This review provides a global summary and analysis of the domains and indicators that have been used in recent studies covering the SDH. These studies are considered here within the context of indicators proposed by the WHO EQuAL project. The objectives are as follows: to describe the range of international and national studies and the types of indicators most frequently used; report how they are used in causal explanation of the SDH; and identify key priorities and challenges reported in current research for national monitoring of the SDH. Design We conducted a scoping review of published SDH studies in the PubMed® database to obtain evidence of socio-economic indicators. We evaluated, selected, and extracted data from national scale studies published from 2004 to 2014. The research included papers published in English, Italian, French, Portuguese, and Spanish. Results The final sample consisted of 96 articles. SDH monitoring is well reported in the scientific literature independent of the economic level of the country and magnitude of deprivation in population groups. The research methods were mostly quantitative and many papers used multilevel and multivariable statistical analyses and indexes to measure health inequalities and SDH. In addition to the usual economic indicators, a high number of socio-economic indicators were used. The indicators covered a broad range of social dimensions, which were given consideration within and across different social groups. Many indicators included in the

  1. Electoral reform and public policy outcomes in Thailand: the politics of the 30-Baht health scheme.

    PubMed

    Selway, Joel Sawat

    2011-01-01

    How do changes in electoral rules affect the nature of public policy outcomes? The current evidence supporting institutional theories that answer this question stems almost entirely from quantitative cross-country studies, the data of which contain very little within-unit variation. Indeed, while there are many country-level accounts of how changes in electoral rules affect such phenomena as the number of parties or voter turnout, there are few studies of how electoral reform affects public policy outcomes. This article contributes to this latter endeavor by providing a detailed analysis of electoral reform and the public policy process in Thailand through an examination of the 1997 electoral reforms. Specifically, the author examines four aspects of policy-making: policy formulation, policy platforms, policy content, and policy outcomes. The article finds that candidates in the pre-1997 era campaigned on broad, generic platforms; parties had no independent means of technical policy expertise; the government targeted health resources to narrow geographic areas; and health was underprovided in Thai society. Conversely, candidates in the post-1997 era relied more on a strong, detailed national health policy; parties created mechanisms to formulate health policy independently; the government allocated health resources broadly to the entire nation through the introduction of a universal health care system, and health outcomes improved. The author attributes these changes in the policy process to the 1997 electoral reform, which increased both constituency breadth (the proportion of the population to which politicians were accountable) and majoritarianism. PMID:21591306

  2. [Brazilian men's integral health attention: using indicators for monitoring health's promotion and attention].

    PubMed

    Moura, Erly Catarina de; Lima, Aline Maria Peixoto; Urdaneta, Margarita

    2012-10-01

    This article presents and discusses the initial actions of Brazilian National Men's Health Policy (PNAISH) concerning indicators used for monitoring promotion and assistance actions of men's health. This multiple case study was developed among five Brazilian cities which had implanted the PNAISH: (Goiânia (GO), Joinville (SC), Petrolina (PE), Rio Branco (AC) and Rio de Janeiro (RJ). A questionnaire was applied to verify the use of data and information required to calculate the indicators recommended by the PNAISH, concerning health's promotion, implementation and expansion of the men's health assistance system, according to the planned goals contained in the cities' local action plans. The results revealed a critical situation concerning monitoring of the activities through the proposed indicators taking into account the lack of standardized procedures to calculate them. Another specific limitation encountered was the limited access to or availability of data by age and sex in the health information systems. These results point out a lack of necessary indicators to define a base line situation, which weakens the systematic monitoring and future evaluation of the actions. PMID:23099747

  3. Cancer Information Seeking and Cancer-Related Health Outcomes: A Scoping Review of the Health Information National Trends Survey Literature.

