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Sample records for home-based health platform

  1. User preferences and usability of iVitality: optimizing an innovative online research platform for home-based health monitoring

    PubMed Central

    van Osch, Mara; Rövekamp, AJM; Bergman-Agteres, Stephanie N; Wijsman, Liselotte W; Ooms, Sharon J; Mooijaart, Simon P; Vermeulen, Joan

    2015-01-01

    Background The iVitality online research platform has been developed to gain insight into the relationship between early risk factors (ie, poorly controlled hypertension, physical or mental inactivity) and onset and possibly prevention of dementia. iVitality consists of a website, a smartphone application, and sensors that can monitor these indicators at home. Before iVitality can be implemented, it should fit the needs and preferences of users, ie, offspring of patients with dementia. This study aimed to explore users’ motivation to participate in home-based health monitoring research, to formulate requirements based on users’ preferences to optimize iVitality, and to test usability of the smartphone application of iVitality. Methods We recruited 13 participants (aged 42–64 years, 85% female), who were offspring of patients with dementia. A user-centered methodology consisting of four iterative phases was used. Three semistructured interviews provided insight into motivation and acceptance of using iVitality (phase 1). A focus group with six participants elaborated on expectations and preferences regarding iVitality (phase 2). Findings from phase 1 and 2 were triangulated by two semistructured interviews (phase 3). Four participants assessed the usability of the smartphone application (phase 4) using a think aloud procedure and a questionnaire measuring ease and efficiency of use (scale 1–7; higher scores indicated better usability). Results All participants were highly motivated to contribute to dementia research. However, the frequency of home-based health monitoring should not be too high. Participants preferred to receive feedback about their measurements and information regarding the relationship between these measurements and dementia. Despite minor technical errors, iVitality was considered easy and efficient to use (mean score 5.50, standard deviation 1.71). Conclusion Offspring of patients with dementia are motivated to contribute to home-based

  2. Privacy and information security risks in a technology platform for home-based chronic disease rehabilitation and education

    PubMed Central

    2013-01-01

    Background Privacy and information security are important for all healthcare services, including home-based services. We have designed and implemented a prototype technology platform for providing home-based healthcare services. It supports a personal electronic health diary and enables secure and reliable communication and interaction with peers and healthcare personnel. The platform runs on a small computer with a dedicated remote control. It is connected to the patient’s TV and to a broadband Internet. The platform has been tested with home-based rehabilitation and education programs for chronic obstructive pulmonary disease and diabetes. As part of our work, a risk assessment of privacy and security aspects has been performed, to reveal actual risks and to ensure adequate information security in this technical platform. Methods Risk assessment was performed in an iterative manner during the development process. Thus, security solutions have been incorporated into the design from an early stage instead of being included as an add-on to a nearly completed system. We have adapted existing risk management methods to our own environment, thus creating our own method. Our method conforms to ISO’s standard for information security risk management. Results A total of approximately 50 threats and possible unwanted incidents were identified and analysed. Among the threats to the four information security aspects: confidentiality, integrity, availability, and quality; confidentiality threats were identified as most serious, with one threat given an unacceptable level of High risk. This is because health-related personal information is regarded as sensitive. Availability threats were analysed as low risk, as the aim of the home programmes is to provide education and rehabilitation services; not for use in acute situations or for continuous health monitoring. Conclusions Most of the identified threats are applicable for healthcare services intended for patients or

  3. ERMHAN: A Context-Aware Service Platform to Support Continuous Care Networks for Home-Based Assistance

    PubMed Central

    Paganelli, Federica; Spinicci, Emilio; Giuli, Dino

    2008-01-01

    Continuous care models for chronic diseases pose several technology-oriented challenges for home-based continuous care, where assistance services rely on a close collaboration among different stakeholders such as health operators, patient relatives, and social community members. Here we describe Emilia Romagna Mobile Health Assistance Network (ERMHAN) a multichannel context-aware service platform designed to support care networks in cooperating and sharing information with the goal of improving patient quality of life. In order to meet extensibility and flexibility requirements, this platform has been developed through ontology-based context-aware computing and a service oriented approach. We also provide some preliminary results of performance analysis and user survey activity. PMID:18695739

  4. GOLIAH: A Gaming Platform for Home-Based Intervention in Autism - Principles and Design.

    PubMed

    Bono, Valentina; Narzisi, Antonio; Jouen, Anne-Lise; Tilmont, Elodie; Hommel, Stephane; Jamal, Wasifa; Xavier, Jean; Billeci, Lucia; Maharatna, Koushik; Wald, Mike; Chetouani, Mohamed; Cohen, David; Muratori, Filippo

    2016-01-01

    -child relationship. This pilot study shows the feasibility of using the developed gaming platform for home-based intensive intervention. However, the overall capability of the platform in delivering intervention needs to be assessed in a bigger open trial. PMID:27199777

  5. GOLIAH: A Gaming Platform for Home-Based Intervention in Autism – Principles and Design

    PubMed Central

    Bono, Valentina; Narzisi, Antonio; Jouen, Anne-Lise; Tilmont, Elodie; Hommel, Stephane; Jamal, Wasifa; Xavier, Jean; Billeci, Lucia; Maharatna, Koushik; Wald, Mike; Chetouani, Mohamed; Cohen, David; Muratori, Filippo

    2016-01-01

    parents–child relationship. This pilot study shows the feasibility of using the developed gaming platform for home-based intensive intervention. However, the overall capability of the platform in delivering intervention needs to be assessed in a bigger open trial. PMID:27199777

  6. Risk management and clinical governance for complex home-based health care.

    PubMed

    Lewis, Mary; Noyes, Jane

    2007-07-01

    Healthcare professionals have an obligation to enable children with complex needs to lead 'ordinary lives' at home but the views of professionals and family members often diverge in relation to the management of risks. Nurses are increasingly taking on the clinical responsibility for children with complex needs within a multidisciplinary, multi-agency team, yet have little training or experience in adapting risk management and clinical governance frameworks to home-based settings. Risk management frameworks for home-based care for children with complex health and social care needs are introduced in this article. Best practice guidance and resources for adapting risk management frameworks are presented to meet this identified gap in knowledge and experience. Children, young people and their parents have increasing expectations relating to the type and quality of home-based support they receive. Developing and applying clinical governance and risk management frameworks are part of improving outcomes for children with complex needs and their families. PMID:17694890

  7. Investment in home-based maternal, newborn and child health records improves immunization coverage in Indonesia.

    PubMed

    Osaki, K; Hattori, T; Kosen, Soewarta; Singgih, Budihardja

    2009-08-01

    Indonesia Demographic and Health Surveys show that the ownership of home-based immunization records among children aged 12-23 months increased from 30.8% in 1997 and 30.7% in 2002-3 to 37% in 2007. In 2002-3, 70.9% of children who owned records had received all vaccines by the time of the survey, whereas 42.9% of children who did not own records had been fully immunized. An Indonesian ministerial decree of 2004 stated that the Maternal and Child Health Handbook (MCH handbook) was to be the only home-based record of maternal, newborn and child health. The increased immunization coverage seen would be a reflection of MCH handbook implementation, through raising awareness of immunization among community and health personnel and children's parents or guardians and allowing more accurate measurement of immunization coverage. PMID:19375141

  8. Clinics and home-based care organisations: an interface between theformal and informal health sectors.

    PubMed

    Boros, Adam Kenneth

    2010-12-01

    The article outlines the findings of a study designed to explore the working relationship between home-based caregivers and clinic nurses at locations in two informal settlements in Johannesburg, South Africa. By considering the views and experiences of both sponsored and unsponsored caregivers, the research focused on how degrees of informality affect this relationship. The nurse/caregiver relationship represents a primary interface between the formal and informal health sectors and is an important part of the country's primary healthcare system. Despite the attention given to linking home-based care (HBC) with the formal health system, very little research has examined the functionality of this link at the ground level. Through a number of qualitative, semi-structured interviews with nurses, home-based caregivers, and staff from the Department of Health, information was collected to better understand what systems are in place to facilitate the relationship between clinics and HBC organisations, and whether these systems are helping to create the desired results. Do the formal and informal health sectors complement and strengthen or do they distract and damage each other? By examining the influence of degrees of informality, the research also lends insight into how this distinction plays a role in healthcare provision. For instance, how does state support impact the link between the formal and informal health sectors and the ultimate quality of care? And what steps can be taken to improve the health system in this regard, as a whole? The findings point to a number of problems and challenges with integrating HBC into the formal health sector. Degrees of informality are found to have a profound impact on the work of home-based caregivers in some respects, but a surprising lack of impact in others. These issues need to be confronted in order to improve the existing system and, ultimately, health outcomes in South Africa. PMID:25875880

  9. Assessing the importance of gender roles in couples' home-based sexual health services in Malawi.

    PubMed

    Gipson, Jessica D; Muntifering, Carie J; Chauwa, Felluna K; Taulo, Frank; Tsui, Amy O; Hindin, Michelle J

    2010-12-01

    To more effectively address individuals' and couples' sexual and reproductive health needs, innovative service delivery strategies are being explored. These strategies are logistically and ethically complicated, considering prevailing gender inequalities in many contexts. We conducted an exploratory study to assess the acceptability of couples' home-based sexual health services in Malawi. We collected qualitative data from six focus group discussions and 10 husband-wife indepth interviews to gain a more thorough understanding of how gender norms influence acceptability of couples' sexual health services. Findings reveal that women are expected to defer to their husbands and may avoid conflict through covert contraceptive use and non-disclosure of HIV status. Many men felt that accessing sexual health services is stigmatizing, causing some to avoid services or to rely on informal information sources. Gender norms and attitudes toward existing services differentially impact men and women in this setting, influencing the perceived benefits of couples' sexual health services. PMID:21812199

  10. Internet Protocol Television for Personalized Home-Based Health Information: Design-Based Research on a Diabetes Education System

    PubMed Central

    Clarke, Ken; Kwong, Mabel; Alzougool, Basil; Hines, Carolyn; Tidhar, Gil; Frukhtman, Feodor

    2014-01-01

    Background The use of Internet protocol television (IPTV) as a channel for consumer health information is a relatively under-explored area of medical Internet research. IPTV may afford new opportunities for health care service providers to provide health information and for consumers, patients, and caretakers to access health information. The technologies of Web 2.0 add a new and even less explored dimension to IPTV’s potential. Objective Our research explored an application of Web 2.0 integrated with IPTV for personalized home-based health information in diabetes education, particularly for people with diabetes who are not strong computer and Internet users, and thus may miss out on Web-based resources. We wanted to establish whether this system could enable diabetes educators to deliver personalized health information directly to people with diabetes in their homes; and whether this system could encourage people with diabetes who make little use of Web-based health information to build their health literacy via the interface of a home television screen and remote control. Methods This project was undertaken as design-based research in two stages. Stage 1 comprised a feasibility study into the technical work required to integrate an existing Web 2.0 platform with an existing IPTV system, populated with content and implemented for user trials in a laboratory setting. Stage 2 comprised an evaluation of the system by consumers and providers of diabetes information. Results The project succeeded in developing a Web 2.0 IPTV system for people with diabetes and low literacies and their diabetes educators. The performance of the system in the laboratory setting gave them the confidence to engage seriously in thinking about the actual and potential features and benefits of a more widely-implemented system. In their feedback they pointed out a range of critical usability and usefulness issues related to Web 2.0 affordances and learning fundamentals. They also described

  11. "Willing but unwilling": attitudinal barriers to adoption of home-based health information technology among older adults.

    PubMed

    Young, Rachel; Willis, Erin; Cameron, Glen; Geana, Mugur

    2014-06-01

    While much research focuses on adoption of electronic health-care records and other information technology among health-care providers, less research explores patient attitudes. This qualitative study examines barriers to adoption of home-based health information technology, particularly personal electronic health records, among older adults. We conducted in-depth interviews (30-90 min duration) with 35 American adults, aged 46-72 years, to determine their perceptions of and attitudes toward home-based health information technology. Analysis of interview data revealed that most barriers to adoption fell under four themes: technological discomfort, privacy or security concerns, lack of relative advantage, and perceived distance from the user representation. Based on our findings, systems to promote home-based health information technology should incorporate familiar computer applications, alleviate privacy and security concerns, and align with older adults' active and engaged self-image. PMID:24056750

  12. Development of a powered mobile module for the ArmAssist home-based telerehabilitation platform.

    PubMed

    Jung, Je Hyung; Valencia, David B; Rodríguez-de-Pablo, Cristina; Keller, Thierry; Perry, Joel C

    2013-06-01

    The ArmAssist, developed by Tecnalia, is a system for at-home telerehabilitation of post-stroke arm impairments. It consists of a wireless mobile base module, a global position and orientation detection mat, a PC with display monitor, and a tele-rehabilitation software platform. This paper presents the recent development results on the mobile module augmenting its functionality by adding actuation components. Three DC servo motors were employed to drive the mobile module and a position control algorithm based on the kinematic model and velocity mode control was implemented such that the module tracks a path defined in the training software. Pilot tests of the powered mobile module were performed in experiments with different load conditions and two unimpaired subjects. Both test results show that the module is able to follow the predefined path within an acceptable error range for reach movement training. Further study and testing of the system in realistic conditions following stroke will be a future topic of research. PMID:24187242

  13. Fragmented implementation of maternal and child health home-based records in Vietnam: need for integration

    PubMed Central

    Aiga, Hirotsugu; Nguyen, Vinh Duc; Nguyen, Cuong Dinh; Nguyen, Tho Thi Thi; Nguyen, Lien Thi Phuong

    2016-01-01

    Background Home-based records (HBRs) are globally implemented as the effective tools that encourage pregnant women and mothers to timely and adequately utilise maternal and child health (MCH) services. While availability and utilisation of nationally representative HBRs have been assessed in several earlier studies, the reality of a number of HBRs subnationally implemented in a less coordinated manner has been neither reported nor analysed. Objectives This study is aimed at estimating the prevalence of HBRs for MCH and the level of fragmentation of and overlapping between different HBRs for MCH in Vietnam. The study further attempts to identify health workers’ and mothers’ perceptions towards HBR operations and utilisations. Design A self-administered questionnaire was sent to the provincial health departments of 28 selected provinces. A copy of each HBR available was collected from them. A total of 20 semi-structured interviews with health workers and mothers were conducted at rural communities in four of 28 selected provinces. Results Whereas HBRs developed exclusively for maternal health and exclusively for child health were available in four provinces (14%) and in 28 provinces (100%), respectively, those for both maternal health and child health were available in nine provinces (32%). The mean number of HBRs in 28 provinces (=5.75) indicates over-availability of HBRs. All 119 minimum required items for recording found in three different HBRs under nationwide scale-up were also included in the Maternal and Child Health Handbook being piloted for nationwide scaling-up. Implementation of multiple HBRs is likely to confuse not only health workers by requiring them to record the same data on several HBRs but also mothers about which HBR they should refer to and rely on at home. Conclusions To enable both health workers and pregnant women to focus on only one type of HBR, province-specific HBRs for maternal and/or child health need to be nationally standardised

  14. The Impact of Perceived Stress, Social Support, and Home-Based Physical Activity on Mental Health among Older Adults

    ERIC Educational Resources Information Center

    Kwag, Kyung Hwa; Martin, Peter; Russell, Daniel; Franke, Warren; Kohut, Marian

    2011-01-01

    This study investigated how perceived stress, social support, and home-based physical activity affected older adults' fatigue, loneliness, and depression. We also explored whether social support and physical activity mediated the relationships between stress and mental health problems. The data of 163 older participants were analyzed in this…

  15. Automated Cognitive Health Assessment From Smart Home-Based Behavior Data.

    PubMed

    Dawadi, Prafulla Nath; Cook, Diane Joyce; Schmitter-Edgecombe, Maureen

    2016-07-01

    Smart home technologies offer potential benefits for assisting clinicians by automating health monitoring and well-being assessment. In this paper, we examine the actual benefits of smart home-based analysis by monitoring daily behavior in the home and predicting clinical scores of the residents. To accomplish this goal, we propose a clinical assessment using activity behavior (CAAB) approach to model a smart home resident's daily behavior and predict the corresponding clinical scores. CAAB uses statistical features that describe characteristics of a resident's daily activity performance to train machine learning algorithms that predict the clinical scores. We evaluate the performance of CAAB utilizing smart home sensor data collected from 18 smart homes over two years. We obtain a statistically significant correlation ( r=0.72) between CAAB-predicted and clinician-provided cognitive scores and a statistically significant correlation ( r=0.45) between CAAB-predicted and clinician-provided mobility scores. These prediction results suggest that it is feasible to predict clinical scores using smart home sensor data and learning-based data analysis. PMID:26292348

  16. Home-Based Mental Health Services for Older Adults: A Review of Ten Model Programs

    PubMed Central

    Bruce, Martha L.

    2015-01-01

    Objective The objective is to provide information on successful programs providing home-based services to mentally ill elderly in order to assist other communities wishing to establish such programs. Participants The ten programs described in this article were selected by peer review from applications for an award given by the American Association for Geriatric Psychiatry and were participants in an invitational conference. Results Eight of the programs were components of a community agency while two were components of a medical school department of psychiatry. Six of the programs focused primarily on individuals with anxiety and depression and employed a range of individual psychotherapies. The other four accepted patients with any psychiatric diagnosis including dementia and included medication management as part of their services. The numbers served by the ten programs ranged from about 50 to 300 new cases per year, and the staffing ranged from 2 to 13 often with a combination of full and part time. The annual budget for the ten programs ranged from $30,000 to $1,250,000. Budget sources usually included some combination of public funds, philanthropy, and fee-for-service income. Conclusions Despite the logistic and fiscal challenges of providing home-based services to mentally ill older adults there are many long-standing successful programs that can serve as models for communities wishing to establish similar programs. A great opportunity exists for a unified outcome research endeavor as well as expansion into many more communities. PMID:23567412

  17. Home-based neuromuscular electrical stimulation improves exercise tolerance and health-related quality of life in patients with COPD

    PubMed Central

    Coquart, Jérémy B; Grosbois, Jean-Marie; Olivier, Cecile; Bart, Frederic; Castres, Ingrid; Wallaert, Benoit

    2016-01-01

    Background This retrospective, observational study of a routine clinical practice reports the feasibility and efficiency of home-based pulmonary rehabilitation (PR), including transcutaneous neuromuscular electrical stimulation (NMES) or usual endurance physical exercise (UEPE), on exercise tolerance, anxiety/depression, and health-related quality of life (HRQoL) in patients with COPD. Methods Seventy-one patients with COPD participated in home-based PR with NMES (Group NMES [GNMES]), while 117 patients participated in home-based PR with the UEPEs (Group UEPE [GUEPE]). NMES was applied for 30 minutes twice a day, every day. The endurance exercises in GUEPE began with a minimum 10-minute session at least 5 days a week, with the goal being 30–45 minutes per session. Three upper and lower limb muscle strengthening exercises lasting 10–15 minutes were also proposed to both the groups for daily practice. Moreover, PR in both the groups included a weekly 90-minute session based on an educational needs assessment. The sessions comprised endurance physical exercise for GUEPE, NMES for GNMES, resumption of physical daily living activities, therapeutic patient education, and psychosocial support to facilitate health behavior changes. Before and after PR, functional mobility and physical exercise capacity, anxiety, depression, and HRQoL were evaluated at home. Results The study revealed that NMES significantly improved functional mobility (−18.8% in GNMES and −20.6% in GUEPE), exercise capacity (+20.8% in GNMES and +21.8% in GUEPE), depression (−15.8% in GNMES and −30.1% in GUEPE), and overall HRQoL (−7.0% in GNMES and −18.5% in GUEPE) in the patients with COPD, regardless of the group (GNMES or GUEPE) or severity of airflow obstruction. Moreover, no significant difference was observed between the groups with respect to these data (P>0.05). Conclusion Home-based PR including self-monitored NMES seems feasible and effective for severely disabled COPD patients

  18. Occupational Safety, Health, and Well-being Among Home-based Workers in the Informal Economy of Thailand.

    PubMed

    Nankongnab, Noppanun; Silpasuwan, Pimpan; Markkanen, Pia; Kongtip, Pornpimol; Woskie, Susan

    2015-08-01

    The objective of this article is to provide a summary of the issues related to occupational safety and health and well-being among workers in the informal economy of Thailand, with a special emphasis on home-based workers. The reviewed literature includes documents and information sources developed by the International Labour Organization, the National Statistical Office of Thailand, peer-reviewed scientific publications, and master's theses conducted in Thailand. This work is part of a needs and opportunities analysis carried out by the Center for Work, Environment, Nutrition and Development--a partnership between Mahidol University and University of Massachusetts Lowell to identify the gaps in knowledge and research to support government policy development in the area of occupational and environmental health for workers in the informal economy. PMID:26059416

  19. Framing the evidence for health smart homes and home-based consumer health technologies as a public health intervention for independent aging: a systematic review

    PubMed Central

    Reeder, Blaine; Meyer, Ellen; Lazar, Amanda; Chaudhuri, Shomir; Thompson, Hilaire J.; Demiris, George

    2013-01-01

    Introduction There is a critical need for public health interventions to support the independence of older adults as the world’s population ages. Health smart homes (HSH) and home-based consumer health (HCH) technologies may play a role in these interventions. Methods We conducted a systematic review of HSH and HCH literature from indexed repositories for health care and technology disciplines (e.g., MEDLINE, CINAHL, and IEEE Xplore) and classified included studies according to an evidence-based public health (EBPH) typology. Results One thousand, six hundred and thirty nine candidate articles were identified. Thirty-one studies from the years 1998–2011 were included. Twenty-one included studies were classified as emerging, 10 as promising and 3 as effective (first tier). Conclusion The majority of included studies were published in the period beginning in the year 2005. All 3 effective (first tier) studies and 9 of 10 of promising studies were published during this period. Almost all studies included an activity sensing component and most of these used passive infrared motion sensors. The three effective (first tier) studies all used a multicomponent technology approach that included activity sensing, reminders and other technologies tailored to individual preferences. Future research should explore the use of technology for self-management of health by older adults, social support and self-reported health measures incorporated into personal health records, electronic medical records, and community health registries. PMID:23639263

  20. A Home-Based Educational Intervention Improves Patient Activation Measures and Diabetes Health Indicators among Zuni Indians

    PubMed Central

    Shah, Vallabh O.; Carroll, Casey; Mals, Ryan; Ghahate, Donica; Bobelu, Jeanette; Sandy, Phillip; Colleran, Kathleen; Schrader, Ronald; Faber, Thomas; Burge, Mark R.