    PubMed

    Wigfall, Lisa T; Friedman, Daniela B

    2016-09-01

    Cancer is a leading cause of death among adults in the United States. Only 54% of U.S. adults reported seeking cancer information in 2014. Cancer information seeking has been positively associated with cancer-related health outcomes such as screening adherence. We conducted a scoping review of studies that used data from the Health Information National Trends Survey (HINTS) in order to examine cancer information seeking in depth and the relationship between cancer information seeking and cancer-related health outcomes. We searched five databases and the HINTS website. The search yielded a total of 274 article titles. After review of 114 de-duplicated titles, 66 abstracts, and 50 articles, 22 studies met inclusion criteria. Cancer information seeking was the outcome in only four studies. The other 18 studies focused on a cancer-related health outcome. Cancer beliefs, health knowledge, and information seeking experience were positive predictors of cancer information seeking. Cancer-related awareness, knowledge, beliefs, preventive behaviors, and screening adherence were higher among cancer information seekers. Results from this review can inform other research study designs and primary data collection focused on specific cancer sites or aimed at populations not represented or underrepresented in the HINTS data (e.g., minority populations, those with lower socioeconomic status). PMID:27466828

  4. [Educational strategies to modify physician behaviours and health care outcomes].

    PubMed

    Nendaz, Mathieu

    2005-11-23

    The current evolution of medicine requires a sustained effort in continuing medical education to maintain an evidence-based practice. To support this process, several educational strategies are available, including guideline diffusion. Their critical analysis reveals that the dissemination of passive information by conferences or by unsolicited materials is generally ineffective to modify the behaviours in practice or patient outcomes. More effective interventions are practice- and community-based rather than didactic, include an evaluation of learning needs, and enhance active participation in multiple activities. Before investing time and money into an educational activity, one should consider the evidence of its efficacy and make an oriented choice, according to the goals aimed and the available resources. PMID:16366448

  5. Cancer-Specific Outcomes Among Young Adults Without Health Insurance

    PubMed Central

    Aizer, Ayal A.; Falit, Benjamin; Mendu, Mallika L.; Chen, Ming-Hui; Choueiri, Toni K.; Hoffman, Karen E.; Hu, Jim C.; Martin, Neil E.; Trinh, Quoc-Dien; Alexander, Brian M.; Nguyen, Paul L.

    2014-01-01

    Purpose The Patient Protection and Affordable Care Act (ACA) will likely improve insurance coverage for most young adults, but subsets of young adults in the United States will face significant premium increases in the individual market. We examined the association between insurance status and cancer-specific outcomes among young adults. Methods We used the SEER program to identify 39,447 patients age 20 to 40 years diagnosed with a malignant neoplasm between 2007 and 2009. The association between insurance status and stage at presentation, employment of definitive therapy, and all-cause mortality was assessed using multivariable logistic or Cox regression, as appropriate. Results Patients who were uninsured were more likely to be younger, male, nonwhite, and unmarried than patients who were insured and were also more likely to be from regions of lower income, education, and population density (P < .001 in all cases). After adjustment for pertinent confounding variables, an association between insurance coverage and decreased likelihood of presentation with metastatic disease (odds ratio [OR], 0.84; 95% CI, 0.75 to 0.94; P = .003), increased receipt of definitive treatment (OR, 1.95; 95% CI, 1.52 to 2.50; P < .001), and decreased death resulting from any cause (hazard ratio, 0.77; 95% CI, 0.65 to 0.91; P = .002) was noted. Conclusion The improved coverage fostered by the ACA may translate into better outcomes among most young adults with cancer. Extra consideration will need to be given to ensure that patients who will face premium increases in the individual market can obtain insurance coverage under the ACA. PMID:24888800

  6. Mental health of prisoners: prevalence, adverse outcomes, and interventions.

    PubMed

    Fazel, Seena; Hayes, Adrian J; Bartellas, Katrina; Clerici, Massimo; Trestman, Robert

    2016-09-01

    More than 10 million people are imprisoned worldwide, and the prevalence of all investigated mental disorders is higher in prisoners than in the general population. Although the extent to which prison increases the incidence of mental disorders is uncertain, considerable evidence suggests low rates of identification and treatment of psychiatric disorders. Prisoners are also at increased risk of all-cause mortality, suicide, self-harm, violence, and victimisation, and research has outlined some modifiable risk factors. Few high quality treatment trials have been done on psychiatric disorders in prisoners. Despite this lack of evidence, trial data have shown that opiate substitution treatments reduce substance misuse relapse and possibly reoffending. The mental health needs of women and older adults in prison are distinct, and national policies should be developed to meet these. In this Review, we present clinical, research, and policy recommendations to improve mental health care in prisons. National attempts to meet these recommendations should be annually surveyed. PMID:27426440