    2015-01-01

    Introduction One in three people will be diagnosed with diabetes by 2050, and the proportion will likely be higher among Native Americans. Diabetes control is currently suboptimal in underserved populations despite a plethora of new therapies. Patient empowerment is a key determinant of diabetes control, but such empowerment can be difficult to achieve due to resource limitation and cultural, language and health literacy barriers. We describe a home-based educational intervention using Community Health Representatives (CHRs), leading to improvement in Patient Activation Measures scores and clinical indicators of diabetes control. Methods Sixty participants with type 2 diabetes (T2D) completed a baseline evaluation including physical exam, Point of Care (POC) testing, and the Patient Activation Measure (PAM) survey. Participants then underwent a one hour group didactic session led by Community Health Representatives (CHRs) who subsequently carried out monthly home-based educational interventions to encourage healthy lifestyles, including diet, exercise, and alcohol and cigarette avoidance until follow up at 6 months, when clinical phenotyping and the PAM survey were repeated. Results PAM scores were increased by at least one level in 35 (58%) participants, while 24 participants who started at higher baseline score did not change. Six months after intervention, mean levels of A1C decreased by 0.7 ± 1.2%; fasting blood glucose decreased by 24.0 ± 38.0 mg/dl; BMI decreased by 1.5 ± 2.1 kg/m2; total cholesterol decreased by 12.0± 28.0 mg/dl; and triglycerides decreased by 52.0 ± 71.0 mg/dl. All of these changes were statistically significant (p<0.05). Conclusion This six month, CHR led and community-oriented educational intervention helps inform standards of practice for the management of diabetes, engages diabetic populations in their own care, and reduces health disparities for the underserved population of Zuni Indians. Trial Registration ClinicalTrials.gov NCT

  1. Narratives of Violence, Pathology, and Empowerment: Mental Health Needs Assessment of Home-Based Female Sex Workers in Rural India.

    PubMed

    Sardana, Srishti; Marcus, Marina; Verdeli, Helen

    2016-08-01

    This study explores the narratives of psychological distress and resilience among a group of female sex workers who use residential spaces to attend to clients in rural India. The narratives reflect the lived experiences of these women. They describe the women's reasons for opting into sex work; guilt, shame, and stigma related to their sex worker status; experiences with intimate partner and domestic violence; health-related problems; communication with their family members about their sex worker status; mental health referral practices among the women; and elements of resilience and strength that they experience within themselves and within their community of fellow sex workers. The article also offers elements of our own experiences of recruiting the women to participate in the focus group, training local outreach workers in conducting focus group discussions, and forging a collaboration with a local community-based organization to highlight important barriers, challenges, and strategies for planning a group-based discussion to explore the mental health needs of home-based sex workers. PMID:27463830

  2. A Home-Based Infant Mental Health Intervention: The Centrality of Relationships in Reflective Supervision

    ERIC Educational Resources Information Center

    Weatherston, Deborah

    2007-01-01

    This article explores the essential relationship needs and capacities of infants, parents, practitioners, and supervisors in a story about reflective practice. The author shares her experience supervising a home visitor who is a trainee in an infant mental health intervention program. The home visitor's relationship with her supervisor was a…

  3. Health and economic benefits of scaling up a home-based neonatal care package in rural India: a modelling analysis.

    PubMed

    Nandi, Arindam; Colson, Abigail R; Verma, Amit; Megiddo, Itamar; Ashok, Ashvin; Laxminarayan, Ramanan

    2016-06-01

    Approximately 900 000 newborn children die every year in India, accounting for 28% of neonatal deaths globally. In 2011, India introduced a home-based newborn care (HBNC) package to be delivered by community health workers across rural areas. We estimate the disease and economic burden that could be averted by scaling up the HBNC in rural India using IndiaSim, an agent-based simulation model, to examine two interventions. In the first intervention, the existing community health worker network begins providing HBNC for rural households without access to home- or facility-based newborn care, as introduced by India's recent programme. In the second intervention, we consider increased coverage of HBNC across India so that total coverage of neonatal care (HBNC or otherwise) in the rural areas of each state reaches at least 90%. We find that compared with a baseline of no coverage, providing the care package through the existing network of community health workers could avert 48 [95% uncertainty range (UR) 34-63] incident cases of severe neonatal morbidity and 5 (95% UR 4-7) related deaths, save $4411 (95% UR $3088-$5735) in out-of-pocket treatment costs, and provide $285 (95% UR $200-$371) in value of insurance per 1000 live births in rural India. Increasing the coverage of HBNC to 90% will avert an additional 9 (95% UR 7-12) incident cases, 1 death (95% UR 0.72-1.33), and $613 (95% UR $430-$797) in out-of-pocket expenditures, and provide $55 (95% UR $39-$72) in incremental value of insurance per 1000 live births. Intervention benefits are greater for lower socioeconomic groups and in the poorer states of Chhattisgarh, Uttarakhand, Bihar, Assam and Uttar Pradesh. PMID:26561440

  4. Pollution Prevention through Peer Education: A Community Health Worker and Small and Home-Based Business Initiative on the Arizona-Sonora Border.

    PubMed

    Ramírez, Denise Moreno; Ramírez-Andreotta, Mónica D; Vea, Lourdes; Estrella-Sánchez, Rocío; Wolf, Ann Marie A; Kilungo, Aminata; Spitz, Anna H; Betterton, Eric A

    2015-09-01

    Government-led pollution prevention programs tend to focus on large businesses due to their potential to pollute larger quantities, therefore leaving a gap in programs targeting small and home-based businesses. In light of this gap, we set out to determine if a voluntary, peer education approach led by female, Hispanic community health workers (promotoras) can influence small and home-based businesses to implement pollution prevention strategies on-site. This paper describes a partnership between promotoras from a non-profit organization and researchers from a university working together to reach these businesses in a predominately Hispanic area of Tucson, Arizona. From 2008 to 2011, the promotora-led pollution prevention program reached a total of 640 small and home-based businesses. Program activities include technical trainings for promotoras and businesses, generation of culturally and language appropriate educational materials, and face-to-face peer education via multiple on-site visits. To determine the overall effectiveness of the program, surveys were used to measure best practices implemented on-site, perceptions towards pollution prevention, and overall satisfaction with the industry-specific trainings. This paper demonstrates that promotoras can promote the implementation of pollution prevention best practices by Hispanic small and home-based businesses considered "hard-to-reach" by government-led programs. PMID:26371028

  5. Pollution Prevention through Peer Education: A Community Health Worker and Small and Home-Based Business Initiative on the Arizona-Sonora Border

    PubMed Central

    Moreno Ramírez, Denise; Ramírez-Andreotta, Mónica D.; Vea, Lourdes; Estrella-Sánchez, Rocío; Wolf, Ann Marie A.; Kilungo, Aminata; Spitz, Anna H.; Betterton, Eric A.

    2015-01-01

    Government-led pollution prevention programs tend to focus on large businesses due to their potential to pollute larger quantities, therefore leaving a gap in programs targeting small and home-based businesses. In light of this gap, we set out to determine if a voluntary, peer education approach led by female, Hispanic community health workers (promotoras) can influence small and home-based businesses to implement pollution prevention strategies on-site. This paper describes a partnership between promotoras from a non-profit organization and researchers from a university working together to reach these businesses in a predominately Hispanic area of Tucson, Arizona. From 2008 to 2011, the promotora-led pollution prevention program reached a total of 640 small and home-based businesses. Program activities include technical trainings for promotoras and businesses, generation of culturally and language appropriate educational materials, and face-to-face peer education via multiple on-site visits. To determine the overall effectiveness of the program, surveys were used to measure best practices implemented on-site, perceptions towards pollution prevention, and overall satisfaction with the industry-specific trainings. This paper demonstrates that promotoras can promote the implementation of pollution prevention best practices by Hispanic small and home-based businesses considered “hard-to-reach” by government-led programs. PMID:26371028

  6. Oral health related quality of life in pregnant and post partum women in two social network domains; predominantly home-based and work-based networks

    PubMed Central

    2012-01-01

    Background Individuals connected to supportive social networks have better general and oral health quality of life. The objective of this study was to assess whether there were differences in oral health related quality of life (OHRQoL) between women connected to either predominantly home-based and work-based social networks. Methods A follow-up prevalence study was conducted on 1403 pregnant and post-partum women (mean age of 25.2 ± 6.3 years) living in two cities in the State of Rio de Janeiro, Brazil. Women were participants in an established cohort followed from pregnancy (baseline) to post-partum period (follow-up). All participants were allocated to two groups; 1. work-based social network group - employed women with paid work, and, 2. home-based social network group - women with no paid work, housewives or unemployed women. Measures of social support and social network were used as well as questions on sociodemographic characteristics and OHRQoL and health related behaviors. Multinomial logistic regression was performed to obtain OR of relationships between occupational contexts, affectionate support and positive social interaction on the one hand, and oral health quality of life, using the Oral Health Impacts Profile (OHIP) measure, adjusted for age, ethnicity, family income, schooling, marital status and social class. Results There was a modifying effect of positive social interaction on the odds of occupational context on OHRQoL. The odds of having a poorer OHIP score, ≥4, was significantly higher for women with home-based social networks and moderate levels of positive social interactions [OR 1.64 (95% CI: 1.08-2.48)], and for women with home-based social networks and low levels of positive social interactions [OR 2.15 (95% CI: 1.40-3.30)] compared with women with work-based social networks and high levels of positive social interactions. Black ethnicity was associated with OHIP scores ≥4 [OR 1.73 (95% CI: 1.23-2.42)]. Conclusions Pregnant and post

  7. Evaluation of a Home-Based Environmental and Educational Intervention to Improve Health in Vulnerable Households: Southeastern Pennsylvania Lead and Healthy Homes Program.

    PubMed

    Mankikar, Deepa; Campbell, Carla; Greenberg, Rachael

    2016-01-01

    This evaluation examined whether participation in a home-based environmental educational intervention would reduce exposure to health and safety hazards and asthma-related medical visits. The home intervention program focused on vulnerable, low-income households, where children had asthma, were at risk for lead poisoning, or faced multiple unsafe housing conditions. Home visitors conducted two home visits, two months apart, consisting of an environmental home assessment, Healthy Homes education, and distribution of Healthy Homes supplies. Measured outcomes included changes in participant knowledge and awareness of environmental home-based hazards, rate of children's asthma-related medical use, and the presence of asthma triggers and safety hazards. Analysis of 2013-2014 baseline and post-intervention program data for a cohort of 150 families revealed a significantly lower three-month rate (p < 0.05) of children's asthma-related doctor visits and hospital admissions at program completion. In addition, there were significantly reduced reports of the presence of home-based hazards, including basement or roof leaks (p = 0.011), plumbing leaks (p = 0.019), and use of an oven to heat the home (p < 0.001). Participants' pre- and post- test scores showed significant improvement (p < 0.05) in knowledge and awareness of home hazards. Comprehensive home interventions may effectively reduce environmental home hazards and improve the health of asthmatic children in the short term. PMID:27618087

  8. Home-based neonatal care by community health workers for preventing mortality in neonates in low- and middle-income countries: a systematic review.

    PubMed

    Gogia, S; Sachdev, H P S

    2016-05-01

    The objective of this review is to assess the effect of home-based neonatal care provided by community health workers (CHWs) for preventing neonatal, infant and perinatal mortality in resource-limited settings with poor access to health facility-based care. The authors conducted a systematic review, including meta-analysis and meta-regression of controlled trials. The data sources included electronic databases, with a hand search of reviews, abstracts and proceedings of conferences to search for randomized, or cluster randomized, controlled trials evaluating the effect of home-based neonatal care provided by CHWs for preventing neonatal, infant and perinatal mortality. Among the included trials, all from South Asian countries, information on neonatal, infant and perinatal mortality was available in five, one and three trials, respectively. The intervention package comprised three components, namely, home visits during pregnancy (four trials), home-based preventive and/or curative neonatal care (all trials) and community mobilization efforts (four trials). Intervention was associated with a reduced risk of mortality during the neonatal (random effects model relative risk (RR) 0.75; 95% confidence intervals (CIs) 0.61 to 0.92, P=0.005; I(2)=82.2%, P<0.001 for heterogeneity; high-quality evidence) and perinatal periods (random effects model RR 0.78; 95% CI 0.64 to 0.94, P=0.009; I(2)=79.6%, P=0.007 for heterogeneity; high-quality evidence). In one trial, a significant decline in infant mortality (RR 0.85; 95% CI 0.77 to 0.94) was documented. Subgroup and meta-regression analyses suggested a greater effect with a higher baseline neonatal mortality rate. The authors concluded that home-based neonatal care is associated with a reduction in neonatal and perinatal mortality in South Asian settings with high neonatal-mortality rates and poor access to health facility-based care. Adoption of a policy of home-based neonatal care provided by CHWs is justified in such settings

  9. Home-based neonatal care by community health workers for preventing mortality in neonates in low- and middle-income countries: a systematic review

    PubMed Central

    Gogia, S; Sachdev, H P S

    2016-01-01

    The objective of this review is to assess the effect of home-based neonatal care provided by community health workers (CHWs) for preventing neonatal, infant and perinatal mortality in resource-limited settings with poor access to health facility-based care. The authors conducted a systematic review, including meta-analysis and meta-regression of controlled trials. The data sources included electronic databases, with a hand search of reviews, abstracts and proceedings of conferences to search for randomized, or cluster randomized, controlled trials evaluating the effect of home-based neonatal care provided by CHWs for preventing neonatal, infant and perinatal mortality. Among the included trials, all from South Asian countries, information on neonatal, infant and perinatal mortality was available in five, one and three trials, respectively. The intervention package comprised three components, namely, home visits during pregnancy (four trials), home-based preventive and/or curative neonatal care (all trials) and community mobilization efforts (four trials). Intervention was associated with a reduced risk of mortality during the neonatal (random effects model relative risk (RR) 0.75; 95% confidence intervals (CIs) 0.61 to 0.92, P=0.005; I2=82.2%, P<0.001 for heterogeneity; high-quality evidence) and perinatal periods (random effects model RR 0.78; 95% CI 0.64 to 0.94, P=0.009; I2=79.6%, P=0.007 for heterogeneity; high-quality evidence). In one trial, a significant decline in infant mortality (RR 0.85; 95% CI 0.77 to 0.94) was documented. Subgroup and meta-regression analyses suggested a greater effect with a higher baseline neonatal mortality rate. The authors concluded that home-based neonatal care is associated with a reduction in neonatal and perinatal mortality in South Asian settings with high neonatal-mortality rates and poor access to health facility-based care. Adoption of a policy of home-based neonatal care provided by CHWs is justified in such settings

  10. Comparison Between Effects of Home Based Cardiac Rehabilitation Programs Versus Usual Care on the Patients’ Health Related Quality of Life After Coronary Artery Bypass Graft

    PubMed Central

    Salavati, Mohsen; Falahinia, Gholamhossein; Vardanjani, Ali Esmaeili; Rafiei, Hossein; Moosavi, Saeid; Torkamani, Mehdi

    2016-01-01

    Background & Aim: To compare home-based cardiac rehabilitation with usual care on the patients’ Health Related Quality of Life (HRQoL) after coronary artery bypass graft in patients with coronary artery bypass graft (CABG) surgery. Methods: In a randomized controlled clinical conducted from March 2013 to June 2013, 110 patients with CABG surgery were randomly assigned into two groups. While patients in group I, were received usual care and patients in group II, in addition to the usual care were received home-based cardiac rehabilitation programs. The 27-item MacNew Heart Disease HRQoL questionnaire was used to evaluate the patient’s HRQoL under and over 2 months after intervention. Results: At the time of 0, mean score of HRQoL was 67.86±7.5 and 64.76±8.4 in patients in group I and group II, respectively (P> 0.05). Although mean score of HRQoL in all patients in both groups increased two month after intervention, but this increase in patients in group II were higher than patients in group I (154.93±4.6 vs 134.20±8.2). This difference were statistically significant (P< 0.05). Conclusion: Quality of Life (QoL) can be considered as a quality indicator of health care systems. Results of present study showed that home-based cardiac rehabilitation program improved patients HRQoL after CABG surgery. PMID:26573042

  11. Virtual health platform for medical tourism purposes.

    PubMed

    Martinez, Debora; Ferriol, Pedro; Tous, Xisco; Cabrer, Miguel; Prats, Mercedes

    2008-01-01

    This paper introduces an overview of the Virtual Health Platform (VHP), an alternative approach to create a functional PHR system in a medical tourism environment. The proposed platform has been designed in order to be integrated with EHR infrastructures and in this way it expects to be useful and more advantageous to the patient or tourist. Use cases of the VHP and its potential benefits summarize the analysis. PMID:18560088

  12. Health Knowledge Effects: An Integrated Community Health Promotion Platform.

    PubMed

    Chang, I-Chiu; Lin, Chih-Yu; Tseng, Hsiao-Ting; Ho, Wen-Yu

    2016-03-01

    The Taiwanese government subsidizes healthcare providers offering preventive medicine to patients to help reduce the threats of chronic sickness and halt skyrocketing medical expenditures. Usually, nurses are the primary workers who perform community health promotion; however, because of the chronic shortage of working nurses, many Taiwan hospitals have closed wards and deferred the responsibility of promoting primary prevention. With a community health promotion platform integrating interactive response features and Web sites for community patients and hospital staff, a case hospital efficiently sustained the community health services. The objective of this study was to assess the impact of the integrated community health promotion platform for conducting education. Fifty-four patients/residents were invited to join a quasi-experiment of health education, and a follow-up survey was conducted to assess the acceptance of the community health promotion platform from both the experimental group of learners/users and the hospital staff. The results showed that the community health promotion platform was effective in improving participant health awareness. The experimental group outperformed the control group, with higher posttest scores and longer knowledge retention. Furthermore, users indicated a high acceptance of the community health promotion platform. PMID:26657621

  13. Determinants of health: a progressive political platform.

    PubMed

    Terris, M

    1994-01-01

    This paper is based on the statement in the Ottawa Charter for Health Promotion that "The fundamental conditions and resources for health are peace, shelter, education, food, income, a stable eco-system, sustainable resources, social justice and equity. Improvement in health requires a secure foundation in these basic prerequisites." It attempts to formulate a progressive political platform for a number of these prerequisites, offering a series of recommendations regarding education, employment, income, and housing, and urging that the proposed programs be funded by progressive taxation and major reductions in the military budget. PMID:8027361

  14. EXAMINING LONG-TERM EFFECTS OF AN INFANT MENTAL HEALTH HOME-BASED EARLY HEAD START PROGRAM ON FAMILY STRENGTHS AND RESILIENCE.

    PubMed

    Mckelvey, Lorraine; Schiffman, Rachel F; Brophy-Herb, Holly E; Bocknek, Erika London; Fitzgerald, Hiram E; Reischl, Thomas M; Hawver, Shelley; Cunningham Deluca, Mary

    2015-01-01

    Infant Mental Health based interventions aim to promote the healthy development of infants and toddlers through promoting healthy family functioning to foster supportive relationships between the young child and his or her important caregivers. This study examined impacts of an Infant Mental Health home-based Early Head Start (IMH-HB EHS) program on family functioning. The sample includes 152 low-income families in the Midwestern United States, expectant or parenting a child younger than 1 year of age, who were randomly assigned to receive IMH-HB EHS services (n = 75) or to a comparison condition (n = 77). Mothers who received IMH-HB EHS services reported healthier psychological and family functioning, outcomes that are consistent with the IMH focus, when their children were between the ages of 3 and 7 years of age. Specifically, mothers in the IMH-HB EHS group reported healthier family functioning and relationships, better coping skills needed to advocate for their families, and less stress in the parenting role versus those in the comparison condition. The study also examined support seeking coping, some of which changed differently over time based on program group assignment. Overall, findings suggest that the gains families achieve from participating in IMH-HB EHS services are maintained after services cease. PMID:26118949

  15. 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.

  16. Home-Based Supervisor's Guide.

    ERIC Educational Resources Information Center

    Research Assessment Management, Inc., Silver Spring, MD.

    The Head Start home-based supervisor provides guidance, support, direction, and continuing staff development opportunities while attempting to maintain and improve quality of services to Head Start children and families. This guide is designed to help the home-based supervisor in carrying out responsibilities while supporting the home visitor, who…

  17. Parents as Teachers Health Literacy Demonstration project: integrating an empowerment model of health literacy promotion into home-based parent education.

    PubMed

    Carroll, Lauren N; Smith, Sandra A; Thomson, Nicole R

    2015-03-01

    The Parents as Teachers (PAT) Health Literacy Demonstration project assessed the impact of integrating data-driven reflective practices into the PAT home visitation model to promote maternal health literacy. PAT is a federally approved Maternal, Infant, Early Childhood Home Visiting program with the goal of promoting school readiness and healthy child development. This 2-year demonstration project used an open-cohort longitudinal design to promote parents' interactive and reflective skills, enhance health education, and provide direct assistance to personalize and act on information by integrating an empowerment paradigm into PAT's parent education model. Eight parent educators used the Life Skills Progression instrument to tailor the intervention to each of 103 parent-child dyads. Repeated-measures analysis of variance, paired t tests, and logistic regression combined with qualitative data demonstrated that mothers achieved overall significant improvements in health literacy, and that home visitors are important catalysts for these improvements. These findings support the use of an empowerment model of health education, skill building, and direct information support to enable parents to better manage personal and child health and health care. PMID:24957219

  18. Medical politics, health policy. Party health platforms, promise and performance.

    PubMed

    Silver, G A

    1976-01-01

    Health policy in the United States is a product of medical politics. "Medical politics" includes not only traditional patterns of interest group pressures but traditional political party philosophies and patient expectations as well. Characteristic Republican politics reflects narrower governmental spending and greater emphasis on support of entrepreneurial effort. Desired effects will "trickle down" to the needy. Democratic politics tend to follow a more generous spending line, not neglecting the entrepreneurs, but spreading some of the funds around to the needy themselves. In addition, Republicans tend to distrust salaried officials, placing governmental power (through government funds) into the hands of private agencies or companies. Democrats hesitate less to build bureaucratic structures. On the record, both parties follow roughly similar lines in spite of these philosophic differences, which turn out to be differences in style. Both parties have practiced restraint in financing of medical services, only recently undertaking payment for these, and only recently undertaking to pay for medical education. Research has been a favored federal focus. Rapid and seemingly uncontrollable inflation has forced both parties to take a harder line. Political platforms are not necessarily clear signals of eventual party action. Nevertheless, they underline what the parties consider to be the problems as the voters see them and they express what the parties see as the appropriate response to these problems. This paper suggests what the party platforms will look like for the presidential election this year and also what the parties will probably do thereafter. PMID:820654

  19. Remotely Delivered Exercise-Based Cardiac Rehabilitation: Design and Content Development of a Novel mHealth Platform

    PubMed Central

    Gant, Nicholas; Meads, Andrew; Warren, Ian; Maddison, Ralph

    2016-01-01

    Background Participation in traditional center-based cardiac rehabilitation exercise programs (exCR) is limited by accessibility barriers. Mobile health (mHealth) technologies can overcome these barriers while preserving critical attributes of center-based exCR monitoring and coaching, but these opportunities have not yet been capitalized on. Objective We aimed to design and develop an evidence- and theory-based mHealth platform for remote delivery of exCR to any geographical location. Methods An iterative process was used to design and develop an evidence- and theory-based mHealth platform (REMOTE-CR) that provides real-time remote exercise monitoring and coaching, behavior change education, and social support. Results The REMOTE-CR platform comprises a commercially available smartphone and wearable sensor, custom smartphone and Web-based applications (apps), and a custom middleware. The platform allows exCR specialists to monitor patients’ exercise and provide individualized coaching in real-time, from almost any location, and provide behavior change education and social support. Intervention content incorporates Social Cognitive Theory, Self-determination Theory, and a taxonomy of behavior change techniques. Exercise components are based on guidelines for clinical exercise prescription. Conclusions The REMOTE-CR platform extends the capabilities of previous telehealth exCR platforms and narrows the gap between existing center- and home-based exCR services. REMOTE-CR can complement center-based exCR by providing an alternative option for patients whose needs are not being met. Remotely monitored exCR may be more cost-effective than establishing additional center-based programs. The effectiveness and acceptability of REMOTE-CR are now being evaluated in a noninferiority randomized controlled trial. PMID:27342791

  20. Home-based renal dialysis.

    PubMed

    Goodenough, G K; Lutz, L J; Gregory, M C

    1988-02-01

    About 20 percent of chronic dialysis patients receive treatment in their homes. An increasing number of these patients choose peritoneal dialysis. Physicians should be aware of the techniques and possible complications of home-based dialysis so that they can assist patients in choosing a form of dialysis and can help manage problems if they arise. An understanding of the technical and psychosocial problems is also necessary. PMID:3344646

  1. Employing the International Classification of Functioning, Disability and Health framework to capture user feedback in the design and testing stage of development of home-based arm rehabilitation technology.