  7. Personal and workgroup incivility: impact on work and health outcomes.

    PubMed

    Lim, Sandy; Cortina, Lilia M; Magley, Vicki J

    2008-01-01

    This article develops a theoretical model of the impact of workplace incivility on employees' occupational and psychological well-being. In Study 1, the authors tested the model on 1,158 employees, finding that satisfaction with work and supervisors, as well as mental health, partially mediated effects of personal incivility on turnover intentions and physical health; this process did not vary by gender. Study 2 cross-validated and extended these results on an independent sample of 271 employees, showing negative effects of workgroup incivility that emerged over and above the impact of personal incivility. In both studies, all results held while controlling for general job stress. Implications for organizational science and practice are discussed. PMID:18211138

  8. Mental health status of infertile couples based on treatment outcome

    PubMed Central

    Baghianimoghadam, Mohammad Hosein; Aminian, Amir Hossein; Baghianimoghadam, Behnam; Ghasemi, Nasrin; Abdoli, Ali Mohammad; Seighal Ardakani, Najmeh; Fallahzadeh, Hosein

    2013-01-01

    Background: Infertility is accompanied by numerous psychological and social problems. Infertile couples are more anxious and emotionally distressed than other fertile people. Previous studies suggested that infertility is more stressful for women than men. Objective: The purpose of this study was to determine the status of general health of infertile couples. Materials and Methods: This cross-sectional study evaluated general health of 150 infertile couples attending to Yazd Research and Clinical Center for Infertility that were selected consequently. The data were gathered by the researchers, based on face to face interview before and after three months of treatment by two questionnaires. The first questionnaire had questions on demographic information and the second one was the General Health Questionnaire-28 (GHQ-28). This questionnaire has four sub- scales areas. All data were transferred directly to SPSS 15 and analyzed. Results: The mean age of women was 28.3 and men were 32.4 years. The scores for all sub- scales of GHQ in women were more than men. There was significant difference between age and general health at physical symptoms scales (p=0.002), anxiety and sleep disorders (p=0.003). The age group 25-29 years had higher scores (more than 7) than other age groups. There was significant difference between the scale of social dysfunction and results of treatment. Conclusion: Our results, similar to the previous studies have revealed negetive social and mental effects of infertility on women is more than men, so there is need that they be educated specially. PMID:24639785

  9. The UAW-GM health promotion program. Successful outcomes.

    PubMed

    Edington, Marilyn; Karjalainen, Terry; Hirschland, David; Edington, Dee W

    2002-01-01

    1. The success of the LifeSteps program may rest in the UAW and GM leadership's vision to use a high level joint steering committee, a day to day working committee, third party program providers, support of confidentiality throughout the entire program, and a comprehensive data driven decision making system. 2. The program design is a multiplatform method of program delivery to a diverse and nationwide population of the active and retired employees and dependents (more than 1 million individuals older than age 18). They receive an annual health risk appraisal, telephone access to a registered nurse 24 hours a day. LifeSteps website, a quarterly health information newsletter and a health care book sent to each of the households, and access to a telephonic audiotape library. 3. A pilot program has a more intense design of low risk maintenance and high risk reduction programs specifically for all active employees who work in the pilot locations. A telephonic program for behavior change is available only to high risk individuals in the total pilot population of active and retired employees and dependents. 4. The major success criterion for the LifeSteps program is helping workers, former employees, and their families maintain or achieve low risk status. The increased number of employees at low risk status (4% gain the second year and a 2% gain from the second to the third year) documents the improved health status of the population. Moreover, of surveyed participants and nonparticipants, 85% supported program continuation and 74% said they had an improved opinion of the UAW and GM due to the program. PMID:11842778