    PubMed

    Sivan, Manoj; Gallagher, Justin; Holt, Ray; Weightman, Andrew; O'Connor, Rory; Levesley, Martin

    2016-01-01

    The purpose of this study was to evaluate the International Classification of Functioning, Disability and Health (ICF) as a framework to ensure that key aspects of user feedback are identified in the design and testing stages of development of a home-based upper limb rehabilitation system. Seventeen stroke survivors with residual upper limb weakness, and seven healthcare professionals with expertise in stroke rehabilitation, were enrolled in the user-centered design process. Through semi-structured interviews, they provided feedback on the hardware, software and impact of a home-based rehabilitation device to facilitate self-managed arm exercise. Members of the multidisciplinary clinical and engineering research team, based on previous experience and existing literature in user-centred design, developed the topic list for the interviews. Meaningful concepts were extracted from participants' interviews based on existing ICF linking rules and matched to categories within the ICF Comprehensive Core Set for stroke. Most of the interview concepts (except personal factors) matched the existing ICF Comprehensive Core Set categories. Personal factors that emerged from interviews e.g. gender, age, interest, compliance, motivation, choice and convenience that might determine device usability are yet to be categorised within the ICF framework and hence could not be matched to a specific Core Set category. PMID:26852630

  2. An open platform for personal health record apps with platform-level privacy protection.

    PubMed

    Van Gorp, P; Comuzzi, M; Jahnen, A; Kaymak, U; Middleton, B

    2014-08-01

    One of the main barriers to the adoption of Personal Health Records (PHR) systems is their closed nature. It has been argued in the literature that this barrier can be overcome by introducing an open market of substitutable PHR apps. The requirements introduced by such an open market on the underlying platform have also been derived. In this paper, we argue that MyPHRMachines, a cloud-based PHR platform recently developed by the authors, satisfies these requirements better than its alternatives. The MyPHRMachines platform leverages Virtual Machines as flexible and secure execution sandboxes for health apps. MyPHRMachines does not prevent pushing hospital- or patient-generated data to one of its instances, nor does it prevent patients from sharing data with their trusted caregivers. External software developers have minimal barriers to contribute innovative apps to the platform, since apps are only required to avoid pushing patient data outside a MyPHRMachines cloud. We demonstrate the potential of MyPHRMachines by presenting two externally contributed apps. Both apps provide functionality going beyond the state-of-the-art in their application domain, while they did not require any specific MyPHRMachines platform extension. PMID:24859286

  3. Health Care Outcomes and Advance Care Planning in Older Adults Who Receive Home-Based Palliative Care: A Pilot Cohort Study

    PubMed Central

    Thorsteinsdottir, Bjorg; Cha, Stephen S.; Hanson, Gregory J.; Peterson, Stephanie M.; Rahman, Parvez A.; Naessens, James M.; Takahashi, Paul Y.

    2015-01-01

    Abstract Background: Approximately 20% of seniors live with five or more chronic medical illnesses. Terminal stages of their lives are often characterized by repeated burdensome hospitalizations and advance care directives are insufficiently addressed. This study reports on the preliminary results of a Palliative Care Homebound Program (PCHP) at the Mayo Clinic in Rochester, Minnesota to service these vulnerable populations. Objective: The study objective was to evaluate inpatient hospital utilization and the adequacy of advance care planning in patients who receive home-based palliative care. Methods: This is a retrospective pilot cohort study of patients enrolled in the PCHP between September 2012 and March 2013. Two control patients were matched to each intervention patient by propensity scoring methods that factor in risk and prognosis. Primary outcomes were six-month hospital utilization including ER visits. Secondary outcomes evaluated advance care directive completion and overall mortality. Results: Patients enrolled in the PCHP group (n=54) were matched to 108 controls with an average age of 87 years. Ninety-two percent of controls and 33% of PCHP patients were admitted to the hospital at least once. The average number of hospital admissions was 1.36 per patient for controls versus 0.35 in the PCHP (p<0.001). Total hospital days were reduced by 5.13 days. There was no difference between rates of ER visits. Advanced care directive were completed more often in the intervention group (98%) as compared to controls (31%), with p<0.001. Goals of care discussions were held at least once for all patients in the PCHP group, compared to 41% in the controls. PMID:25375663

  4. Public Health Platforms: An Emerging Informatics Approach to Health Professional Learning and Development

    PubMed Central

    Gray, Kathleen

    2016-01-01

    Health informatics has a major role to play in optimising the management and use of data, information and knowledge in health systems. As health systems undergo digital transformation, it is important to consider informatics approaches not only to curriculum content but also to the design of learning environments and learning activities for health professional learning and development. An example of such an informatics approach is the use of large-scale, integrated public health platforms on the Internet as part of health professional learning and development. This article describes selected examples of such platforms, with a focus on how they may influence the direction of health professional learning and development. Significance for public health The landscape of healthcare systems, public health systems, health research systems and professional education systems is fragmented, with many gaps and silos. More sophistication in the management of health data, information, and knowledge, based on public health informatics expertise, is needed to tackle key issues of prevention, promotion and policy-making. Platform technologies represent an emerging large-scale, highly integrated informatics approach to public health, combining the technologies of Internet, the web, the cloud, social technologies, remote sensing and/or mobile apps into an online infrastructure that can allow more synergies in work within and across these systems. Health professional curricula need updating so that the health workforce has a deep and critical understanding of the way that platform technologies are becoming the foundation of the health sector. PMID:27190977

  5. Public Health Platforms: An Emerging Informatics Approach to Health Professional Learning and Development.

    PubMed

    Gray, Kathleen

    2016-04-26

    Health informatics has a major role to play in optimising the management and use of data, information and knowledge in health systems. As health systems undergo digital transformation, it is important to consider informatics approaches not only to curriculum content but also to the design of learning environments and learning activities for health professional learning and development. An example of such an informatics approach is the use of large-scale, integrated public health platforms on the Internet as part of health professional learning and development. This article describes selected examples of such platforms, with a focus on how they may influence the direction of health professional learning and development. Significance for public healthThe landscape of healthcare systems, public health systems, health research systems and professional education systems is fragmented, with many gaps and silos. More sophistication in the management of health data, information, and knowledge, based on public health informatics expertise, is needed to tackle key issues of prevention, promotion and policy-making. Platform technologies represent an emerging large-scale, highly integrated informatics approach to public health, combining the technologies of Internet, the web, the cloud, social technologies, remote sensing and/or mobile apps into an online infrastructure that can allow more synergies in work within and across these systems. Health professional curricula need updating so that the health workforce has a deep and critical understanding of the way that platform technologies are becoming the foundation of the health sector. PMID:27190977

  6. Java-based Open Platform for distributed health telematics applications.

    PubMed

    Hoepner, Petra; Eckert, Klaus-Peter

    2003-01-01

    Within the European HARP project, a Java-based Open Platform has been specified and implemented to support trustworthy distributed applications for health. Emphasis was put on security services for enabling both communication and application security. The Open Platform is Web-based and comprises the Client environment, Web/Application server, as well as Database and Archive servers. Servlets composed and executed according to the user's authorisation create signed XML messages. From those messages, user-role-related applets are generated. The technical details of the realisation are presented. Possible future enhancements for user-centric, adaptable services based on next-generation mobile service environments are outlined. PMID:15061527

  7. 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

  8. 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

  9. 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

  10. Health-e-Child: a grid platform for european paediatrics

    NASA Astrophysics Data System (ADS)

    Skaburskas, K.; Estrella, F.; Shade, J.; Manset, D.; Revillard, J.; Rios, A.; Anjum, A.; Branson, A.; Bloodsworth, P.; Hauer, T.; McClatchey, R.; Rogulin, D.

    2008-07-01

    The Health-e-Child (HeC) project [1], [2] is an EC Framework Programme 6 Integrated Project that aims to develop a grid-based integrated healthcare platform for paediatrics. Using this platform biomedical informaticians will integrate heterogeneous data and perform epidemiological studies across Europe. The resulting Grid enabled biomedical information platform will be supported by robust search, optimization and matching techniques for information collected in hospitals across Europe. In particular, paediatricians will be provided with decision support, knowledge discovery and disease modelling applications that will access data in hospitals in the UK, Italy and France, integrated via the Grid. For economy of scale, reusability, extensibility, and maintainability, HeC is being developed on top of an EGEE/gLite [3] based infrastructure that provides all the common data and computation management services required by the applications. This paper discusses some of the major challenges in bio-medical data integration and indicates how these will be resolved in the HeC system. HeC is presented as an example of how computer science (and, in particular Grid infrastructures) originating from high energy physics can be adapted for use by biomedical informaticians to deliver tangible real-world benefits.

  11. Promoting Oral Health Using Social Media Platforms: Seeking Arabic Online Oral Health Related Information (OHRI).

    PubMed

    Almaiman, Sarah; Bahkali, Salwa; Alabdulatif, Norah; Bahkaly, Ahlam; Al-Surimi, Khaled; Househ, Mowafa

    2016-01-01

    Access to oral health care services around the world is limited by a lack of universal coverage. The internet and social media can be an important source for patients to access supplementary oral health related information (OHRI). Online OHRI presents an opportunity to enhance dental public health education about innumerable oral health issues and promote dental self-care. The aim of this study is to estimate the prevalence of social media users among the Saudi population and identify the preferred social media platform for seeking Arabic OHRI and its impact on seekers' knowledge, attitude, and behavior. A total of 2652 Twitter followers were surveyed, using a web-based self-administered questionnaire to collect data on demographic characteristics and online OHRI seeking behavior More than two thirds, 67.7% (n= 1796), of the participants reported they were seeking Arabic online OHRI, while 41.1% of the participants reported they had no preference for using a specific social media platform. These results emphasize the need and importance of supporting the content of social media with trusted and high quality online OHRI resources to promote a high level of public awareness about oral health and dental health services. Further studies in this regard are highly recommended on a larger scale of nationalities to explore the role of social media platform preference in promoting health promotion and dental public health awareness. PMID:27350526

  12. Open innovation in health care: analysis of an open health platform.

    PubMed

    Bullinger, Angelika C; Rass, Matthias; Adamczyk, Sabrina; Moeslein, Kathrin M; Sohn, Stefan

    2012-05-01

    Today, integration of the public in research and development in health care is seen as essential for the advancement of innovation. This is a paradigmatic shift away from the traditional assumption that solely health care professionals are able to devise, develop, and disseminate novel concepts and solutions in health care. The present study builds on research in the field of open innovation to investigate the adoption of an open health platform by patients, care givers, physicians, family members, and the interested public. Results suggest that open innovation practices in health care lead to interesting innovation outcomes and are well accepted by participants. During the first three months, 803 participants of the open health platform submitted challenges and solutions and intensively communicated by exchanging 1454 personal messages and 366 comments. Analysis of communication content shows that empathic support and exchange of information are important elements of communication on the platform. The study presents first evidence for the suitability of open innovation practices to integrate the general public in health care research in order to foster both innovation outcomes and empathic support. PMID:22440194

  13. OpenHealth Platform for Interactive Contextualization of Population Health Open Data.

    PubMed

    Almeida, Jonas S; Hajagos, Janos; Crnosija, Ivan; Kurc, Tahsin; Saltz, Mary; Saltz, Joel

    2015-01-01

    The financial incentives for data science applications leading to improved health outcomes, such as DSRIP (bit.ly/dsrip), are well-aligned with the broad adoption of Open Data by State and Federal agencies. This creates entirely novel opportunities for analytical applications that make exclusive use of the pervasive Web Computing platform. The framework described here explores this new avenue to contextualize Health data in a manner that relies exclusively on the native JavaScript interpreter and data processing resources of the ubiquitous Web Browser. The OpenHealth platform is made publicly available, and is publicly hosted with version control and open source, at https://github.com/mathbiol/openHealth. The different data/analytics workflow architectures explored are accompanied with live applications ranging from DSRIP, such as Hospital Inpatient Prevention Quality Indicators at http://bit.ly/pqiSuffolk, to The Cancer Genome Atlas (TCGA) as illustrated by http://bit.ly/tcgascopeGBM. PMID:26958160

  14. OpenHealth Platform for Interactive Contextualization of Population Health Open Data

    PubMed Central

    Almeida, Jonas S; Hajagos, Janos; Crnosija, Ivan; Kurc, Tahsin; Saltz, Mary; Saltz, Joel

    2015-01-01

    The financial incentives for data science applications leading to improved health outcomes, such as DSRIP (bit.ly/dsrip), are well-aligned with the broad adoption of Open Data by State and Federal agencies. This creates entirely novel opportunities for analytical applications that make exclusive use of the pervasive Web Computing platform. The framework described here explores this new avenue to contextualize Health data in a manner that relies exclusively on the native JavaScript interpreter and data processing resources of the ubiquitous Web Browser. The OpenHealth platform is made publicly available, and is publicly hosted with version control and open source, at https://github.com/mathbiol/openHealth. The different data/analytics workflow architectures explored are accompanied with live applications ranging from DSRIP, such as Hospital Inpatient Prevention Quality Indicators at http://bit.ly/pqiSuffolk, to The Cancer Genome Atlas (TCGA) as illustrated by http://bit.ly/tcgascopeGBM. PMID:26958160

  15. An international randomized study of a home-based self-management program for severe COPD: the COMET

    PubMed Central

    Bourbeau, Jean; Casan, Pere; Tognella, Silvia; Haidl, Peter; Texereau, Joëlle B; Kessler, Romain

    2016-01-01

    Introduction Most hospitalizations and costs related to COPD are due to exacerbations and insufficient disease management. The COPD patient Management European Trial (COMET) is investigating a home-based multicomponent COPD self-management program designed to reduce exacerbations and hospital admissions. Design Multicenter parallel randomized controlled, open-label superiority trial. Setting Thirty-three hospitals in four European countries. Participants A total of 345 patients with Global initiative for chronic Obstructive Lung Disease III/IV COPD. Intervention The program includes extensive patient coaching by health care professionals to improve self-management (eg, develop skills to better manage their disease), an e-health platform for reporting frequent health status updates, rapid intervention when necessary, and oxygen therapy monitoring. Comparator is the usual management as per the center’s routine practice. Main outcome measures Yearly number of hospital days for acute care, exacerbation number, quality of life, deaths, and costs. PMID:27418817

  16. Platform-dependent optimization considerations for mHealth applications

    NASA Astrophysics Data System (ADS)

    Kaghyan, Sahak; Akopian, David; Sarukhanyan, Hakob

    2015-03-01

    Modern mobile devices contain integrated sensors that enable multitude of applications in such fields as mobile health (mHealth), entertainment, sports, etc. Human physical activity monitoring is one of such the emerging applications. There exists a range of challenges that relate to activity monitoring tasks, and, particularly, exploiting optimal solutions and architectures for respective mobile software application development. This work addresses mobile computations related to integrated inertial sensors for activity monitoring, such as accelerometers, gyroscopes, integrated global positioning system (GPS) and WLAN-based positioning, that can be used for activity monitoring. Some of the aspects will be discussed in this paper. Each of the sensing data sources has its own characteristics such as specific data formats, data rates, signal acquisition durations etc., and these specifications affect energy consumption. Energy consumption significantly varies as sensor data acquisition is followed by data analysis including various transformations and signal processing algorithms. This paper will address several aspects of more optimal activity monitoring implementations exploiting state-of-the-art capabilities of modern platforms.

  17. Effective Treatment in Home-Based Services.

    ERIC Educational Resources Information Center

    Simboli, Tim; Darou, Wes G.

    The use of home-based treatment programs has become increasingly popular over the last few years. Such a program is offered by the Youth Services Bureau of Ottawa-Carleton through its Detached Worker Program. This program uses paraprofessionals who employ an eclectic combination of behavioral, client-centered, family and reality therapies. Two…

  18. A Handbook for Home-Based Services.

    ERIC Educational Resources Information Center

    Kenney, Maggie

    The manual discusses home based approaches to support families of developmentally disabled children. The first section presents in question and answer format the rationale for such support services. Succeeding sections address the following aspects: respite care, sitter/companion services; parent counseling, education, and training; in home…

  19. Extension and Home-Based Businesses.

    ERIC Educational Resources Information Center

    Loker, Suzanne; And Others

    1990-01-01

    Includes "Building Home Businesses in Rural Communities" (Loker et al.); "Home-Based Business...A Means to Economic Growth in Rural Areas" (Bastow-Shoop et al.); "Business Not As Usual" (Millar, Mallilo); and "Economic Options for Farm Families" (Williams). (SK)

  20. Platforms.

    PubMed

    Josko, Deborah

    2014-01-01

    The advent of DNA sequencing technologies and the various applications that can be performed will have a dramatic effect on medicine and healthcare in the near future. There are several DNA sequencing platforms available on the market for research and clinical use. Based on the medical laboratory scientist or researcher's needs and taking into consideration laboratory space and budget, one can chose which platform will be beneficial to their institution and their patient population. Although some of the instrument costs seem high, diagnosing a patient quickly and accurately will save hospitals money with fewer hospital stays and targeted treatment based on an individual's genetic make-up. By determining the type of disease an individual has, based on the mutations present or having the ability to prescribe the appropriate antimicrobials based on the knowledge of the organism's resistance patterns, the clinician will be better able to treat and diagnose a patient which ultimately will improve patient outcomes and prognosis. PMID:25219075

  1. Query Health: standards-based, cross-platform population health surveillance

    PubMed Central

    Klann, Jeffrey G; Buck, Michael D; Brown, Jeffrey; Hadley, Marc; Elmore, Richard; Weber, Griffin M; Murphy, Shawn N

    2014-01-01

    Objective Understanding population-level health trends is essential to effectively monitor and improve public health. The Office of the National Coordinator for Health Information Technology (ONC) Query Health initiative is a collaboration to develop a national architecture for distributed, population-level health queries across diverse clinical systems with disparate data models. Here we review Query Health activities, including a standards-based methodology, an open-source reference implementation, and three pilot projects. Materials and methods Query Health defined a standards-based approach for distributed population health queries, using an ontology based on the Quality Data Model and Consolidated Clinical Document Architecture, Health Quality Measures Format (HQMF) as the query language, the Query Envelope as the secure transport layer, and the Quality Reporting Document Architecture as the result language. Results We implemented this approach using Informatics for Integrating Biology and the Bedside (i2b2) and hQuery for data analytics and PopMedNet for access control, secure query distribution, and response. We deployed the reference implementation at three pilot sites: two public health departments (New York City and Massachusetts) and one pilot designed to support Food and Drug Administration post-market safety surveillance activities. The pilots were successful, although improved cross-platform data normalization is needed. Discussions This initiative resulted in a standards-based methodology for population health queries, a reference implementation, and revision of the HQMF standard. It also informed future directions regarding interoperability and data access for ONC's Data Access Framework initiative. Conclusions Query Health was a test of the learning health system that supplied a functional methodology and reference implementation for distributed population health queries that has been validated at three sites. PMID:24699371

  2. Home-based versus centre-based cardiac rehabilitation

    PubMed Central

    Taylor, Rod S; Dalal, Hayes; Jolly, Kate; Moxham, Tiffany; Zawada, Anna

    2014-01-01

    Background The burden of cardiovascular disease world-wide is one of great concern to patients and health care agencies alike. Traditionally centre-based cardiac rehabilitation (CR) programmes are offered to individuals after cardiac events to aid recovery and prevent further cardiac illness. Home-based cardiac rehabilitation programmes have been introduced in an attempt to widen access and participation. Objectives To determine the effectiveness of home-based cardiac rehabilitation programmes compared with supervised centre-based cardiac rehabilitation on mortality and morbidity, health-related quality of life and modifiable cardiac risk factors in patients with coronary heart disease. Search methods We updated the search of a previous review by searching the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (2007, Issue 4), MEDLINE, EMBASE and CINAHL from 2001 to January 2008. We checked reference lists and sought advice from experts. No language restrictions were applied. Selection criteria Randomised controlled trials (RCTs) that compared centre-based cardiac rehabilitation (e.g. hospital, gymnasium, sports centre) with home-based programmes, in adults with myocardial infarction, angina, heart failure or who had undergone revascularisation. Data collection and analysis Studies were selected independently by two reviewers, and data extracted by a single reviewer and checked by a second one. Authors were contacted where possible to obtain missing information. Main results Twelve studies (1,938 participants) met the inclusion criteria. The majority of studies recruited a lower risk patient following an acute myocardial infarction (MI) and revascularisation. There was no difference in outcomes of home- versus centre-based cardiac rehabilitation in mortality risk ratio (RR) was 1.31 (95% confidence interval (C) 0.65 to 2.66), cardiac events, exercise capacity standardised mean difference (SMD) −0.11 (95% CI −0.35 to 0.13), as well

  3. Intelligent Systems for Assessing Aging Changes: Home-Based, Unobtrusive, and Continuous Assessment of Aging

    PubMed Central

    Maxwell, Shoshana A.; Mattek, Nora; Hayes, Tamara L.; Dodge, Hiroko; Pavel, Misha; Jimison, Holly B.; Wild, Katherine; Boise, Linda; Zitzelberger, Tracy A.