  10. The Impact of Mobile Health Interventions on Chronic Disease Outcomes in Developing Countries: A Systematic Review

    PubMed Central

    Lee, Allison G.; Willner, Jonathan M.; Jahangir, Eiman; Ciapponi, Agustín; Rubinstein, Adolfo

    2014-01-01

    Abstract Introduction: Rates of chronic diseases will continue to rise in developing countries unless effective and cost-effective interventions are implemented. This review aims to discuss the impact of mobile health (m-health) on chronic disease outcomes in low- and middle-income countries (LMIC). Materials and Methods: Systematic literature searches were performed using CENTRAL, MEDLINE, EMBASE, and LILACS databases and gray literature. Scientific literature was searched to identify controlled studies evaluating cell phone voice and text message interventions to address chronic diseases in adults in low- or middle-income countries. Outcomes measured included morbidity, mortality, hospitalization rates, behavioral or lifestyle changes, process of care improvements, clinical outcomes, costs, patient–provider satisfaction, compliance, and health-related quality of life (HRQoL). Results: From the 1,709 abstracts retrieved, 163 articles were selected for full text review, including 9 randomized controlled trials with 4,604 participants. Most of the studies addressed more than one outcome. Of the articles selected, six studied clinical outcomes, six studied processes of care, three examined healthcare costs, and two examined HRQoL. M-health positively impacted on chronic disease outcomes, improving attendance rates, clinical outcomes, and HRQoL, and was cost-effective. Conclusions: M-health is emerging as a promising tool to address access, coverage, and equity gaps in developing countries and low-resource settings. The results for m-health interventions showed a positive impact on chronic diseases in LMIC. However, a limiting factor of this review was the relatively small number of studies and patients enrolled, highlighting the need for more rigorous research in this area in developing countries. PMID:24205809

  11. Using Patient Reported Outcome Measures to Improve Service Effectiveness (UPROMISE): Training clinicians to Use Outcome Measures in Child Mental Health.

    PubMed

    Edbrooke-Childs, Julian; Wolpert, Miranda; Deighton, Jessica

    2016-05-01

    Patient reported outcome measures (PROMs) are prevalent in child mental health services. In this point of view, we discuss our experience of training clinicians to use PROMs and to interpret and discuss feedback from measures. Findings from pre-post observational data from clinicians who attended either a 1- or 3-day training course showed that clinicians in both courses had more positive attitudes and higher levels of self-efficacy regarding administering measures and using feedback after training. We hope that this special issue will lead the way for future research on training clinicians to use outcome measures so that PROMs may be a source of clinically useful practice based evidence. PMID:25331446

  12. DNA methylation, early life environment, and health outcomes

    PubMed Central

    Mitchell, Colter; Schneper, Lisa M.; Notterman, Daniel A.

    2016-01-01

    Epigenetics, and especially DNA methylation, have recently become provocative biological explanations for early-life environmental effects on later health. Despite the large increase in papers on the topic over the last few years, many questions remain with regards to the biological feasibility of this mechanism and the strength of the evidence to date. In this review, we examine the literature on early-life effects on epigenetic patterns, with special emphasis on social environmental influences. First, we review the basic biology of epigenetic modification of DNA and debate the role of early-life stressful, protective, and positive environments on gene-specific, system-specific, and whole-genome epigenetic patterns later in life. Second, we compare the epigenetic literatures of both humans and other animals and review the research linking epigenetic patterns to health in order to complete the mechanistic pathway. Third, we discuss physical environmental and social environmental effects, which have to date, generally not been jointly considered. Finally, we close with a discussion of the current state of the area’s research, its future direction, and its potential use in pediatric health. PMID:26466079

  13. Family-Based Hip-Hop to Health: Outcome Results

    PubMed Central

    Fitzgibbon, M. L.; Stolley, M. R.; Schiffer, L.; Kong, A.; Braunschweig, C. L.; Gomez-Perez, S. L.; Odoms-Young, A.; Van Horn, L.; Christoffel, K. Kaufer; Dyer, A. R.