    2011-01-01

    Objectives. To describe a longitudinal community cohort study, Intelligent Systems for Assessing Aging Changes, that has deployed an unobtrusive home-based assessment platform in many seniors homes in the existing community. Methods. Several types of sensors have been installed in the homes of 265 elderly persons for an average of 33 months. Metrics assessed by the sensors include total daily activity, time out of home, and walking speed. Participants were given a computer as well as training, and computer usage was monitored. Participants are assessed annually with health and function questionnaires, physical examinations, and neuropsychological testing. Results. Mean age was 83.3 years, mean years of education was 15.5, and 73% of cohort were women. During a 4-week snapshot, participants left their home twice a day on average for a total of 208 min per day. Mean in-home walking speed was 61.0 cm/s. Participants spent 43% of days on the computer averaging 76 min per day. Discussion. These results demonstrate for the first time the feasibility of engaging seniors in a large-scale deployment of in-home activity assessment technology and the successful collection of these activity metrics. We plan to use this platform to determine if continuous unobtrusive monitoring may detect incident cognitive decline. PMID:21743050

  4. An e-Health Platform for the Elderly Population: The Butler System

    ERIC Educational Resources Information Center

    Etchemendy, E.; Banos, R. M.; Botella, C.; Castilla, D.; Alcaniz, M.; Rasal, P.; Farfallini, L.

    2011-01-01

    The Butler system is an e-health platform designed to improve the elderly population's quality of life. The Butler system has three applications diagnostic, therapeutic and playful. The objective of this work is to present the influence of the use of the platform on elderly users' mood states and the degree of acceptance. These measures were…

  5. House Calls: The Impact of Home-Based Care for Older Adults With Alzheimer's and Dementia.

    PubMed

    Wilson, Kasey; Bachman, Sara S

    2015-01-01

    Older adults with Alzheimer's/dementia have high health care costs; they may benefit from home-based care, but few have home visits. This article describes a home-based care program for frail elders, including those with Alzheimer's/dementia. Descriptive statistics are provided for Medicare-enrolled program participants and matched controls with Alzheimer's/dementia on expenditures along six services: skilled nursing facility, inpatient acute, physician, home health, hospice, and social services. Cases with dementia were significantly more likely to have home health and hospice expenditures than controls, suggesting potential for the program to improve end-of-life care. Very few cases or controls had any social service expenditures. Social workers should advocate for the expanded role of home-based care for older adults with dementia and for increased Medicare reimbursement of social work services. PMID:26186425

  6. Mobile health platform for pressure ulcer monitoring with electronic health record integration.

    PubMed

    Rodrigues, Joel J P C; Pedro, Luís M C C; Vardasca, Tomé; de la Torre-Díez, Isabel; Martins, Henrique M G

    2013-12-01

    Pressure ulcers frequently occur in patients with limited mobility, for example, people with advanced age and patients wearing casts or prostheses. Mobile information communication technologies can help implement ulcer care protocols and the monitoring of patients with high risk, thus preventing or improving these conditions. This article presents a mobile pressure ulcer monitoring platform (mULCER), which helps control a patient's ulcer status during all stages of treatment. Beside its stand-alone version, it can be integrated with electronic health record systems as mULCER synchronizes ulcer data with any electronic health record system using HL7 standards. It serves as a tool to integrate nursing care among hospital departments and institutions. mULCER was experimented with in different mobile devices such as LG Optimus One P500, Samsung Galaxy Tab, HTC Magic, Samsung Galaxy S, and Samsung Galaxy i5700, taking into account the user's experience of different screen sizes and processing characteristics. PMID:24255053

  7. Home-based care, technology, and the maintenance of selves.

    PubMed

    Parks, Jennifer A

    2015-06-01

    In this paper, I will argue that there is a deep connection between home-based care, technology, and the self. Providing the means for persons (especially older persons) to receive care at home is not merely a kindness that respects their preference to be at home: it is an important means of extending their selfhood and respecting the unique selves that they are. Home-based technologies like telemedicine and robotic care may certainly be useful tools in providing care for persons at home, but they also have important implications for sustaining selfhood in ways that are of value to individuals and those who care for them. I will argue, by appealing to Hilde Lindemann's notion of "holding" persons' identities in place, that technological interventions are not only useful tools for improving and sustaining health and good care at home, but that they may also help to extend our personal identities and relational capacities in ways that are practically and ethically good. Because of these important goods, I will claim that there is a prima facie moral duty to do this "holding" work and that it is best done by family members and loved ones who are well suited to the job because of their history and relationship with the individual that needs to be "held" in place. PMID:25787720

  8. Research on public health emergency response system platform

    NASA Astrophysics Data System (ADS)

    Li, Qi; Gan, Jie-fu; Qu, Yi-zhen

    2006-01-01

    The present public health system has continually struggled to combat ongoing and emerging public health threats and emergencies. The main impediment to improving public health readiness is the lack of an effective Public Health Emergency Response System. Although many health systems have been built and large amount of data collected, it is hard to analyze these data in depth and use them efficiently. An effective PHEMS should be able to manage data, produce information and provide services. Based on digital city, such a PHEMS has a most possible chance to be built. Detailed analysis of the architecture of the PHEMS, including (1) the surveillance system for data collection, (2) the consolidated information model based on HL7 Reference Information Model (RIM), (3) and the public health service framework, is focused in this paper. As a test-bed, the implementation of a prototype, which is a part of Digital Beijing Pilot, is illustrated. In the end, some operational and technical difficulties are discussed.

  9. The Health Systems Funding Platform: Is this where we thought we were going?

    PubMed Central

    2011-01-01

    Background In March 2009, the Task Force for Innovative International Financing for Health Systems recommended "a health systems funding platform for the Global Fund, GAVI Alliance, the World Bank and others to coordinate, mobilize, streamline and channel the flow of existing and new international resources to support national health strategies." Momentum to establish the Health Systems Funding Platform was swift, with the World Bank convening a Technical Workshop on Health Systems Strengthening (HSS), and serial meetings organized to progress the agenda. Despite its potential significance, there has been little comment in peer-reviewed literature, though some disquiet in the international development community around the scope of the Platform and the capacity of the partners, which appears disproportionate to the available information. Methods This case study uses documentary analysis, participant observation and 24 in-depth interviews to examine the processes of development and key issues raised by the Platform. Results The findings show a fluid and volatile process, with debate over whether ongoing engagement in HSS by Global Fund and GAVI represents a dilution of organizational focus, risking ongoing support, or a paradigm shift that facilitates the achievement of targeted objectives, builds systems capacity, and will attract additional resources. Uncertainty in the development of the Platform reflects the flexibility of the recently formed global health initiatives, and the instability of donor commitments, particularly in the current financial climate. But implicit in the conflict is tension between key global stakeholders over defining and ownership of the health systems agenda. Conclusions The tensions appear to have been resolved through a focus on national planning, applying International Health Partnership principles, though the global financial crisis and key personnel changes may yet alter outcomes. Despite its dynamic evolution, the Platform may offer

  10. Between ideals and reality in home-based rehabilitation

    PubMed Central

    Steihaug, Sissel; Lippestad, Jan-W.; Werner, Anne

    2016-01-01

    Setting and objective The growing elderly population and the rising number of people with chronic diseases indicate an increasing need for rehabilitation. Norwegian municipalities are required by law to offer rehabilitation. The aim of this study was to investigate how rehabilitation work is perceived and carried out by first-line service providers compared with the guidelines issued by Norway’s health authorities. Design and subjects In this action research project, qualitative data were collected through 24 individual interviews and seven group interviews with employees – service providers and managers – in the home-based service of two boroughs in Oslo, Norway. The data were analysed using a systematic text-condensation method. Results The results show that rehabilitation receives little attention in the boroughs and that patients are seldom rehabilitated at home. There is disagreement among professional staff as to what rehabilitation is and should be. The purchaser–provider organization, high speed of service delivery, and scarcity of resources are reported to hamper rehabilitation work. Conclusion and implications A discrepancy exists between the high level of ambitious goals of Norwegian health authorities and the possibilities that practitioners have to achieve them. This situation results in healthcare staff being squeezed by the increasing expectations and demands of the population and the promises and statutory rights coming from politicians and administrators. For the employees in the municipalities to place rehabilitation on the agenda, it is a requirement that authorities understand the clinical aspect of rehabilitation and provide the municipalities with adequate framework conditions for successful rehabilitation work. Key pointsHome-based rehabilitation is documented to be effective, and access to rehabilitation has been established in Norwegian law.The purchaser–provider organization, high rate of speed, and a scarcity of resources in

  11. Model, Framework, and Platform of Health Persuasive Social Network

    ERIC Educational Resources Information Center

    Al Ayubi, Soleh Udin

    2013-01-01

    Persuasive technology (PT) has the potential to support individuals to perform self-management and social support as a part of health behavior change. This has led a few researchers in the intersection of the areas of health behavior change and software engineering to apply behavior change and persuasion theories to software development practices,…

  12. A Platform to Build Mobile Health Apps: The Personal Health Intervention Toolkit (PHIT).

    PubMed

    Eckhoff, Randall Peter; Kizakevich, Paul Nicholas; Bakalov, Vesselina; Zhang, Yuying; Bryant, Stephanie Patrice; Hobbs, Maria Ann

    2015-01-01

    Personal Health Intervention Toolkit (PHIT) is an advanced cross-platform software framework targeted at personal self-help research on mobile devices. Following the subjective and objective measurement, assessment, and plan methodology for health assessment and intervention recommendations, the PHIT platform lets researchers quickly build mobile health research Android and iOS apps. They can (1) create complex data-collection instruments using a simple extensible markup language (XML) schema; (2) use Bluetooth wireless sensors; (3) create targeted self-help interventions based on collected data via XML-coded logic; (4) facilitate cross-study reuse from the library of existing instruments and interventions such as stress, anxiety, sleep quality, and substance abuse; and (5) monitor longitudinal intervention studies via daily upload to a Web-based dashboard portal. For physiological data, Bluetooth sensors collect real-time data with on-device processing. For example, using the BinarHeartSensor, the PHIT platform processes the heart rate data into heart rate variability measures, and plots these data as time-series waveforms. Subjective data instruments are user data-entry screens, comprising a series of forms with validation and processing logic. The PHIT instrument library consists of over 70 reusable instruments for various domains including cognitive, environmental, psychiatric, psychosocial, and substance abuse. Many are standardized instruments, such as the Alcohol Use Disorder Identification Test, Patient Health Questionnaire-8, and Post-Traumatic Stress Disorder Checklist. Autonomous instruments such as battery and global positioning system location support continuous background data collection. All data are acquired using a schedule appropriate to the app's deployment. The PHIT intelligent virtual advisor (iVA) is an expert system logic layer, which analyzes the data in real time on the device. This data analysis results in a tailored app of interventions

  13. A Platform to Build Mobile Health Apps: The Personal Health Intervention Toolkit (PHIT)

    PubMed Central

    2015-01-01

    Personal Health Intervention Toolkit (PHIT) is an advanced cross-platform software framework targeted at personal self-help research on mobile devices. Following the subjective and objective measurement, assessment, and plan methodology for health assessment and intervention recommendations, the PHIT platform lets researchers quickly build mobile health research Android and iOS apps. They can (1) create complex data-collection instruments using a simple extensible markup language (XML) schema; (2) use Bluetooth wireless sensors; (3) create targeted self-help interventions based on collected data via XML-coded logic; (4) facilitate cross-study reuse from the library of existing instruments and interventions such as stress, anxiety, sleep quality, and substance abuse; and (5) monitor longitudinal intervention studies via daily upload to a Web-based dashboard portal. For physiological data, Bluetooth sensors collect real-time data with on-device processing. For example, using the BinarHeartSensor, the PHIT platform processes the heart rate data into heart rate variability measures, and plots these data as time-series waveforms. Subjective data instruments are user data-entry screens, comprising a series of forms with validation and processing logic. The PHIT instrument library consists of over 70 reusable instruments for various domains including cognitive, environmental, psychiatric, psychosocial, and substance abuse. Many are standardized instruments, such as the Alcohol Use Disorder Identification Test, Patient Health Questionnaire-8, and Post-Traumatic Stress Disorder Checklist. Autonomous instruments such as battery and global positioning system location support continuous background data collection. All data are acquired using a schedule appropriate to the app’s deployment. The PHIT intelligent virtual advisor (iVA) is an expert system logic layer, which analyzes the data in real time on the device. This data analysis results in a tailored app of interventions

  14. Evaluation of bluetooth low power for physiological monitoring in a home based cardiac rehabilitation program.

    PubMed

    Martin, Timothy; Ding, Hang; D'Souza, Matthew; Karunanithi, Mohan

    2012-01-01

    Cardiovascular disease (CVD) is the leading cause of mortality in Australia, and places large burdens on the healthcare system. To assist patients with CVDs in recovering from cardiac events and mediating cardiac risk factors, a home based cardiac rehabilitation program, known as the Care Assessment Platform (CAP), was developed. In the CAP program, patients are required to manually enter health information into their mobile phones on a daily basis. The manual operation is often subject to human errors and is inconvenient for some elderly patients. To improve this, an automated wireless solution has been desired. The objectives of this paper are to investigate the feasibility of implementing the newly released Bluetooth 4.0 (BT4.0) for the CAP program, and practically evaluate BT4.0 communications between a developed mobile application and some emulated healthcare devices. The study demonstrated that BT4.0 addresses usability, interoperability and security for healthcare applications, reduces the power consumption in wireless communication, and improves the flexibility of interface for software development. This evaluation study provides an essential mobile BT4.0 framework to incorporate a large range of healthcare devices for clinical assessment and intervention in the CAP program, and hence it is useful for similar development and research work of other mobile healthcare solutions. PMID:22797030

  15. Home-based system for stroke rehabilitation.

    PubMed

    Durfee, William; Deng, Huiqiong; Nuckley, David; Rheude, Brandon; Severson, Amy; Skluzacek, Katie; Spindler, Kristen; Davey, Cynthia; Carey, James

    2011-01-01

    A system was developed for home-based stroke motor rehabilitation of the ankle. A study was conducted to test the hypothesis that moving while concentrating will lead to greater recovery than movement alone. Sixteen post-stroke subjects participated, one half in a tracking training group and the other have in a move group. The tracking training group tracked a target waveform by moving their ankle to control the tracking cursor while the move group moved their ankle approximately the same amount but without target following. Over four weeks subjects completed 3600 trials. The results showed that the Tracking group had more improvement in ankle dorsiflexion compared to the Move group. The remaining assessment criteria showed no significant differences between the groups. PMID:22254683

  16. Platform links clinical data with electronic health records

    Cancer.gov

    To make data gathered from patients in clinical trials available for use in standard care, NCI has created a new computer tool to support interoperability between clinical research and electronic health record systems. This new software represents an inno

  17. User Interaction Design for a Home-Based Telecare System

    NASA Astrophysics Data System (ADS)

    Raptis, Spyros; Tsiakoulis, Pirros; Chalamandaris, Aimilios; Karabetsos, Sotiris

    This paper presents the design of the user-interaction component of a home-based telecare system for congestive heart failure patients. It provides a short overview of the overall system and offers details on the different interaction types supported by the system. Interacting with the user occurs either as part of a scheduled procedure or as a consequence of identifying or predicting a potentially hazardous deterioration of the patients' health state. The overall logic of the interaction is structured around event-scenario associations, where a scenario consists of concrete actions to be performed, some of which may involve the patient. A key objective in this type of interaction that it is very simple, intuitive and short, involving common everyday objects and familiar media such as speech.

  18. THE VALUE OF HOME-BASED COLLECTION OF BIOSPECIMENS IN REPRODUCTIVE EPIDEMIOLOGY

    EPA Science Inventory

    The Value of Home-Based Collection of Biospecimens in Reproductive Epidemiology
    John C. Rockett1, Germaine M. Buck2, Courtney D. Johnson2 and Sally D. Perreault1
    1Reproductive Toxicology Division, National Health and Environmental Effects Research Laboratory, Office of Rese...

  19. Perceptions of Personal Well-Being among Youth Accessing Residential or Intensive Home-Based Treatment

    ERIC Educational Resources Information Center

    Preyde, Michele; Watkins, Hanna; Ashbourne, Graham; Lazure, Kelly; Carter, Jeff; Penney, Randy; White, Sara; Frensch, Karen; Cameron, Gary

    2013-01-01

    The outcomes of youth accessing residential treatment or intensive home-based treatment are varied. Understanding youth's perceptions of their well-being may inform service. The purpose of this report was to explore perceptions of youth's mental health, life satisfaction, and outlook for the future. Youth reported ongoing struggles with mental…

  20. A platform for real-time online health analytics during spaceflight

    NASA Astrophysics Data System (ADS)

    McGregor, Carolyn

    Monitoring the health and wellbeing of astronauts during spaceflight is an important aspect of any manned mission. To date the monitoring has been based on a sequential set of discontinuous samplings of physiological data to support initial studies on aspects such as weightlessness, and its impact on the cardiovascular system and to perform proactive monitoring for health status. The research performed and the real-time monitoring has been hampered by the lack of a platform to enable a more continuous approach to real-time monitoring. While any spaceflight is monitored heavily by Mission Control, an important requirement within the context of any spaceflight setting and in particular where there are extended periods with a lack of communication with Mission Control, is the ability for the mission to operate in an autonomous manner. This paper presents a platform to enable real-time astronaut monitoring for prognostics and health management within space medicine using online health analytics. The platform is based on extending previous online health analytics research known as the Artemis and Artemis Cloud platforms which have demonstrated their relevance for multi-patient, multi-diagnosis and multi-stream temporal analysis in real-time for clinical management and research within Neonatal Intensive Care. Artemis and Artemis Cloud source data from a range of medical devices capable of transmission of the signal via wired or wireless connectivity and hence are well suited to process real-time data acquired from astronauts. A key benefit of this platform is its ability to monitor their health and wellbeing onboard the mission as well as enabling the astronaut's physiological data, and other clinical data, to be sent to the platform components at Mission Control at each stage when that communication is available. As a result, researchers at Mission Control would be able to simulate, deploy and tailor predictive analytics and diagnostics during the same spaceflight for

  1. Building a knowledge translation platform in Malawi to support evidence-informed health policy.

    PubMed

    Berman, Joshua; Mitambo, Collins; Matanje-Mwagomba, Beatrice; Khan, Shiraz; Kachimanga, Chiyembekezo; Wroe, Emily; Mwape, Lonia; van Oosterhout, Joep J; Chindebvu, Getrude; van Schoor, Vanessa; Puchalski Ritchie, Lisa M; Panisset, Ulysses; Kathyola, Damson

    2015-01-01

    With the support of the World Health Organization's Evidence-Informed Policy Network, knowledge translation platforms have been developed throughout Africa, the Americas, Eastern Europe, and Asia to further evidence-informed national health policy. In this commentary, we discuss the approaches, activities and early lessons learned from the development of a Knowledge Translation Platform in Malawi (KTPMalawi). Through ongoing leadership, as well as financial and administrative support, the Malawi Ministry of Health has strongly signalled its intention to utilize a knowledge translation platform methodology to support evidence-informed national health policy. A unique partnership between Dignitas International, a medical and research non-governmental organization, and the Malawi Ministry of Health, has established KTPMalawi to engage national-level policymakers, researchers and implementers in a coordinated approach to the generation and utilization of health-sector research. Utilizing a methodology developed and tested by knowledge translation platforms across Africa, a stakeholder mapping exercise and initial capacity building workshops were undertaken and a multidisciplinary Steering Committee was formed. This Steering Committee prioritized the development of two initial Communities of Practice to (1) improve data utilization in the pharmaceutical supply chain and (2) improve the screening and treatment of hypertension within HIV-infected populations. Each Community of Practice's mandate is to gather and synthesize the best available global and local evidence and produce evidence briefs for policy that have been used as the primary input into structured deliberative dialogues. While a lack of sustained initial funding slowed its early development, KTPMalawi has greatly benefited from extensive technical support and mentorship by an existing network of global knowledge translation platforms. With the continued support of the Malawi Ministry of Health and the

  2. On Curating Multimodal Sensory Data for Health and Wellness Platforms.

    PubMed

    Amin, Muhammad Bilal; Banos, Oresti; Khan, Wajahat Ali; Muhammad Bilal, Hafiz Syed; Gong, Jinhyuk; Bui, Dinh-Mao; Cho, Soung Ho; Hussain, Shujaat; Ali, Taqdir; Akhtar, Usman; Chung, Tae Choong; Lee, Sungyoung

    2016-01-01

    In recent years, the focus of healthcare and wellness technologies has shown a significant shift towards personal vital signs devices. The technology has evolved from smartphone-based wellness applications to fitness bands and smartwatches. The novelty of these devices is the accumulation of activity data as their users go about their daily life routine. However, these implementations are device specific and lack the ability to incorporate multimodal data sources. Data accumulated in their usage does not offer rich contextual information that is adequate for providing a holistic view of a user's lifelog. As a result, making decisions and generating recommendations based on this data are single dimensional. In this paper, we present our Data Curation Framework (DCF) which is device independent and accumulates a user's sensory data from multimodal data sources in real time. DCF curates the context of this accumulated data over the user's lifelog. DCF provides rule-based anomaly detection over this context-rich lifelog in real time. To provide computation and persistence over the large volume of sensory data, DCF utilizes the distributed and ubiquitous environment of the cloud platform. DCF has been evaluated for its performance, correctness, ability to detect complex anomalies, and management support for a large volume of sensory data. PMID:27355955

  3. On Curating Multimodal Sensory Data for Health and Wellness Platforms

    PubMed Central

    Amin, Muhammad Bilal; Banos, Oresti; Khan, Wajahat Ali; Muhammad Bilal, Hafiz Syed; Gong, Jinhyuk; Bui, Dinh-Mao; Cho, Soung Ho; Hussain, Shujaat; Ali, Taqdir; Akhtar, Usman; Chung, Tae Choong; Lee, Sungyoung

    2016-01-01

    In recent years, the focus of healthcare and wellness technologies has shown a significant shift towards personal vital signs devices. The technology has evolved from smartphone-based wellness applications to fitness bands and smartwatches. The novelty of these devices is the accumulation of activity data as their users go about their daily life routine. However, these implementations are device specific and lack the ability to incorporate multimodal data sources. Data accumulated in their usage does not offer rich contextual information that is adequate for providing a holistic view of a user’s lifelog. As a result, making decisions and generating recommendations based on this data are single dimensional. In this paper, we present our Data Curation Framework (DCF) which is device independent and accumulates a user’s sensory data from multimodal data sources in real time. DCF curates the context of this accumulated data over the user’s lifelog. DCF provides rule-based anomaly detection over this context-rich lifelog in real time. To provide computation and persistence over the large volume of sensory data, DCF utilizes the distributed and ubiquitous environment of the cloud platform. DCF has been evaluated for its performance, correctness, ability to detect complex anomalies, and management support for a large volume of sensory data. PMID:27355955

  4. Health care and social media platforms in hospitals.

    PubMed

    McCarroll, Michele L; Armbruster, Shannon D; Chung, Jae Eun; Kim, Junghyun; McKenzie, Alissa; von Gruenigen, Vivian E

    2014-01-01

    The objective of this article is to illustrate user characteristics of a hospital's social media structure using analytics and user surveys. A 1-year retrospective analysis was conducted along with an Internet survey of users of the hospital's Facebook, Twitter, and blog. Of the survey respondents (n = 163), 95.7% are female and 4.3% are male; most are ages 50-59 years (31.5%) and 40-49 years (27.8%); and 93.2% are Caucasian. However, the hospital system database revealed 55% female and 37% minority population, respectively. Of the survey respondents, 61.4% reported having a bachelor's degree or higher, whereas only 11.7% reported having a high school degree/equivalent or lower. However, within the hospital patient databases, 93% of patients have a high school degree/equivalent or lower and only 3% have a bachelor's degree or higher in our women's services population. Social media were used to seek personal health information 68.7% (n = 112), to learn about hospital programming 27.6% (n = 45), and to seek family health information 25.2% (n = 41). Respondents younger than 49 years of age were more likely to seek personal health information using social media compared to those 50 years of age and older (p = .02). Respondents with a bachelor's degree or higher education were statistically less likely to search for physician information compared to those less educated individuals (p = .04). We conclude that social media may play an important role in personal health information, especially for young female respondents; however, the survey provides strong evidence that further research is needed to ensure that social network sites provided by hospitals are reaching the full spectrum of health system patients. PMID:24295109

  5. The use of regional platforms for managing electronic health records for the production of regional public health indicators in France

    PubMed Central

    2012-01-01

    Background In France, recent developments in healthcare system organization have aimed at strengthening decision-making and action in public health at the regional level. Firstly, the 2004 Public Health Act, by setting 100 national and regional public health targets, introduced an evaluative approach to public health programs at the national and regional levels. Meanwhile, the implementation of regional platforms for managing electronic health records (EHRs) has also been under assessment to coordinate the deployment of this important instrument of care within each geographic area. In this context, the development and implementation of a regional approach to epidemiological data extracted from EHRs are an opportunity that must be seized as soon as possible. Our article addresses certain design and organizational aspects so that the technical requirements for such use are integrated into regional platforms in France. The article will base itself on organization of the Rhône-Alpes regional health platform. Discussion Different tools being deployed in France allow us to consider the potential of these regional platforms for epidemiology and public health (implementation of a national health identification number and a national information system interoperability framework). The deployment of the Rhône-Alpes regional health platform began in the 2000s in France. By August 2011, 2.6 million patients were identified in this platform. A new development step is emerging because regional decision-makers need to measure healthcare efficiency. To pool heterogeneous information contained in various independent databases, the format, norm and content of the metadata have been defined. Two types of databases will be created according to the nature of the data processed, one for extracting structured data, and the second for extracting non-structured and de-identified free-text documents. Summary Regional platforms for managing EHRs could constitute an important data source for

  6. PARAMO: A Parallel Predictive Modeling Platform for Healthcare Analytic Research using Electronic Health Records

    PubMed Central

    Ng, Kenney; Ghoting, Amol; Steinhubl, Steven R.; Stewart, Walter F.; Malin, Bradley; Sun, Jimeng

    2014-01-01

    Objective Healthcare analytics research increasingly involves the construction of predictive models for disease targets across varying patient cohorts using electronic health records (EHRs). To facilitate this process, it is critical to support a pipeline of tasks: 1) cohort construction, 2) feature construction, 3) cross-validation, 4) feature selection, and 5) classification. To develop an appropriate model, it is necessary to compare and refine models derived from a diversity of cohorts, patient-specific features, and statistical frameworks. The goal of this work is to develop and evaluate a predictive modeling platform that can be used to simplify and expedite this process for health data. Methods To support this goal, we developed a PARAllel predictive MOdeling (PARAMO) platform which 1) constructs a dependency graph of tasks from specifications of predictive modeling pipelines, 2) schedules the tasks in a topological ordering of the graph, and 3) executes those tasks in parallel. We implemented this platform using Map-Reduce to enable independent tasks to run in parallel in a cluster computing environment. Different task scheduling preferences are also supported. Results We assess the performance of PARAMO on various workloads using three datasets derived from the EHR systems in place at Geisinger Health System and Vanderbilt University Medical Center and an anonymous longitudinal claims database. We demonstrate significant gains in computational efficiency against a standard approach. In particular, PARAMO can build 800 different models on a 300,000 patient data set in 3 hours in parallel compared to 9 days if running sequentially. Conclusion This work demonstrates that an efficient parallel predictive modeling platform can be developed for EHR data. This platform can facilitate large-scale modeling endeavors and speed-up the research workflow and reuse of health information. This platform is only a first step and provides the foundation for our ultimate

  7. Home-Based Resistance Training: Predictors of Participation and Adherence.

    ERIC Educational Resources Information Center

    Jette, Alan M.; Rooks, Dan; Lachman, Margie; Lin, Ting H.; Levenson, Claudia; Heislein, Diane; Giorgetti, Marie M.; Harris, B. A.

    1998-01-01

    Identifies factors associated with exercise participation and adherence in a sample of sedentary, functionally limited, community-dwelling adults ages 60 to 94 who participated in a home-based resistance training program (N=102). Results show that psychological factors were most important to adherence to the home-based program. (Author/MKA)

  8. A Mobile Cloud-Based Parkinson’s Disease Assessment System for Home-Based Monitoring

    PubMed Central

    Petitti, Diana B

    2015-01-01

    Background Parkinson’s disease (PD) is the most prevalent movement disorder of the central nervous system, and affects more than 6.3 million people in the world. The characteristic motor features include tremor, bradykinesia, rigidity, and impaired postural stability. Current therapy based on augmentation or replacement of dopamine is designed to improve patients’ motor performance but often leads to levodopa-induced adverse effects, such as dyskinesia and motor fluctuation. Clinicians must regularly monitor patients in order to identify these effects and other declines in motor function as soon as possible. Current clinical assessment for Parkinson’s is subjective and mostly conducted by brief observations made during patient visits. Changes in patients’ motor function between visits are hard to track and clinicians are not able to make the most informed decisions about the course of therapy without frequent visits. Frequent clinic visits increase the physical and economic burden on patients and their families. Objective In this project, we sought to design, develop, and evaluate a prototype mobile cloud-based mHealth app, “PD Dr”, which collects quantitative and objective information about PD and would enable home-based assessment and monitoring of major PD symptoms. Methods We designed and developed a mobile app on the Android platform to collect PD-related motion data using the smartphone 3D accelerometer and to send the data to a cloud service for storage, data processing, and PD symptoms severity estimation. To evaluate this system, data from the system were collected from 40 patients with PD and compared with experts’ rating on standardized rating scales. Results The evaluation showed that PD Dr could effectively capture important motion features that differentiate PD severity and identify critical symptoms. For hand resting tremor detection, the sensitivity was .77 and accuracy was .82. For gait difficulty detection, the sensitivity was .89

  9. Older Adult Perceptions of Participation in Group- and Home-Based Falls Prevention Exercise.

    PubMed

    Robins, Lauren M; Hill, K D; Day, Lesley; Clemson, Lindy; Finch, Caroline; Haines, Terry

    2016-07-01

    This paper describes why older adults begin, continue, and discontinue group- and home-based falls prevention exercise and benefits and barriers to participation. Telephone surveys were used to collect data for 394 respondents. Most respondents reported not participating in group- (66%) or home-based (78%) falls prevention exercise recently. Reasons for starting group-based falls prevention exercise include health benefits (23-39%), health professional recommendation (13-19%), and social interaction (4-16%). They discontinued because the program finished (44%) or due to poor health (20%). Commonly reported benefits were social interaction (41-67%) and health (15-31%). Disliking groups was the main barrier (2-14%). Home-based falls prevention exercise was started for rehabilitation (46-63%) or upon health professional recommendation (22-48%) and stopped due to recovery (30%). Improvement in health (18-46%) was the main benefit. These findings could assist health professionals in prescribing group-based falls prevention exercise by considering characteristics of older adults who perceive social interaction to be beneficial. PMID:26539657

  10. Individualised home-based rehabilitation after stroke in eastern Finland--the client's perspective.

    PubMed

    Reunanen, Merja A T; Järvikoski, Aila; Talvitie, Ulla; Pyöriä, Outi; Härkäpää, Kristiina

    2016-01-01

    Reintegration into society is one of the main purposes of post-stroke rehabilitation. The experiences of clients returning home after a stroke have been studied before. There is, however, little knowledge about activities carried out during home-based rehabilitation interventions and about the involvement of clients in the process. This study focused on clients' experiences of a 3-month individualised, home-based rehabilitation programme supervised by a multidisciplinary team. The data were collected in 2009-2010, and it was based on interviews with 14 clients (48-83 years of age) conducted approximately 7 months after stroke. In the thematic analysis, five main topics describing the goals and functions of the home-based rehabilitation were identified as follows: (i) learning strategies for solving problems in daily activities at home and in the community; (ii) receiving exercise coaching; (iii) exploring community services and facilities; (iv) having a dialogue with professionals; and (v) engaging in activities aimed at returning to work. Implementing rehabilitation activities in the home environment seemed to enhance the participants' active involvement and their ability to evaluate themselves and to set goals for their recovery. Work was an important goal for clients of working age, but work-related tasks were not sufficiently integrated with home-based rehabilitation. A challenge for local communities is to provide health promotion and recreation services that are also suitable for persons with limited functioning. PMID:25676161

  11. The Architecture of an Automatic eHealth Platform With Mobile Client for Cerebrovascular Disease Detection

    PubMed Central

    Wang, Xingce; Bie, Rongfang; Wu, Zhongke; Zhou, Mingquan; Cao, Rongfei; Xie, Lizhi; Zhang, Dong

    2013-01-01

    Background In recent years, cerebrovascular disease has been the leading cause of death and adult disability in the world. This study describes an efficient approach to detect cerebrovascular disease. Objective In order to improve cerebrovascular treatment, prevention, and care, an automatic cerebrovascular disease detection eHealth platform is designed and studied. Methods We designed an automatic eHealth platform for cerebrovascular disease detection with a four-level architecture: object control layer, data transmission layer, service supporting layer, and application service layer. The platform has eight main functions: cerebrovascular database management, preprocessing of cerebral image data, image viewing and adjustment model, image cropping compression and measurement, cerebrovascular segmentation, 3-dimensional cerebrovascular reconstruction, cerebrovascular rendering, cerebrovascular virtual endoscope, and automatic detection. Several key technologies were employed for the implementation of the platform. The anisotropic diffusion model was used to reduce the noise. Statistics segmentation with Gaussian-Markov random field model (G-MRF) and Stochastic Estimation Maximization (SEM) parameter estimation method were used to realize the cerebrovascular segmentation. Ball B-Spline curve was proposed to model the cerebral blood vessels. Compute unified device architecture (CUDA) based on ray-casting volume rendering presented by curvature enhancement and boundary enhancement were used to realize the volume rendering model. We implemented the platform with a network client and mobile phone client to fit different users. Results The implemented platform is running on a common personal computer. Experiments on 32 patients’ brain computed tomography data or brain magnetic resonance imaging data stored in the system verified the feasibility and validity of each model we proposed. The platform is partly used in the cranial nerve surgery of the First Hospital

  12. Developing a Common Health Information Exchange Platform to Implement a Nationwide Health Information Network in South Korea

    PubMed Central

    Lee, Minho; Heo, Eunyoung; Lim, Heesook; Lee, Jun Young; Weon, Sangho; Chae, Hoseok; Hwang, Hee

    2015-01-01

    Objectives We aimed to develop a common health information exchange (HIE) platform that can provide integrated services for implementing the HIE infrastructure in addition to guidelines for participating in an HIE network in South Korea. Methods By exploiting the Health Level 7 (HL7) Clinical Document Architecture (CDA) and Integrating the Healthcare Enterprise (IHE) Cross-enterprise Document Sharing-b (XDS.b) profile, we defined the architectural model, exchanging data items and their standardization, messaging standards, and privacy and security guidelines, for a secure, nationwide, interoperable HIE. We then developed a service-oriented common HIE platform to minimize the effort and difficulty of fulfilling the standard requirements for participating in the HIE network. The common platform supports open application program interfaces (APIs) for implementing a document registry, a document repository, a document consumer, and a master patient index. It could also be used for testing environments for the implementation of standard requirements. Results As the initial phase of implementing a nationwide HIE network in South Korea, we built a regional network for workers' compensation (WC) hospitals and their collaborating clinics to share referral and care record summaries to ensure the continuity of care for industrially injured workers, using the common HIE platform and verifying the feasibility of our technologies. Conclusions We expect to expand the HIE network on a national scale with rapid support for implementing HL7 and IHE standards in South Korea. PMID:25705554

  13. 77 FR 33740 - Announcement of Requirements and Registration for “Health Data Platform Simple Sign-On Challenge”

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-07

    ...As part of the HHS Open Government Plan, the HealthData.gov Platform (HDP) is a flagship initiative and focal point helping to establish learning communities that collaboratively evolve and mature the utility and usability of a broad range of health and human service data. HDP will deliver greater potential for new data driven insights into complex interactions of health and health care......

  14. Evaluation of Game Engines for Cross-Platform Development of Mobile Serious Games for Health.

    PubMed

    Kleinschmidt, Carina; Haag, Martin

    2016-01-01

    Studies have shown that serious games for health can improve patient compliance and help to increase the quality of medical education. Due to a growing availability of mobile devices, especially the development of cross-platform mobile apps is helpful for improving healthcare. As the development can be highly time-consuming and expensive, an alternative development process is needed. Game engines are expected to simplify this process. Therefore, this article examines the question whether using game engines for cross-platform serious games for health can simplify the development compared to the development of a plain HTML5 app. At first, a systematic review of the literature was conducted in different databases (MEDLINE, ACM and IEEE). Afterwards three different game engines were chosen, evaluated in different categories and compared to the development of a HTML5 app. This was realized by implementing a prototypical application in the different engines and conducting a utility analysis. The evaluation shows that the Marmalade engine is the best choice for development in this scenario. Furthermore, it is obvious that the game engines have great benefits against plain HTML5 development as they provide components for graphics, physics, sounds, etc. The authors recommend to use the Marmalade Engine for a cross-platform mobile Serious Game for Health. PMID:27139405

  15. The SMART Platform: early experience enabling substitutable applications for electronic health records

    PubMed Central

    Mandel, Joshua C; Murphy, Shawn N; Bernstam, Elmer Victor; Ramoni, Rachel L; Kreda, David A; McCoy, J Michael; Adida, Ben; Kohane, Isaac S

    2012-01-01

    Objective The Substitutable Medical Applications, Reusable Technologies (SMART) Platforms project seeks to develop a health information technology platform with substitutable applications (apps) constructed around core services. The authors believe this is a promising approach to driving down healthcare costs, supporting standards evolution, accommodating differences in care workflow, fostering competition in the market, and accelerating innovation. Materials and methods The Office of the National Coordinator for Health Information Technology, through the Strategic Health IT Advanced Research Projects (SHARP) Program, funds the project. The SMART team has focused on enabling the property of substitutability through an app programming interface leveraging web standards, presenting predictable data payloads, and abstracting away many details of enterprise health information technology systems. Containers—health information technology systems, such as electronic health records (EHR), personally controlled health records, and health information exchanges that use the SMART app programming interface or a portion of it—marshal data sources and present data simply, reliably, and consistently to apps. Results The SMART team has completed the first phase of the project (a) defining an app programming interface, (b) developing containers, and (c) producing a set of charter apps that showcase the system capabilities. A focal point of this phase was the SMART Apps Challenge, publicized by the White House, using http://www.challenge.gov website, and generating 15 app submissions with diverse functionality. Conclusion Key strategic decisions must be made about the most effective market for further disseminating SMART: existing market-leading EHR vendors, new entrants into the EHR market, or other stakeholders such as health information exchanges. PMID:22427539

  16. Implementation of a health policy advisory committee as a knowledge translation platform: the Nigeria experience

    PubMed Central

    Uneke, Chigozie Jesse; Ndukwe, Chinwendu Daniel; Ezeoha, Abel Abeh; Uro-Chukwu, Henry Chukwuemeka; Ezeonu, Chinonyelum Thecla

    2015-01-01

    Background: In recent times, there has been a growing demand internationally for health policies to be based on reliable research evidence. Consequently, there is a need to strengthen institutions and mechanisms that can promote interactions among researchers, policy-makers and other stakeholders who can influence the uptake of research findings. The Health Policy Advisory Committee (HPAC) is one of such mechanisms that can serve as an excellent forum for the interaction of policy-makers and researchers. Therefore, the need to have a long term mechanism that allows for periodic interactions between researchers and policy-makers within the existing government system necessitated our implementation of a newly established HPAC in Ebonyi State Nigeria, as a Knowledge Translation (KT) platform. The key study objective was to enhance the capacity of the HPAC and equip its members with the skills/competence required for the committee to effectively promote evidence informed policy-making and function as a KT platform. Methods: A series of capacity building programmes and KT activities were undertaken including: i) Capacity building of the HPAC using Evidence-to-Policy Network (EVIPNet) SUPPORT tools; ii) Capacity enhancement mentorship programme of the HPAC through a three-month executive training programme on health policy/health systems and KT in Ebonyi State University Abakaliki; iii) Production of a policy brief on strategies to improve the performance of the Government’s Free Maternal and Child Health Care Programme in Ebonyi State Nigeria; and iv) Hosting of a multi-stakeholders policy dialogue based on the produced policy brief on the Government’s Free Maternal and Child Health Care Programme. Results: The study findings indicated a noteworthy improvement in knowledge of evidence-to-policy link among the HPAC members; the elimination of mutual mistrust between policy-makers and researchers; and an increase in the awareness of importance of HPAC in the Ministry

  17. Use of an Internet “Viral” Marketing Software Platform in Health Promotion

    PubMed Central

    Poitras, Philippe

    2008-01-01

    Background Health-related websites have become a common tool for public health authorities to inform the general public of their health promotion information and programs. However, building traffic in the cluttered health Internet universe is becoming increasingly complex, costly, and challenging for governmental health promotion websites. In 2006, the Canadian Health Network (CHN), a cooperative program made up of the Public Health Agency of Canada (PHAC) and some 20 health non-governmental organizations (NGOs), was looking for an affordable marketing tool for the promotion of its website and contents to specific populations. Objective To test new and innovative marketing tools for a health promotion website in Canada. Methods Within the context and constraints of a governmental health promotion website, an adaptation of a commercial Internet viral marketing software platform was developed and implemented under the name “The Crazy Race”. This process was done interactively between seven NGOs and the CHN staff. The communication objectives were (a) to provide a meaningful visit that could communicate important public health messages, and (b) to increase subscriptions to its e-newsletter. A nine-step standardized Web-user experience (Internet path) was thus defined and experimented with under a pre-determined operating budget of less then Can$50,000, mainly paid for by participating organizations on a pay-per-performance basis. Results An initial group of 215 people were sent an invitation to participate in the campaign. Over its 15-day duration, the campaign generated by itself and without any media support a total of 110,200 Web user participants who registered and sent a total of 439,275 invitations (2% of the Canadian Web-user population of 21.8 million in 2006). The epidemic self-dissemination of the campaign occurred in both French and English populations and spread across all age groups. Two-thirds of the participants were women. Conclusions The use of an

  18. [Development of human embryonic stem cell platforms for human health-safety evaluation].

    PubMed

    Yu, Guang-yan; Cao, Tong; Zou, Xiao-hui; Zhang, Xue-hui; Fu, Xin; Peng, Shuang-qing; Deng, Xu-liang; Li, Sheng-lin; Liu, He; Xiao, Ran; Ouyang, Hong-wei; Peng, Hui; Chen, Xiao; Zhao, Zeng-ming; Wang, Xiao-ying; Fang, Hai-qin; Lu, Lu; Ren, Yu-lan; Xu, Ming-ming

    2016-02-18

    The human embryonic stem cells (hESCs) serve as a self-renewable, genetically-healthy, pluripotent and single source of all body cells, tissues and organs. Therefore, it is considered as the good standard for all human stem cells by US, Europe and international authorities. In this study, the standard and healthy human mesenchymal progenitors, ligament tissues, cardiomyocytes, keratinocytes, primary neurons, fibroblasts, and salivary serous cells were differentiated from hESCs. The human cellular health-safety of NaF, retinoic acid, 5-fluorouracil, dexamethasone, penicillin G, adriamycin, lead acetate PbAc, bisphenol A-biglycidyl methacrylate (Bis-GMA) were evaluated selectively on the standardized platforms of hESCs, hESCs-derived cardiomyocytes, keratinocytes, primary neurons, and fibroblasts. The evaluations were compared with those on the currently most adopted cellular platforms. Particularly, the sensitivity difference of PM2.5 toxicity on standardized and healthy hESCs derived fibroblasts, currently adopted immortalized human bronchial epithelial cells Beas-2B and human umbilical vein endothelial cells (HUVECs) were evaluated. The RESULTS showed that the standardized hESCs cellular platforms provided more sensitivity and accuracy for human cellular health-safety evaluation. PMID:26885900

  19. Cost-effectiveness of community health worker versus home-based guardians for directly observed treatment of tuberculosis in Vitória, Espírito Santo State, Brazil

    PubMed Central

    do Prado, Thiago Nascimento; Wada, Nikolas; Guidoni, Leticia Molino; Golub, Jonathan E.; Dietze, Reynaldo; Maciel, Ethel Leonor Noia

    2013-01-01

    The objective of this study was to compare the costs and outcomes associated with guardian-supervised directly observed treatment relative to the standard of care Directly Observed Therapy, Short Course (DOTS) provided by community health workers (CHW). New cases of culture-positive pulmonary tuberculosis (TB) treated in Vitória, Espírito Santo State, Brazil, between January 2005 and December 2006 were interviewed and chose their preferred treatment strategy. Costs incurred by providers and patients (and patients’ families) were estimated, and cost-effectiveness was assessed by comparing costs per successfully treated patient. 130 patients were included in the study; 84 chose CHW-supervised DOTS and 46 chose guardian-supervised DOTS. 45 of 46 (98%) patients treated with guardian-supervised DOTS were cured or completed treatment compared to 70/84 (83%) of the CHW-supervised patients (p = 0.01). Logistic regression showed only the strategy of supervision to be a significant association with treatment outcome, with guardian-supervised care strongly protective. Cost per patient treated with guardian-supervised DOTS was US$398, compared to US$548 for CHW-supervised DOTS. The guardian-supervised DOTS is an attractive option to complement CHW-supervised DOTS. PMID:21655845

  20. Indivo X: Developing a Fully Substitutable Personally Controlled Health Record Platform

    PubMed Central

    Adida, Ben; Sanyal, Arjun; Zabak, Steve; Kohane, Isaac S.; Mandl, Kenneth D.