    2012-01-01

    This pilot study tested the feasibility of Family-Based Hip-Hop to Health, a school-based obesity prevention intervention for 3–5 year old Latino children and their parents, and estimated its effectiveness in producing smaller average changes in body mass index at one year follow-up. Four Head Start preschools administered through the Chicago Public Schools were randomly assigned to receive a Family-Based Intervention (FBI) or a General Health intervention (GHI). Parents signed consent forms for 147 of the 157 children enrolled. Both the school-based and family-based components of the intervention were feasible, but attendance for the parent intervention sessions was low. Contrary to expectations, a downtrend in BMI Z score was observed in both the intervention and control groups. While the data reflect a downward trend in obesity among these young Hispanic children, obesity rates remained higher at one-year follow-up (15%) than those reported by the National Health and Nutrition Examination Survey (2009–2010) for 2–5 year old children (12.1%). Developing evidence-based strategies for obesity prevention among Hispanic families remains a challenge. PMID:23532990

  14. Physiology of Sedentary Behavior and Its Relationship to Health Outcomes

    PubMed Central

    Thyfault, John P; Du, Mengmeng; Kraus, William E; Levine, James A; Booth, Frank W

    2014-01-01

    Purpose This paper reports on the findings and recommendations of the “Physiology of Sedentary Behavior and its Relationship to Health Outcomes” group, a part of a larger workshop entitled Sedentary Behavior: Identifying Research Priorities sponsored by the National Heart, and Lung and Blood Institute and the National Institute on Aging, which aimed to establish sedentary behavior research priorities. Methods The discussion within our workshop lead to the formation of critical physiological research objectives related to sedentary behaviors, that if appropriately researched would greatly impact our overall understanding of human health and longevity. Results and Conclusions Primary questions are related to physiological “health outcomes” including the influence of physical activity vs. sedentary behavior on function of a number of critical physiological systems (aerobic capacity, skeletal muscle metabolism and function, telomeres/genetic stability, and cognitive function). The group also derived important recommendations related to the “central and peripheral mechanisms” that govern sedentary behavior and how energy balance has a role in mediating these processes. General recommendations for future sedentary physiology research efforts include that studies of sedentary behavior, including that of sitting time only, should focus on the physiological impact of a “lack of human movement” in contradistinction to the effects of physical movement and that new models or strategies for studying sedentary behavior induced adaptations and links to disease development are needed to elucidate underlying mechanism(s). PMID:25222820

  15. Differences in mental health outcomes by acculturation status following a major urban disaster.

    PubMed

    Adams, Richard E; Boscarino, Joseph A

    2013-01-01

    A number of studies have assessed the association between acculturation and psychological outcomes following a traumatic event. Some suggest that low acculturation is associated with poorer health outcomes, while others show no differences or that low acculturation is associated with better outcomes. One year after the terrorist attacks on the World Trade Center, we surveyed a multi-ethnic population of New York City adults (N= 2,368). We assessed posttraumatic stress disorder (PTSD), major depression, panic attack, anxiety symptoms, and general physical and mental health status. We classified study respondents into "low," "moderate," or "high" acculturation, based on survey responses. Bivariate results indicated that low acculturation individuals were more likely to experience negative life events, have low social support, and less likely to have pre-disaster mental health disorders. Those in the low acculturation group were also more likely to experience post-disaster perievent panic attacks, have higher anxiety, and have poorer mental health status. However, using logistic regression to control for confounding, and adjusting for multiple comparisons, we found that none of these outcomes were associated with acculturation status. Thus, our study suggests that acculturation was not associated with mental health outcomes following a major traumatic event. PMID:24558696

  16. Antidepressant pharmacotherapy: economic outcomes in a health maintenance organization.

    PubMed

    Sclar, D A; Robison, L M; Skaer, T L; Legg, R F; Nemec, N L; Galin, R S; Hughes, T E; Buesching, D P

    1994-01-01

    Recent pharmacotherapeutic advances in the treatment of depression have included the development of selective serotonin re-uptake inhibitors (SSRIs). The present study was designed to contrast direct health service expenditures for the treatment of depression among patients enrolled in a health maintenance organization (HMO) and prescribed either the SSRI fluoxetine or one of three tricyclic antidepressants (TCAs) (amitriptyline, nortriptyline, or desipramine). Information regarding health service utilizati