    2010-01-01

    To support a rich ecosystem of third-party applications around a personally controlled health record (PCHR), we have redesigned Indivo, the original PCHR, as a web-based platform with feature-level substitutability. Core to this new release is the Indivo X Application Programming Interface (API), the contract between the PCHR platform and the end-user apps. Using rapid iterative development to build a minimal feature set from real-world requirements, the resulting Indivo X API, now in public stable beta, is enabling developers, including third-party contributors, to quickly create and integrate novel features into patients’ online records, ultimately building a fully customizable experience for diverse patient needs. PMID:21346930

  1. Photoacoustic imaging: a potential new platform for assessment of bone health

    NASA Astrophysics Data System (ADS)

    Feng, Ting; Kozloff, Kenneth M.; Hsiao, Yi-Sing; Xu, Guan; Du, Sidan; Yuan, Jie; Deng, Cheri X.; Wang, Xueding

    2015-02-01

    The ultimate goal of this work is to develop a novel photoacoustic (QPA) platform for highly-sensitive and quantitative assessment of bone health. First, the feasibility to perform 3D photoacoustic imaging (PAI) of bone was investigated. Then another two techniques, including thermal photoacoustic measurement (TPAM) and photoacoustic spectral analysis (PASA), both being able to achieve quantitative results were investigated for bone characterization. TPAM, by evaluating the dependence of photoacoustic signal amplitude on the sample temperature, is sensitive to the chemical constituents in tissue and holds promise for assessment of bone mineral density (BMD). PASA characterizes micron size physical features in tissue, and has shown feasibility for objective assessment of bone microarchitecture (BMA). This integrated QPA platform can assess both bone mass and microstructure simultaneously without involving invasive biopsy or ionizing radiation. Since QPA is non-ionizing, non-invasive, and has sufficient penetration in both soft tissue and bone, it has unique advantages for clinical translation.

  2. Creating an Ethnodrama to Catalyze Dialogue in Home-Based Dementia Care.

    PubMed

    Speechley, Mark; DeForge, Ryan T; Ward-Griffin, Catherine; Marlatt, Nicole M; Gutmanis, Iris

    2015-11-01

    This article describes the development of a theater script derived from a critical ethnographic study that followed people living with dementia--and their family and professional caregivers--over an 18-month period. Analysis of the ethnographic data yielded four themes that characterized home-based dementia care relationships: managing care resources, making care decisions, evaluating care practices, and reifying care norms. The research team expanded to include a colleague with playwright experience, who used these themes to write a script. A theater director was included to cast and direct the play, and finally, a videography company filmed the actors on a realistic set. To contribute to the qualitative health research and the research-based theater knowledge translation literatures, this article describes and explains the creative decisions taken as part of our effort to disseminate research focused on home-based dementia care in a way that catalyzes and fosters critical (actionable) dialogue. PMID:26468252

  3. Reach Out to Enhance Wellness Home-Based Diet-Exercise Intervention Promotes Reproducible and Sustainable Long-Term Improvements in Health Behaviors, Body Weight, and Physical Functioning in Older, Overweight/Obese Cancer Survivors

    PubMed Central

    Demark-Wahnefried, Wendy; Morey, Miriam C.; Sloane, Richard; Snyder, Denise C.; Miller, Paige E.; Hartman, Terryl J.; Cohen, Harvey J.

    2012-01-01

    Purpose Diet and exercise interventions have been tested in cancer survivors as a means to reduce late effects and comorbidity, but few have assessed adherence and health outcomes long term. Methods Between July 2005 and May 2007, the Reach Out to Enhance Wellness (RENEW) trial accrued 641 locoregionally staged, long-term (≥ 5 years from diagnosis) colorectal, breast, and prostate cancer survivors in the United States (21 states), Canada, and the United Kingdom. All participants were sedentary (< 150 minutes of physical activity [PA] a week), overweight or obese (body mass index, 25 to 40 kg/m2), and over age 65 years. The trial tested a diet-exercise intervention delivered via mailed print materials and telephone counseling. RENEW used a wait-list control, cross-over design (ie, participants received the year-long intervention immediately or after a 1-year delay), which allowed the opportunity to assess program efficacy (previously reported primary outcome), durability, and reproducibility (reported herein). Measures included diet quality (DQ), PA, BMI, and physical function (PF). Results No significant relapse was observed in the immediate-intervention arm for DQ, PA, and BMI; however, rates of functional decline increased when the intervention ceased. From year 1 to year 2, significant improvements were observed in the delayed-intervention arm; mean change scores in behaviors and BMI and PF slopes were as follows: DQ score, 5.2 (95% CI, 3.4 to 7.0); PA, 45.8 min/wk (95% CI, 26.9 to 64.6 min/wk); BMI, −0.56 (95% CI, −0.75 to −0.36); and Short Form-36 PF, −1.02 versus −5.52 (P < .001 for all measures). Overall, both arms experienced significant improvements in DQ, PA, and BMI from baseline to 2-year follow-up (P < .001). Conclusion Older cancer survivors respond favorably to lifestyle interventions and make durable changes in DQ and PA that contribute to sustained weight loss. These changes positively reorient functional decline trajectories during

  4. Grasping the health horizon: toward a virtual, interoperable platform of health innovations.

    PubMed

    Dawe, Marcus; Dugdale, Paul; Mcgann, Mathew

    2015-01-01

    The emergence of digital health, wearables, apps, telehealth and the proliferation of health services online are all indications that health is undergoing rapid innovation. Health innovation however has been traditionally slow, high cost and the commercialisation journey was not a guaranteed path to adoption outside the setting where it was developed whether in a hospital, university, clinic or lab. Most significant with this new explosion of health innovations is the sheer volume. The startup revolution, mobile health, personalised heath and globalisation of knowledge means that consumers are demanding innovations and are pulling health innovations through commercialisation with new modes of funding such as crowdsourcing and direct vendor purchases. Our Australian team initiated a project to use machine learning, data mining and classification techniques to bring together and analyse this expansion of heath innovations from all over the world. Following two years of data aggregation and quality analysis we present our findings which are applied to over 200,000 innovations from more than 25,000 organisations. Our findings have identified the dynamics and basis for a marketplace for health innovations that could assist innovators, health practitioners, consumers, investors and other health participants to research, evaluate and promote these innovations. PMID:26571640

  5. A proposed Next Generation Service Delivery Platform (NG-SDP) for eHealth domain.

    PubMed

    Andriopoulou, Foteini Gr; Lazarou, Nicolaos G; Lymberopoulos, Dimitrios K

    2012-01-01

    Nowadays, providing healthcare personalized services in user's intelligent space is an important issue for improving personal health, supporting predictive care and saving medical costs. In this paper, we propose an architecture for the Next Generation Service Delivery Platform (NG-SDP), suitable for composing and delivering personalized healthcare services. The core component of NG-SDP is a Context Decision Making Enabler (CDME) that assesses user contextual and bio information to yield personalized services. A prototype implementation of the proposed NG-SDP is also demonstrated. Finally a real case study demonstrates the CDME performance. PMID:23367312

  6. Linking Human Health and Livestock Health: A “One-Health” Platform for Integrated Analysis of Human Health, Livestock Health, and Economic Welfare in Livestock Dependent Communities

    PubMed Central

    Thumbi, S. M.; Njenga, M. Kariuki; Marsh, Thomas L.; Noh, Susan; Otiang, Elkanah; Munyua, Peninah; Ochieng, Linus; Ogola, Eric; Yoder, Jonathan; Audi, Allan; Montgomery, Joel M.; Bigogo, Godfrey; Breiman, Robert F.; Palmer, Guy H.; McElwain, Terry F.

    2015-01-01

    Background For most rural households in sub-Saharan Africa, healthy livestock play a key role in averting the burden associated with zoonotic diseases, and in meeting household nutritional and socio-economic needs. However, there is limited understanding of the complex nutritional, socio-economic, and zoonotic pathways that link livestock health to human health and welfare. Here we describe a platform for integrated human health, animal health and economic welfare analysis designed to address this challenge. We provide baseline epidemiological data on disease syndromes in humans and the animals they keep, and provide examples of relationships between human health, animal health and household socio-economic status. Method We designed a study to obtain syndromic disease data in animals along with economic and behavioral information for 1500 rural households in Western Kenya already participating in a human syndromic disease surveillance study. Data collection started in February 2013, and each household is visited bi-weekly and data on four human syndromes (fever, jaundice, diarrhea and respiratory illness) and nine animal syndromes (death, respiratory, reproductive, musculoskeletal, nervous, urogenital, digestive, udder disorders, and skin disorders in cattle, sheep, goats and chickens) are collected. Additionally, data from a comprehensive socio-economic survey is collected every 3 months in each of the study households. Findings Data from the first year of study showed 93% of the households owned at least one form of livestock (55%, 19%, 41% and 88% own cattle, sheep, goats and chickens respectively). Digestive disorders, mainly diarrhea episodes, were the most common syndromes observed in cattle, goats and sheep, accounting for 56% of all livestock syndromes, followed by respiratory illnesses (18%). In humans, respiratory illnesses accounted for 54% of all illnesses reported, followed by acute febrile illnesses (40%) and diarrhea illnesses (5%). While controlling

  7. Using a digital marketing platform for the promotion of an internet based health encyclopedia in saudi arabia.

    PubMed

    Al Ateeq, Asma; Al Moamary, Eman; Daghestani, Tahani; Al Muallem, Yahya; Al Dogether, Majed; Alsughayr, Abdulrahman; Altuwaijri, Majid; Househ, Mowafa

    2015-01-01

    The objective of this paper is to investigate the experiences of using a digital marketing platform to promote the use of an internet based health encyclopedia in Saudi Arabia. Key informant interviews, meeting documentation, and Google Analytics were the data collection sources used in the study. Findings show that using a digital marketing platform led to a significant increase in the number of visitors to the health encyclopedia. The results demonstrate that digital marketing platforms are effective tools to be used for promoting internet based health education interventions. Future work will examine long-term educational impacts and costs in using digital marketing platforms to promote online healthcare sites in Saudi Arabia. PMID:25676939

  8. A home-based nutrition and physical activity intervention for grandparents raising grandchildren: a pilot study.

    PubMed

    Kicklighter, Jana R; Whitley, Deborah M; Kelley, Susan J; Lynch, Judith E; Melton, Tamara S

    2009-04-01

    Five African American grandparents raising their grandchildren participated in a home-based nutrition and physical activity intervention. The primary goals were to increase grandparents' knowledge and skills in selecting and preparing healthy foods and to increase the grandparents' and grandchildren's physical activity levels. Results revealed that grandparents' concerns regarding their chronic diseases and desire to prevent health problems in their grandchildren served as motivators. Following the intervention, grandparents scored higher on nutrition and physical activity knowledge and their self-efficacy improved, although most health status indicators remained unchanged. Self-reported changes included walking more, reading food labels, and switching to a healthier type of fat. PMID:21184365

  9. Predictors of Home Based Long-Term Care Services.

    ERIC Educational Resources Information Center

    Luppens, Jean; And Others

    An attempt was made to determine predictors of service need, use, and outcome among chronically impaired adults and aged who were living in the community and using the home-based, long term care services of the Chronic Illness Center (CIC) of the Cuyahoga County Hospitals (Ohio). Randomly selected consumer service records (N=200) were coded for…

  10. A multi-method review of home-based chemotherapy.

    PubMed

    Evans, J M; Qiu, M; MacKinnon, M; Green, E; Peterson, K; Kaizer, L

    2016-09-01

    This study summarises research- and practice-based evidence on home-based chemotherapy, and explores existing delivery models. A three-pronged investigation was conducted consisting of a literature review and synthesis of 54 papers, a review of seven home-based chemotherapy programmes spanning four countries, and two case studies within the Canadian province of Ontario. The results support the provision of home-based chemotherapy as a safe and patient-centred alternative to hospital- and outpatient-based service. This paper consolidates information on home-based chemotherapy programmes including services and drugs offered, patient eligibility criteria, patient views and experiences, delivery structures and processes, and common challenges. Fourteen recommendations are also provided for improving the delivery of chemotherapy in patients' homes by prioritising patient-centredness, provider training and teamwork, safety and quality of care, and programme management. The results of this study can be used to inform the development of an evidence-informed model for the delivery of chemotherapy and related care, such as symptom management, in patients' homes. PMID:26545409

  11. Home-Based Contingency Management Programs that Teachers Can Use.

    ERIC Educational Resources Information Center

    Taylor, Vincent L.; And Others

    1984-01-01

    Offers three guidelines to aid teachers in selecting effective contingency management programs, based on degree of positiveness, effectiveness, and costs to teachers and parents. Describes how to use a simple home-based program, which resulted in successful reduction of mild classroom disruptive behavior. (JAC)

  12. Home-Based Crisis Therapy: A Comparative Outcome Study.

    ERIC Educational Resources Information Center

    Rowland, Charity; And Others

    Substitute care for a child at risk has been been associated with psychological distress in the child and his family and a drain on public finances. To investigate the cost effectiveness and ultimate influence on family intactness of home-based family crisis intervention, 77 low income, inner city families with an adolescent child at risk of…

  13. Home Based Care: Direction for the 80s.

    ERIC Educational Resources Information Center

    Bryce, Marvin E.

    Home based family centered (HBFC) service programs have been developed as alternatives to out-of-home placement. These programs have reported relatively high service success rates at costs signficantly lower than foster home and institutional care while, at the same time, avoiding the social and psychological risks of out-of-home placement.…

  14. 45 CFR 1306.33 - Home-based program option.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... specified in 45 CFR 1304.23(b)(2) and provide appropriate snacks and meals to the children during group... 45 Public Welfare 4 2011-10-01 2011-10-01 false Home-based program option. 1306.33 Section 1306.33... PROGRAM HEAD START STAFFING REQUIREMENTS AND PROGRAM OPTIONS Head Start Program Options § 1306.33...

  15. 45 CFR 1306.33 - Home-based program option.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... specified in 45 CFR 1304.23(b)(2) and provide appropriate snacks and meals to the children during group... 45 Public Welfare 4 2010-10-01 2010-10-01 false Home-based program option. 1306.33 Section 1306.33... PROGRAM HEAD START STAFFING REQUIREMENTS AND PROGRAM OPTIONS Head Start Program Options § 1306.33...

  16. Extension and Home-Based Business: A Collaborative Approach.

    ERIC Educational Resources Information Center

    Burns, Marilyn; Biers, Karen

    1991-01-01

    The Center for Home-Based Entrepreneurship at Oklahoma State University developed from collaborative efforts of extension, government agencies, business associations, and the vo-tech system. It provides education, directories, information services, and other assistance to people interested in establishing businesses in their homes. (SK)

  17. 45 CFR 1306.33 - Home-based program option.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... specified in 45 CFR 1304.23(b)(2) and provide appropriate snacks and meals to the children during group... 45 Public Welfare 4 2013-10-01 2013-10-01 false Home-based program option. 1306.33 Section 1306.33... PROGRAM HEAD START STAFFING REQUIREMENTS AND PROGRAM OPTIONS Head Start Program Options § 1306.33...

  18. 45 CFR 1306.33 - Home-based program option.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... specified in 45 CFR 1304.23(b)(2) and provide appropriate snacks and meals to the children during group... 45 Public Welfare 4 2014-10-01 2014-10-01 false Home-based program option. 1306.33 Section 1306.33... PROGRAM HEAD START STAFFING REQUIREMENTS AND PROGRAM OPTIONS Head Start Program Options § 1306.33...

  19. 45 CFR 1306.33 - Home-based program option.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... specified in 45 CFR 1304.23(b)(2) and provide appropriate snacks and meals to the children during group... 45 Public Welfare 4 2012-10-01 2012-10-01 false Home-based program option. 1306.33 Section 1306.33... PROGRAM HEAD START STAFFING REQUIREMENTS AND PROGRAM OPTIONS Head Start Program Options § 1306.33...

  20. Home-Based Educational Curricula for Mothers and Infants.

    ERIC Educational Resources Information Center

    Apfel, Nancy; Brion, LaRue

    This package contains five home-based intervention curricula for families with children between 12 and 30 months of age. Three independent curricula (each emphasizing children's language, play or social development) enlist the mother's aid as observer, teacher and researcher, and promote a three-way interaction among mother, child, and…

  1. An Evaluation of Home-Based Respite Care.

    ERIC Educational Resources Information Center

    Upshur, Carole C.

    1982-01-01

    Findings of an evaluation of a pilot home-based respite care program designed to serve 35 severely mentally retarded and disabled persons were reported. Results indicated that respite care services had never been previously received by 51.8% of the families. (Author/SB)

  2. Health scorecard of spacecraft platforms: Track record of on-orbit anomalies and failures and preliminary comparative analysis

    NASA Astrophysics Data System (ADS)

    Wise, Marcie A.; Saleh, Joseph H.; Haga, Rachel A.

    2011-01-01

    Choosing the "right" satellite platform for a given market and mission requirements is a major investment decision for a satellite operator. With a variety of platforms available on the market from different manufacturers, and multiple offerings from the same manufacturer, the down-selection process can be quite involved. In addition, because data for on-obit failures and anomalies per platform is unavailable, incomplete, or fragmented, it is difficult to compare options and make an informed choice with respect to the critical attribute of field reliability of different platforms. In this work, we first survey a large number of geosynchronous satellite platforms by the major satellite manufacturers, and we provide a brief overview of their technical characteristics, timeline of introduction, and number of units launched. We then analyze an extensive database of satellite failures and anomalies, and develop for each platform a "health scorecard" that includes all the minor and major anomalies, and complete failures—that is failure events of different severities—observed on-orbit for each platform. We identify the subsystems that drive these failure events and how much each subsystem contributes to these events for each platform. In addition, we provide the percentage of units in each platform which have experienced failure events, and, after calculating the total number of years logged on-orbit by each platform, we compute its corresponding average failure and anomaly rate. We conclude this work with a preliminary comparative analysis of the health scorecards of different platforms. The concept of a "health scorecard" here introduced provides a useful snapshot of the failure and anomaly track record of a spacecraft platform on orbit. As such, it constitutes a useful and transparent benchmark that can be used by satellite operators to inform their acquisition choices ("inform" not "base" as other considerations are factored in when comparing different spacecraft

  3. ¡Miranos! (Look at Us! We Are Healthy!): Home-Based and Parent Peer-Led Childhood Obesity Prevention.

    PubMed

    Sosa, Erica T; Parra-Medina, Deborah; He, Meizi; Trummer, Virginia; Yin, Zenong

    2016-09-01

    Parent interventions for childhood obesity prevention have traditionally experienced low participation rates or used passive methods such as newsletters. In contrast, the ¡Miranos! intervention home-based activities included parent-led face-to-face meetings delivered after school, take-home bags with educational materials, and scavenger hunt games to deliver health information to Head Start families regarding nutrition, physical activity, and healthy growth promotion for their preschooler. This study employed a quasi-experimental design with three intervention centers (two that received only center-based activities and one that received center- and home-based activities) and one comparison center. Data were collected on participating Head Start children and their parents/guardians and included parent attendance, parent health message recall through intercept interviews, parent knowledge through pre- and posttests, and family supportive behaviors and child health behaviors through a parent questionnaire. Parents/guardians that received both center- and home-based activities significantly increased knowledge scores (t = 2.50, degrees of freedom = 123, p < .05) and family supportive behaviors from baseline to follow-up (t = 2.12, degrees of freedom = 122, p < .05). This study demonstrates the effects home-based interventions can have when coupled with center-based activities and implemented in the center at the end of the school day. PMID:26895848

  4. Recent enhancements to and applications of the SmartBrick structural health monitoring platform

    NASA Astrophysics Data System (ADS)

    Gunasekaran, A.; Cross, S.; Patel, N.; Sedigh, S.

    2012-04-01

    The SmartBrick network is an autonomous and wireless solution for structural health monitoring of civil infrastructures. The base station is currently in its third generation and has been laboratory- and field-tested in the United States and Italy. The second generation of the sensor nodes has been laboratory-tested as of publication. In this paper, we present recent enhancements made to hardware and software of the SmartBrick platform. Salient improvements described include the development of a new base station with fully-integrated long-range GSM (cellular) and short-range ZigBee communication. The major software improvement described in this paper is migration to the ZigBee PRO stack, which was carried out in the interest of interoperability. To broaden the application of the platform to critical environments that require survivability and fault tolerance, we have striven to achieve compliance with military standards in the areas of hardware, software, and communication. We describe these efforts and present a survey of the military standards investigated. Also described is instrumentation of a three-span experimental bridge in Washington County, Missouri; with the SmartBrick platform. The sensors, whose output is conditioned and multiplexed; include strain gauges, thermocouples, push potentiometers, and three-axis inclinometers. Data collected is stored on site and reported over the cellular network. Real-time alerts are generated if any monitored parameter falls outside its acceptable range. Redundant sensing and communication provide reliability and facilitate corroboration of the data collected. A web interface is used to issue remote configuration commands and to facilitate access to and visualization of the data collected.

  5. The Analytic Information Warehouse (AIW): a Platform for Analytics using Electronic Health Record Data

    PubMed Central

    Post, Andrew R.; Kurc, Tahsin; Cholleti, Sharath; Gao, Jingjing; Lin, Xia; Bornstein, William; Cantrell, Dedra; Levine, David; Hohmann, Sam; Saltz, Joel H.

    2013-01-01

    Objective To create an analytics platform for specifying and detecting clinical phenotypes and other derived variables in electronic health record (EHR) data for quality improvement investigations. Materials and Methods We have developed an architecture for an Analytic Information Warehouse (AIW). It supports transforming data represented in different physical schemas into a common data model, specifying derived variables in terms of the common model to enable their reuse, computing derived variables while enforcing invariants and ensuring correctness and consistency of data transformations, long-term curation of derived data, and export of derived data into standard analysis tools. It includes software that implements these features and a computing environment that enables secure high-performance access to and processing of large datasets extracted from EHRs. Results We have implemented and deployed the architecture in production locally. The software is available as open source. We have used it as part of hospital operations in a project to reduce rates of hospital readmission within 30 days. The project examined the association of over 100 derived variables representing disease and co-morbidity phenotypes with readmissions in five years of data from our institution’s clinical data warehouse and the UHC Clinical Database (CDB). The CDB contains administrative data from over 200 hospitals that are in academic medical centers or affiliated with such centers. Discussion and Conclusion A widely available platform for managing and detecting phenotypes in EHR data could accelerate the use of such data in quality improvement and comparative effectiveness studies. PMID:23402960

  6. A fully-integrated aptamer-based affinity assay platform for monitoring astronaut health in space.

    SciTech Connect

    Yang, Xianbin; Durland, Ross H.; Hecht, Ariel H.; Singh, Anup K.; Sommer, Gregory Jon; Hatch, Anson V.

    2010-07-01

    Here we demonstrate the suitability of robust nucleic acid affinity reagents in an integrated point-of-care diagnostic platform for monitoring proteomic biomarkers indicative of astronaut health in spaceflight applications. A model thioaptamer targeting nuclear factor-kappa B (NF-{kappa}B) is evaluated in an on-chip electrophoretic gel-shift assay for human serum. Key steps of (i) mixing sample with the aptamer, (ii) buffer exchange, and (iii) preconcentration of sample were successfully integrated upstream of fluorescence-based detection. Challenges due to (i) nonspecific interactions with serum, and (ii) preconcentration at a nanoporous membrane are discussed and successfully resolved to yield a robust, rapid, and fully-integrated diagnostic system.

  7. Overcoming Barriers in Kidney Health-Forging a Platform for Innovation.

    PubMed

    Linde, Peter G; Archdeacon, Patrick; Breyer, Matthew D; Ibrahim, Tod; Inrig, Jula K; Kewalramani, Reshma; Lee, Celeste Castillo; Neuland, Carolyn Y; Roy-Chaudhury, Prabir; Sloand, James A; Meyer, Rachel; Smith, Kimberly A; Snook, Jennifer; West, Melissa; Falk, Ronald J

    2016-07-01

    Innovation in kidney diseases is not commensurate with the effect of these diseases on human health and mortality or innovation in other key therapeutic areas. A primary cause of the dearth in innovation is that kidney diseases disproportionately affect a demographic that is largely disenfranchised, lacking sufficient advocacy, public attention, and funding. A secondary and likely consequent cause is that the existing infrastructure supporting nephrology research pales in comparison with those for other internal medicine specialties, especially cardiology and oncology. Citing such inequities, however, is not enough. Changing the status quo will require a coordinated effort to identify and redress the existing deficits. Specifically, these deficits relate to the need to further develop and improve the following: understanding of the disease mechanisms and pathophysiology, patient engagement and activism, clinical trial infrastructure, and investigational clinical trial designs as well as coordinated efforts among critical stakeholders. This paper identifies potential solutions to these barriers, some of which are already underway through the Kidney Health Initiative. The Kidney Health Initiative is unique and will serve as a current and future platform from which to overcome these barriers to innovation in nephrology. PMID:27127187

  8. Design of a Community-Engaged Health Informatics Platform with an Architecture of Participation

    PubMed Central

    Millery, Mari; Ramos, Wilson; Lien, Chueh; Aguirre, Alejandra N.; Kukafka, Rita

    2015-01-01

    Community-engaged health informatics (CEHI) applies information technology and participatory approaches to improve the health of communities. Our objective was to translate the concept of CEHI into a usable and replicable informatics platform that will facilitate community-engaged practice and research. The setting is a diverse urban neighborhood in New York City. The methods included community asset mapping, stakeholder interviews, logic modeling, analysis of affordances in open-source tools, elicitation of use cases and requirements, and a survey of early adopters. Based on synthesis of data collected, GetHealthyHeigths.org (GHH) was developed using open-source LAMP stack and Drupal content management software. Drupal’s organic groups module was used for novel participatory functionality, along with detailed user roles and permissions. Future work includes evaluation of GHH and its impact on agency and service networks. We plan to expand GHH with additional functionality to further support CEHI by combining informatics solutions with community engagement to improve health. PMID:26958227

  9. Living Profiles: design of a health media platform for teens with special healthcare needs.

    PubMed

    Chira, Peter; Nugent, Lisa; Miller, Kimberly; Park, Tina; Donahue, Sean; Soni, Amit; Nugent, Diane; Sandborg, Christy

    2010-10-01

    Living Profiles is a health media platform in development that aggregates multiple data flows to help teens with special healthcare needs (SHCN), particularly with regard to self-management and independence. A teen-oriented personal health record (PHR) incorporates typical teen behaviors and attitudes about health and wellness, encompasses how teens perceive and convey quality of life, and aligns with data related to their chronic medical condition. We have conceived a secure personalized user interface called the Quality of Life Timeline, which will assist with the transition from pediatric care to an adult provider through modules that include a mood meter, reminder device, and teleport medicine. With this personalized PHR, teens with SHCN can better understand their condition and its effects on daily activities and life goals and vice versa; additionally, use of this PHR allows for better information sharing and communication between providers and patients. The use of a teen-oriented tool such as Living Profiles can impact teens' overall quality of life and disease self-management, important attributes for a successful transition program. PMID:20937487

  10. Design of a Community-Engaged Health Informatics Platform with an Architecture of Participation.

    PubMed

    Millery, Mari; Ramos, Wilson; Lien, Chueh; Aguirre, Alejandra N; Kukafka, Rita

    2015-01-01

    Community-engaged health informatics (CEHI) applies information technology and participatory approaches to improve the health of communities. Our objective was to translate the concept of CEHI into a usable and replicable informatics platform that will facilitate community-engaged practice and research. The setting is a diverse urban neighborhood in New York City. The methods included community asset mapping, stakeholder interviews, logic modeling, analysis of affordances in open-source tools, elicitation of use cases and requirements, and a survey of early adopters. Based on synthesis of data collected, GetHealthyHeigths.org (GHH) was developed using open-source LAMP stack and Drupal content management software. Drupal's organic groups module was used for novel participatory functionality, along with detailed user roles and permissions. Future work includes evaluation of GHH and its impact on agency and service networks. We plan to expand GHH with additional functionality to further support CEHI by combining informatics solutions with community engagement to improve health. PMID:26958227

  11. The challenges of a home-based nursing consultation business.

    PubMed

    Schulmeister, L

    1999-03-01

    The transition from working in a traditional setting to working at home alone can be challenging for new nurse consultants. Home-based consultants can use a variety of strategies to stay focused and connected, such as having a designated work area, limiting distractions, and networking. Nurse consultants can obtain information about business management from community resources, and computer on-line services offer a means of contacting other small-business owners. Ongoing business evaluations, which include professional accomplishments as well as an examination of income and expenses, help in planning. Home-based nurse consultants can increase the likelihood of business success by setting objectives, working diligently, and networking with others in the business community. PMID:10382409

  12. Foreclosure and Health in Southern Europe: Results from the Platform for People Affected by Mortgages.

    PubMed

    Vásquez-Vera, Hugo; Rodríguez-Sanz, Maica; Palència, Laia; Borrell, Carme

    2016-04-01

    Housing instability has been shown to be related to poorer health outcomes in various studies, mainly in the USA and UK. Affected individuals are more prone to psychiatric (e.g., major depression, anxiety) and physical disorders (e.g., hypertension). This situation has deteriorated with the onset of the economic crisis. One of the most affected countries is Spain, which has high rates of foreclosure and eviction that continue to rise. In response, a civil movement, The Platform for People Affected by Mortgages (PAH), works to provide solutions to its members affected by foreclosure and advocates for the right to decent housing. The aims of this study ware to describe and compare the health status of PAH members from Catalonia to a sample of the general population and to analyze the association between health status and mortgage status, foreclosure stage, and other socioeconomic variables, among members of the PAH. We conducted a cross-sectional study using a self-administered online questionnaire (2014) administered to 905 PAH members in Catalonia (>18 years; 559 women and 346 men). Results were compared with health indicators from The Health Survey of Catalonia 2013 (n = 4830). The dependent variables were poor mental health (GHQ 12 ≥ 3), and poor self-reported health (fair or poor). All analyses were stratified by sex. We computed age-standardized prevalence and prevalence ratios of poor mental and self-reported health in both samples. We also analyzed health outcomes among PAH members according to mortgage status (mortgage holders or guarantors), stage of foreclosure, and other socioeconomic variables by computing prevalence ratios from robust Poisson regression models. The prevalence of poor mental health among PAH members was 90.6 % in women and 84.4 % in men, and 15.5 and 10.2 % in the general population, respectively. The prevalence of poor self-reported health was 55.6 % in women and 39.4 % in men from the PAH, and 19.2 and 16.1 % in the general

  13. Geographic Concentration Of Home-Based Medical Care Providers.

    PubMed

    Yao, Nengliang; Ritchie, Christine; Camacho, Fabian; Leff, Bruce

    2016-08-01

    The United States faces a shortage of providers who care for homebound patients. About 5,000 primary care providers made 1.7 million home visits to Medicare fee-for-service beneficiaries in 2013, accounting for 70 percent of all home-based medical visits. Nine percent of these providers performed 44 percent of visits. However, most homebound people live more than thirty miles from a high-volume provider. PMID:27503964

  14. Home-based exercise and support programme for people with dementia and their caregivers: study protocol of a randomised controlled trial

    PubMed Central

    2011-01-01

    Background Dementia affects the mood of people with dementia but also of their caregivers. In the coming years, the number of people with dementia will increase worldwide and most of them will continue to live in the community as long as possible. Home-based psychosocial interventions reducing the depressive symptoms of both people with dementia and their caregivers in their own home are highly needed. Methods/Design This manuscript describes the design of a Randomised Controlled Trial (RCT) of the effects of a home-based exercise and support programme for people with dementia and their caregivers. The aim is to randomly assign 156 dyads (caregiver and dementia diagnosed person) to an intervention group or a comparison group. The experimental group receives a home programme in which exercise and support for the people with dementia and their caregivers are combined and integrated. The comparison group receives a minimal intervention. Primary outcomes are physical health (people with dementia) and mood (people with dementia and caregivers). In addition, to get more insight in the working components of the intervention and the impact of the intervention on the relationship of the dyads a qualitative sub-study is carried out. Discussion This study aims to contribute to an evidence-based treatment to reduce depressive symptoms among people with dementia and their caregivers independently living in the community. Trial Registration The study has been registered at the Netherlands National Trial Register (NTR), which is connected to the International Clinical Trials Registry Platform of the WHO. Trial number: NTR1802. PMID:22117691

  15. Home based versus centre based cardiac rehabilitation: Cochrane systematic review and meta-analysis

    PubMed Central

    Zawada, Anna; Jolly, Kate; Moxham, Tiffany; Taylor, Rod S

    2010-01-01

    Objective To compare the effect of home based and supervised centre based cardiac rehabilitation on mortality and morbidity, health related quality of life, and modifiable cardiac risk factors in patients with coronary heart disease. Design Systematic review. Data sources Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, Medline, Embase, CINAHL, and PsycINFO, without language restriction, searched from 2001 to January 2008. Review methods Reference lists checked and advice sought from authors. Included randomised controlled trials that compared centre based cardiac rehabilitation with home based programmes in adults with acute myocardial infarction, angina, or heart failure or who had undergone coronary revascularisation. Two reviewers independently assessed the eligibility of the identified trials and extracted data independently. Authors were contacted when possible to obtain missing information. Results 12 studies (1938 participants) were included. Most studies recruited patients with a low risk of further events after myocardial infarction or revascularisation. No difference was seen between home based and centre based cardiac rehabilitation in terms of mortality (relative risk 1.31, 95% confidence interval 0.65 to 2.66), cardiac events, exercise capacity (standardised mean difference −0.11, −0.35 to 0.13), modifiable risk factors (weighted mean difference systolic blood pressure (0.58 mm Hg, −3.29 mm Hg to 4.44 mm Hg), total cholesterol (−0.13 mmol/l, −0.31 mmol/l to 0.05 mmol/l), low density lipoprotein cholesterol (−0.15 mmol/l, −0.31 mmol/l to 0.01 mmol/l), or relative risk for proportion of smokers at follow-up (0.98, 0.73 to 1.31)), or health related quality of life, with the exception of high density lipoprotein cholesterol (−0.06, −0.11 to −0.02) mmol/l). In the home based participants, there was evidence of superior adherence. No consistent difference was seen in the healthcare costs of the two forms

  16. Do home-based exercise interventions improve outcomes for frail older people? Findings from a systematic review

    PubMed Central

    Barber, Sally E; Young, John B; Forster, Anne; Iliffe, Steve J

    2016-01-01

    Background Frailty is common in older age, and is associated with important adverse health outcomes including increased risk of disability and long-term care admission. Objectives To evaluate whether home-based exercise interventions improve outcomes for frail older people. Data sources We searched systematically for randomised controlled trials (RCTs) and cluster RCTs, with literature searching to February 2010. Study selection All trials that evaluated home-based exercise interventions for frail older people were eligible. Primary outcomes were mobility, quality of life and daily living activities. Secondary outcomes included long-term care admission and hospitalisation. Results Six RCTs involving 987 participants met the inclusion criteria. Four trials were considered of high quality. One high quality trial reported improved disability in those with moderate but not severe frailty. Meta-analysis of long-term care admission rates identified a trend towards reduced risk. Inconsistent effects on other primary and secondary outcomes were reported in the other studies. Conclusions There is preliminary evidence that home-based exercise interventions may improve disability in older people with moderate, but not severe, frailty. There is considerable uncertainty regarding effects on important outcomes including quality of life and long-term care admission. Home-based exercises are a potentially simple, safe and widely applicable intervention to prevent dependency decline for frail older people.

  17. Mobile and home-based vendors' contributions to the retail food environment in rural South Texas Mexican-origin settlements.

    PubMed

    Valdez, Zulema; Dean, Wesley R; Sharkey, Joseph R

    2012-10-01

    A growing concern with high rates of obesity and overweight among immigrant minority populations in the US has focused attention on the availability and accessibility to healthy foods in such communities. Small-scale vending in rural, impoverished and underserved areas, however, is generally overlooked; yet, this type of informal activity and source for food is particularly important in such environs, or "food desserts," where traditional forms of work and mainstream food outlets are limited or even absent. This exploratory study investigates two types of small-scale food vending that take place in rural colonias, or Mexican-origin settlements along the South Texas border with Mexico: mobile and home-based. Using a convenience sample of 23 vendors who live and work in Texas colonias, this study identifies the characteristics associated with mobile and home-based food vendors and their businesses and its contributions to the rural food environment. Findings reveal that mobile and home-based vending provides a variety of food and beverage options to colonia residents, and suggests that home-based vendors contribute a greater assortment of food options, including some healthier food items, than mobile food vendors, which offer and sell a limited range of products. Findings may contribute to the development of innovative policy solutions and interventions aimed at increasing healthy food options or reducing health disparities in immigrant communities. PMID:22531289

  18. Addition of home-based cognitive retraining to treatment as usual in first episode schizophrenia patients: A randomized controlled study

    PubMed Central

    Hegde, Shantala; Rao, Shobini L.; Raguram, Ahalya; Gangadhar, Bangalore N.

    2012-01-01

    Objective: We examined the effectiveness of a 2-month-long home-based cognitive retraining program together with treatment as usual (TAU; psychoeducation and drug therapy) on neuropsychological functions, psychopathology, and global functioning in patients with first episode schizophrenia (FES) as well as on psychological health and perception of level of family distress in their caregivers. Materials and Methods: Forty-five FES patients were randomly assigned to either treatment group receiving home-based cognitive retraining along with TAU (n=22) or to control group receiving TAU alone (n=23). Patients and caregivers received psychoeducation. Patients and one of their caregivers were assessed for the above parameters at baseline, post-assessment (2 months) and at 6-months follow-up assessment. Results: Of the 45 patients recruited, 12 in the treatment group and 11 in the control group completed post-intervention and follow-up assessments. Addition of home-based cognitive retraining along with TAU led to significant improvement in neuropsychological functions of divided attention, concept formation and set-shifting ability, and planning. Effect sizes were large, although the sample size was small. Conclusions: Home-based cognitive retraining program has shown promise. However, further studies examining this program on a larger cohort with rigorous design involving independent raters are suggested. PMID:22556432

  19. Identification of COPD patients' health status using an intelligent system in the CHRONIOUS wearable platform.

    PubMed

    Bellos, Christos C; Papadopoulos, Athanasios; Rosso, Roberto; Fotiadis, Dimitrios I

    2014-05-01

    The CHRONIOUS system offers an integrated platform aiming at the effective management and real-time assessment of the health status of the patient suffering from chronic obstructive pulmonary disease (COPD). An intelligent system is developed for the analysis and the real-time evaluation of patient's condition. A hybrid classifier has been implemented on a personal digital assistant, combining a support vector machine, a random forest, and a rule-based system to provide a more advanced categorization scheme for the early and in real-time characterization of a COPD episode. This is followed by a severity estimation algorithm which classifies the identified pathological situation in different levels and triggers an alerting mechanism to provide an informative and instructive message/advice to the patient and the clinical supervisor. The system has been validated using data collected from 30 patients that have been annotated by experts indicating 1) the severity level of the current patient's health status, and 2) the COPD disease level of the recruited patients according to the GOLD guidelines. The achieved characterization accuracy has been found 94%. PMID:24808219

  20. Issues Concerning The Development Of A Mobile Platform For Health Care Applications

    NASA Astrophysics Data System (ADS)

    Korba, Larry W.; Liscano, Ramiro; Green, David; Durie, Nelson

    1989-03-01

    There are a number of problems that must yet be overcome before robotic technology can be applied in a hospital or a home care setting. The four basic problems are: cost, safety, finding appropriate applications and developing application specific solutions. Advanced robotics technology is now costly because of the complexity associated with autonomous systems. In any application, it is most important that the safety of the individuals using or exposed to the vehicle is ensured. Often in the health care field, innovative and useful new devices require an inordinate amount of time before they are accepted. The technical and ergonomic problems associated with any application must be solved so that cost containment, safety, ease of use, and quality of life are ensured. This paper discusses these issues in relation to our own development of an autonomous vehicle for health care applications. In this advancement, a commercially available platform is being equipped with an on-board, multiprocessor computer system and a variety of sensor systems. In order to develop pertinent solutions to the technical problems, there must be a framework wherein there is a focus upon the practical issues associated with the end application.

  1. Developing Initiatives for Home-Based Child Care: Current Research and Future Directions

    ERIC Educational Resources Information Center

    Porter, Toni; Paulsell, Diane

    2011-01-01

    Home-based child care accounts for a significant share of the child care supply in the United States, especially for infants and toddlers. A synthesis of the home-based care research literature and information about recent home-based care quality initiatives points to a critical need for more systematic efforts to develop and test quality…

  2. Indian experience of home based mothers card: ICMR task force study.

    PubMed

    Abraham, S; Joshi, S; Kumar, V; Patwary, A; Pratinidhi, A; Saxena, V B; Maitra, K; Singh, K K; Saxena, N C; Saxena, B N

    1991-01-01

    To improve the quality of MCH services, a Home Based Mothers Card (HBMC) prepared and recommended by World Health Organization was adapted to Indian situation, and introduced in 1.5 lakh population of rural area covered by 6 participating centres under the aegis of Indian Council of Medical Research. Two thousand four hundred and forty six mothers were given this card and were followed up for a period of 2 years. Only 89.2 percent retrieval of the cards was possible after a period of 18 months. Screening of the population for "at risk" women monitoring and referral could be undertaken with the help of this card. Improved antenatal, and referral services were observed during the study period. The card (HBMC) was acceptable to the mothers as well as to the health workers, as a tool for improving the quality and coverage of MCH services being rendered at the Primary Health Centre. PMID:1818874

  3. Home-based care for people living with HIV/AIDS in Plateau State, Nigeria: findings from qualitative study.

    PubMed

    Agbonyitor, M

    2009-01-01

    As health-care services in Nigeria and other African countries are becoming overstrained with patients, home-based care has increasingly been touted as a possible solution. The faith-based organisation, Gospel Health and Development Services, provides a home-based care programme for people living with HIV/AIDS (PLWHA) residing in Plateau State, Nigeria. This paper assesses the challenges that PLWHA in the programme faced while maintaining their health and livelihoods. The frustrations that volunteers endured in performing their work are also described, as well as the benefits and weaknesses of the programme from the perspective of PLWHA and their volunteer caregivers. Focus groups and interviews were done with 30 PLWHA and 22 volunteers to learn about their experiences with the home-based care programme and possible areas for its improvement. From these discussions three major challenges facing PLWHA emerged: discrimination towards PLWHA; the lack of money, food, and transport to health-care centres; and the desire for closer antiretroviral drug access. PMID:19437217

  4. Developing a Service Platform Definition to Promote Evidence-Based Planning and Funding of the Mental Health Service System

    PubMed Central

    Lee, Yong Yi; Meurk, Carla S.; Harris, Meredith G.; Diminic, Sandra; Scheurer, Roman W.; Whiteford, Harvey A.

    2014-01-01

    Ensuring that a mental health system provides ‘value for money’ requires policy makers to allocate resources to the most cost-effective interventions. Organizing cost-effective interventions into a service delivery framework will require a concept that can guide the mapping of evidence regarding disorder-level interventions to aggregations of services that are meaningful for policy makers. The ‘service platform’ is an emerging concept that could be used to this end, however no explicit definition currently exists in the literature. The aim of this study was to develop a service platform definition that is consistent with how policy makers conceptualize the major elements of the mental health service system and to test the validity and utility of this definition through consultation with mental health policy makers. We derived a provisional definition informed by existing literature and consultation with experienced mental health researchers. Using a modified Delphi method, we obtained feedback from nine Australian policy makers. Respondents provided written answers to a questionnaire eliciting their views on the acceptability, comprehensibility and usefulness of a service platform definition which was subject to qualitative analysis. Overall, respondents understood the definition and found it both acceptable and useful, subject to certain conditions. They also provided suggestions for its improvement. Our findings suggest that the service platform concept could be a useful way of aggregating mental health services as a means for presenting priority setting evidence to policy makers in mental health. However, further development and testing of the concept is required. PMID:25431877

  5. Pre-Sleep and Sleeping Platform Construction Behavior in Captive Orangutans (Pongo spp.): Implications for Ape Health and Welfare.

    PubMed

    Samson, David R; Shumaker, Rob

    2015-01-01

    The nightly construction of a 'nest' or sleeping platform is a behavior that has been observed in every wild great ape population studied, yet in captivity, few analyses have been performed on sleep related behavior. Here, we report on such behavior in three female and two male captive orangutans (Pongo spp.), in a natural light setting, at the Indianapolis Zoo. Behavioral samples were generated, using infrared cameras for a total of 47 nights (136.25 h), in summer (n = 25) and winter (n = 22) periods. To characterize sleep behaviors, we used all-occurrence sampling to generate platform construction episodes (n = 217). Orangutans used a total of 2.4 (SD = 1.2) techniques and 7.5 (SD = 6.3) actions to construct a sleeping platform; they spent 10.1 min (SD - 9.9 min) making the platform and showed a 77% preference for ground (vs. elevated) sleep sites. Comparisons between summer and winter platform construction showed winter start times (17:12 h) to be significantly earlier and longer in duration than summer start times (17:56 h). Orangutans should be provisioned with seasonally appropriate, high quality materials suitable for construction of sleeping platforms to increase sleep quality and improve animal health and welfare. PMID:25998256

  6. Research on a Community-based Platform for Promoting Health and Physical Fitness in the Elderly Community

    PubMed Central

    Tsai, Tsai-Hsuan; Wong, Alice May-Kuen; Hsu, Chien-Lung; Tseng, Kevin C.

    2013-01-01

    This study aims to assess the acceptability of a fitness testing platform (iFit) for installation in an assisted living community with the aim of promoting fitness and slowing the onset of frailty. The iFit platform develops a means of testing Bureau of Health Promotion mandated health assessment items for the elderly (including flexibility tests, grip strength tests, balance tests, and reaction time tests) and integrates wireless remote sensors in a game-like environment to capture and store subject response data, thus providing individuals in elderly care contexts with a greater awareness of their own physical condition. In this study, we specifically evaluated the users’ intention of using the iFit using a technology acceptance model (TAM). A total of 101 elderly subjects (27 males and 74 females) were recruited. A survey was conducted to measure technology acceptance, to verify that the platform could be used as intended to promote fitness among the elderly. Results indicate that perceived usefulness, perceived ease of use and usage attitude positively impact behavioral intention to use the platform. The iFit platform can offer user-friendly solutions for a community-based fitness care and monitoring of elderly subjects. In summary, iFit was determined by three key drivers and discussed as follows: risk factors among the frail elderly, mechanism for slowing the advance frailty, and technology acceptance and support for promoting physical fitness. PMID:23460859

  7. Exploring pharmacy and home-based sexually transmissible infection testing

    PubMed Central

    Habel, Melissa A.; Scheinmann, Roberta; Verdesoto, Elizabeth; Gaydos, Charlotte; Bertisch, Maggie; Chiasson, Mary Ann

    2015-01-01

    Background This study assessed the feasibility and acceptability of pharmacy and home-based sexually transmissible infection (STI) screening as alternate testing venues among emergency contraception (EC) users. Methods The study included two phases in February 2011–July 2012. In Phase I, customers purchasing EC from eight pharmacies in Manhattan received vouchers for free STI testing at onsite medical clinics. In Phase II, three Facebook ads targeted EC users to connect them with free home-based STI test kits ordered online. Participants completed a self-administered survey. Results Only 38 participants enrolled in Phase I: 90% female, ≤29 years (74%), 45% White non-Hispanic and 75% college graduates; 71% were not tested for STIs in the past year and 68% reported a new partner in the past 3 months. None tested positive for STIs. In Phase II, ads led to >45 000 click-throughs, 382 completed the survey and 290 requested kits; 28% were returned. Phase II participants were younger and less educated than Phase I participants; six tested positive for STIs. Challenges included recruitment, pharmacy staff participation, advertising with discretion and cost. Conclusions This study found low uptake of pharmacy and home-based testing among EC users; however, STI testing in these settings is feasible and the acceptability findings indicate an appeal among younger women for testing in non-traditional settings. Collaborating with and training pharmacy and medical staff are key elements of service provision. Future research should explore how different permutations of expanding screening in non-traditional settings could improve testing uptake and detect additional STI cases. PMID:26409484

  8. Cost-Effectiveness of a Home Based Intervention for Secondary Prevention of Readmission with Chronic Heart Disease.

    PubMed

    Byrnes, Joshua; Carrington, Melinda; Chan, Yih-Kai; Pollicino, Christine; Dubrowin, Natalie; Stewart, Simon; Scuffham, Paul A

    2015-01-01

    The aim of this study is to consider the cost-effectiveness of a nurse-led, home-based intervention (HBI) in cardiac patients with private health insurance compared to usual post-discharge care. A within trial analysis of the Young @ Heart multicentre, randomized controlled trial along with a micro-simulation decision analytical model was conducted to estimate the incremental costs and quality adjusted life years associated with the home based intervention compared to usual care. For the micro-simulation model, future costs, from the perspective of the funder, and effects are estimated over a twenty-year time horizon. An Incremental Cost-Effectiveness Ratio, along with Incremental Net Monetary Benefit, is evaluated using a willingness to pay threshold of $50,000 per quality adjusted life year. Sub-group analyses are conducted for men and women across three age groups separately. Costs and benefits that arise in the future are discounted at five percent per annum. Overall, home based intervention for secondary prevention in patients with chronic heart disease identified in the Australian private health care sector is not cost-effective. The estimated within trial incremental net monetary benefit is -$3,116 [95% CI: -11,145, $4,914]; indicating that the costs outweigh the benefits. However, for males and in particular males aged 75 years and above, home based intervention indicated a potential to reduce health care costs when compared to usual care (within trial: -$10,416 [95% CI: -$26,745, $5,913]; modelled analysis: -$1,980 [95% CI: -$22,843, $14,863]). This work provides a crucial impetus for future research to understand for whom disease management programs are likely to benefit most. PMID:26657844

  9. Cost-Effectiveness of a Home Based Intervention for Secondary Prevention of Readmission with Chronic Heart Disease

    PubMed Central

    Byrnes, Joshua; Carrington, Melinda; Chan, Yih-Kai; Pollicino, Christine; Dubrowin, Natalie; Stewart, Simon; Scuffham, Paul A.

    2015-01-01

    The aim of this study is to consider the cost-effectiveness of a nurse-led, home-based intervention (HBI) in cardiac patients with private health insurance compared to usual post-discharge care. A within trial analysis of the Young @ Heart multicentre, randomized controlled trial along with a micro-simulation decision analytical model was conducted to estimate the incremental costs and quality adjusted life years associated with the home based intervention compared to usual care. For the micro-simulation model, future costs, from the perspective of the funder, and effects are estimated over a twenty-year time horizon. An Incremental Cost-Effectiveness Ratio, along with Incremental Net Monetary Benefit, is evaluated using a willingness to pay threshold of $50,000 per quality adjusted life year. Sub-group analyses are conducted for men and women across three age groups separately. Costs and benefits that arise in the future are discounted at five percent per annum. Overall, home based intervention for secondary prevention in patients with chronic heart disease identified in the Australian private health care sector is not cost-effective. The estimated within trial incremental net monetary benefit is -$3,116 [95%CI: -11,145, $4,914]; indicating that the costs outweigh the benefits. However, for males and in particular males aged 75 years and above, home based intervention indicated a potential to reduce health care costs when compared to usual care (within trial: -$10,416 [95%CI: -$26,745, $5,913]; modelled analysis: -$1,980 [95%CI: -$22,843, $14,863]). This work provides a crucial impetus for future research to understand for whom disease management programs are likely to benefit most. PMID:26657844

  10. Usability, learnability and performance evaluation of Intelligent Research and Intervention Software: A delivery platform for eHealth interventions.

    PubMed

    Wozney, Lori; McGrath, Patrick J; Newton, Amanda; Huguet, Anna; Franklin, Marcia; Perri, Kaitlin; Leuschen, K; Toombs, Elaine; Lingley-Pottie, Patricia

    2016-09-01

    Evaluation of an eHealth platform, Intelligent Research and Intervention Software was undertaken via cross-sectional survey of staff users and application performance monitoring. The platform is used to deliver psychosocial interventions across a range of clinical contexts, project scopes, and delivery modalities (e.g. hybrid telehealth, fully online self-managed, randomized control trials, and clinical service delivery). Intelligent Research and Intervention Software supports persuasive technology elements (e.g. tailoring, reminders, and personalization) as well as staff management tools. Results from the System Usability Scale involving 30 Staff and Administrative users across multiple projects were positive with overall mean score of 70 ("Acceptable"). The mean score for "Usability" sub-scale was 82 and for "Learnability" sub-scale 61. There were no significant differences in perceptions of usability across user groups or levels of experience. Application performance management analytics (e.g. Application Performance Index scores) across two test sites indicate the software platform is robust and reliable when compared to industry standards. Intelligent Research and Intervention Software is successfully operating as a flexible platform for creating, delivering, and evaluating eHealth interventions. PMID:26105726

  11. Home-Based Functional Electrical Stimulation Cycling Enhances Quality of Life in Individuals with Spinal Cord Injury

    PubMed Central

    2013-01-01

    Background: With advances in medicine and increased survival rates, the focus of health care after spinal cord injury (SCI) has evolved from extending life to increasing independence and quality of life (QOL). Because enhancing QOL is an ultimate goal of the rehabilitation process, research involving the improvement of QOL is of great importance. Objective: The purpose of this study was to determine the effects of a home-based functional electrical stimulation lower extremity cycling (FES-LEC) program on the QOL of persons with SCI. Design: Eleven veterans with posttraumatic C4-T11 AIS A-C SCI participated in 8 weeks of 3 times weekly home-based FES-LEC. QOL was assessed using the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire. Tests were completed by all participants prior to and after the 8-week FES-LEC program. Results: There were significant increases in the physical and environmental domain QOL scores. There were nominal nonsignificant increases in the psychological and social domain QOL scores. Conclusions: The results of this study provide evidence that home-based FES-LEC 3 times per week for 8 weeks has the potential to result in QOL improvements. PMID:24244097

  12. Serious Games for Home-based Stroke Rehabilitation.

    PubMed

    Friedrich, Raoul; Hiesel, Patrick; Peters, Sebastian; Siewiorek, Daniel P; Smailagic, Asim; Brügge, Bernd

    2015-01-01

    On average, two thousand residents in the United States experience a stroke every day. These circumstances account for $28 billion direct costs annually and given the latest predictions, these costs will more than triple by 2030. In our research, we propose a portfolio of serious games for home-based stroke rehabilitation. The objective of the game approach is to enrich the training experience and establish a higher level of compliance to prescribed exercises, while maintaining a supportive training environment as found in common therapy sessions. Our system provides a collection of mini games based on rehabilitation exercises used in conventional physical therapy, monitors the patient's performance while exercising and provides clinicians with an interface to personalize the training. The clinician can set the current state of rehabilitation and change the playable games over time to drive diversification. While the system still has to be evaluated, an early stage case study with one patient offered positive indications towards this concept. PMID:26152980

  13. Home-Based and Facility-Based Directly Observed Therapy of Tuberculosis Treatment under Programmatic Conditions in Urban Tanzania

    PubMed Central

    Hella, Jerry; Maroa, Thomas; Kisandu, Shadrack; Chiryamkubi, Magreth; Said, Khadija; Mhalu, Grace; Mkopi, Abdallah; Mutayoba, Beatrice; Reither, Klaus; Gagneux, Sébastien; Fenner, Lukas

    2016-01-01

    Introduction Decentralization of Directly Observed Treatment (DOT) for tuberculosis (TB) to the community (home-based DOT) has improved the coverage of TB treatment and reduced the burden to the health care facilities (facility-based DOT). We aimed to compare TB treatment outcomes in home-based and facility-based DOT under programmatic conditions in an urban setting with a high TB burden. Methodology A retrospective analysis of a cohort of adult TB patients (≥15 years) routinely notified between 2010 and 2013 in two representative TB sub-districts in the Temeke district, Dar es Salaam, Tanzania. We assessed differences in treatment outcomes by calculating Risk Ratios (RRs). We used logistic regression to assess the association between DOT and treatment outcomes. Results Data of 4,835 adult TB patients were analyzed, with a median age of 35 years, 2,943 (60.9%) were men and TB/HIV co-infection prevalence of 39.9%. A total of 3,593 (74.3%) patients were treated under home-based DOT. Patients on home-based DOT were more likely to die compared to patients on facility-based DOT (RR 2.04, 95% Confidence Interval [95% CI]: 1.52–2.73), and more likely to complete TB treatment (RR 1.14, 95% CI: 1.06–1.23), but less likely to have a successful treatment outcome (RR 0.94, 95% CI: 0.92–0.97). Home-based DOT was preferred by women (adjusted Odds Ratio [aOR] 1.55, 95% CI: 1.34–1.80, p<0.001), older people (aOR 1.01 for each year increase, 95% CI: 1.00–1.02, p = 0.001) and patients with extra-pulmonary TB (aOR 1.45, 95% CI: 1.16–1.81, p = 0.001), but less frequently by patients on a retreatment regimen (aOR 0.12, 95% CI: 0.08–0.19, p<0.001). Conclusions/significance TB patients under home-based DOT had more frequently risk factors of death such as older age, HIV infection and sputum smear-negative TB, and had higher mortality compared to patients under facility-based DOT. Further operational research is needed to monitor the implementation of DOT under

  14. Co-Creation With TickiT: Designing and Evaluating a Clinical eHealth Platform for Youth

    PubMed Central

    Issenman, Robert; Paone, Mary

    2013-01-01

    Background All youth are susceptible to mental health issues and engaging in risky behavior, and for youth with chronic health conditions, the consequences can be more significant than in their healthy peers. Standardized paper-based questionnaires are recommended by the American Academy of Pediatrics in community practice to screen for health risks. In hospitals, psychosocial screening is traditionally undertaken using the Home Education, Eating, Activities, Drugs, Depression, Sex, Safety (HEEADDSS) interview. However, time constraints and patient/provider discomfort reduce implementation. We report findings from an eHealth initiative undertaken to improve uptake of psychosocial screening among youth. Objective Youth are sophisticated “technology natives.” Our objective was to leverage youth’s comfort with technology, creating a youth-friendly interactive mobile eHealth psychosocial screening tool, TickiT. Patients enter data into the mobile application prior to a clinician visit. Response data is recorded in a report, which generates alerts for clinicians, shifting the clinical focus from collecting information to focused management. Design goals included improving the patient experience, improving efficiency through electronic patient based data entry, and supporting the collection of aggregated data for research. Methods This paper describes the iterative design and evaluation processes undertaken to develop TickiT including co-creation processes, and a pilot study utilizing mixed qualitative and quantitative methods. A collaborative industry/academic partnership engaged stakeholders (youth, health care providers, and administrators) in the co-creation development process. An independent descriptive study conducted in 2 Canadian pediatric teaching hospitals evaluated the feasibility of the platform in both inpatient and ambulatory clinical settings, evaluating both providers and patient responses to the platform. Results The independent pilot feasibility

  15. Analyzing the Interprofessional Working of a Home-Based Primary Care Team.

    PubMed

    Smith-Carrier, Tracy; Neysmith, Sheila

    2014-09-01

    Increasingly, interprofessional teams are responsible for providing integrated health care services. Effective teams, however, are not the result of chance but require careful planning and ongoing attention to team processes. Based on a case study involving interviews, participant observation, and a survey, we identified key attributes for effective interprofessional working (IPW) within a home-based primary care (HBPC) setting. Recognizing the importance of a theoretical model that reflects the multidimensional nature of team effectiveness research, we employed the integrated team effectiveness model to analyze our findings. The results indicated that a shared vision, common goals, respect, and trust among team members – as well as processes for ongoing communication, effective leadership, and mechanisms for conflict resolution – are vital in the development of a high-functioning IPW team. The ambiguity and uncertainty surrounding the context of service provision (clients' homes), as well the negotiation of external relationships in the HBPC field, require further investigation. PMID:26261888

  16. Geographic Health Information Systems: A Platform To Support The ‘Triple Aim’

    PubMed Central

    Miranda, Marie Lynn; Ferranti, Jeffrey; Strauss, Benjamin; Neelon, Brian; Califf, Robert M.

    2014-01-01

    Despite the rapid growth of electronic health data, most data systems do not connect individual patient records to data sets from outside the health care delivery system. These isolated data systems cannot support efforts to recognize or address how the physical and environmental context of each patient influences health choices and health outcomes. In this article we describe how a geographic health information system in Durham, North Carolina, links health system and social and environmental data via shared geography to provide a multidimensional understanding of individual and community health status and vulnerabilities. Geographic health information systems can be useful in supporting the Institute for Healthcare Improvement’s Triple Aim Initiative to improve the experience of care, improve the health of populations, and reduce per capita costs of health care. A geographic health information system can also provide a comprehensive information base for community health assessment and intervention for accountable care that includes the entire population of a geographic area. PMID:24019366

  17. Geographic health information systems: a platform to support the 'triple aim'.

    PubMed

    Miranda, Marie Lynn; Ferranti, Jeffrey; Strauss, Benjamin; Neelon, Brian; Califf, Robert M

    2013-09-01

    Despite the rapid growth of electronic health data, most data systems do not connect individual patient records to data sets from outside the health care delivery system. These isolated data systems cannot support efforts to recognize or address how the physical and environmental context of each patient influences health choices and health outcomes. In this article we describe how a geographic health information system in Durham, North Carolina, links health system and social and environmental data via shared geography to provide a multidimensional understanding of individual and community health status and vulnerabilities. Geographic health information systems can be useful in supporting the Institute for Healthcare Improvement's Triple Aim Initiative to improve the experience of care, improve the health of populations, and reduce per capita costs of health care. A geographic health information system can also provide a comprehensive information base for community health assessment and intervention for accountable care that includes the entire population of a geographic area. PMID:24019366

  18. Development and feasibility of a home-based education model for families of children with sickle cell disease

    PubMed Central

    2014-01-01

    Background Children with sickle cell disease (SCD) commonly have cognitive deficits, even among toddlers. Much medical literature emphasizes disease-based factors to account for these deficits. However, the social environment plays a large role in child development. To address the specific needs of early childhood, a monthly hospital-based education program was initiated to educate parents about child development. Education sessions were poorly attended (20-25%) and deemed unsuccessful. This study describes the development and implementation of a home-based education service to teach parents about SCD, developmental milestones and positive parenting techniques. Methods This was a prospective, single-arm intervention to study the feasibility of a home-based caregiver education program for families with infants and toddlers with SCD. Parents of children aged 0-3 years with SCD from one Midwestern hospital were approached to participate in a home-based program. The program followed the Born to Learn™ curriculum provided through the Parents as Teachers™ National Center. Reminder calls or texts were provided the day before each visit. Results of the first twenty-six months of the program are presented. Results A total of 62% (56 of 91) of families approached agreed to participate; all were African American. The majority of caregivers were single mothers with a high school education or less and whose children had Medicaid for health coverage. The phenotypes of SCD represented in this sample were similar to those in the general SCD population. Over 26 months, 39 families received at least one home visit. Parents of infants (younger than 8 months) were more likely to participate in the home-based education program than parents of older children, (Fisher’s exact test, p < .001). Conclusions For participating families, home-based visits were a feasible method for reinforcing clinic education. About 43% of eligible families participated in the education, a two

  19. Free love: a case study of church-run home-based caregivers in a high vulnerability setting.

    PubMed

    Root, Robin; van Wyngaard, Arnau

    2011-01-01

    The purpose of this study is to explore the concept of religious health assets (RHA) and its relevance to HIV/AIDS. This manuscript describes the experiences of caregivers with a church-run home-based care organisation in Swaziland, site of the world's highest HIV prevalence (42%). In light of reduced antiretroviral treatment rollout in some areas of Africa, strengthening mechanisms of treatment support with HIV prevention has never been more critical. One modality may be community home-based care (CHBC), a core feature of the World Bank's Multi-Country HIV/AIDS Program for Africa. Yet, these entities, and the frontline activities of local congregations, remain underexplored. Part of a larger anthropological study of religion and HIV/AIDS in Swaziland, this manuscript draws on 20 semi-structured caregiver interviews to discern patterns in motivations; perceived client needs; care practices; and meanings of religiosity. Thirteen participants were care coordinators who oversaw approximately 455 caregivers across nearly half of the 22 communities served. Grounded theory analysis suggested that caregivers facilitated vital decisions around HIV testing, HIV disclosure, treatment uptake/adherence, as well as reduced HIV stigma. Also salient was the importance of a Christian ethos, in the form of 'talk' and 'love', as critical culturally situated care practices. Having expanded to an estimated 600 caregivers and 2500 home-based clients between 2006 and 2009, Participants' reports intimated their roles as agents of broader social transformation. This article contributes to the expanding study of RHA and challenges authoritative global public health strategies that have largely marginalised local religious aspects of HIV/AIDS. Future applied research examining how 'home' and 'church' may be vital public health settings outside of, but integral to, formal health services and HIV programming is warranted. PMID:21728893

  20. Establishment and Evaluation of Biotechnological Platform for Screening Health Food with Antiinflammation Ability

    PubMed Central

    Hsieh, Wang-Ju; Chiou, Shih-Ting; Pan, Min-Hsiung; Hsieh, Shu-Chen

    2012-01-01

    Chronic inflammation leads to a progressive inflammation in certain types of cells. Recent studies report that the activation of nuclear factor kappa B (NF-κB) increases the expression of inflammation-related protein such as inducible nitric oxide synthase (iNOS), and cyclooxygenase-2 (COX-2), which further enhance the chronic inflammation, thus conduct the development of disorders. The aim of the study is to develop an efficient method for screening food components with anti-inflammation function. Here we employed a reporter plasmid, which contains NF-κB response element followed by a minimal promoter for driving the down-stream luciferase reporter gene. After transfection of this plasmid to a mouse cell line RAW264.7, we obtained stable clones by using Hygromycin selection. Our results reveal that the luciferase activity of the cell based platform can be induced by the inflammation inducing reagent LPS and can be further suppressed by the administration of CAPE, an anti-inflammation chemical. The results estimated by our platform present good correlation to that analyzed by RT-Q-PCR. Additionally, the known anti-inflammation factors such as resveratrol, significantly counteracted the effect of LPS on our platform. Furthermore, the screening result of various mushroom extract showed that some fractions revealed NF-κB activating effects. Therefore, we conclude that the platform is effective in large scale screening for inflammatory regulating compounds. PMID:24716118

  1. Predictors of caregiver burden across the home-based palliative care trajectory in Ontario, Canada.

    PubMed

    Guerriere, Denise; Husain, Amna; Zagorski, Brandon; Marshall, Denise; Seow, Hsien; Brazil, Kevin; Kennedy, Julia; Burns, Sheri; Brooks, Heather; Coyte, Peter C

    2016-07-01

    Family caregivers of patients enrolled in home-based palliative care programmes provide unpaid care and assistance with daily activities to terminally ill family members. Caregivers often experience caregiver burden, which is an important predictor of anxiety and depression that can extend into bereavement. We conducted a longitudinal, prospective cohort study to comprehensively assess modifiable and non-modifiable patient and caregiver factors that account for caregiver burden over the palliative care trajectory. Caregivers (n = 327) of patients with malignant neoplasm were recruited from two dedicated home-based palliative care programmes in Southern Ontario, Canada from 1 July 2010 to 31 August 2012. Data were obtained from bi-weekly telephone interviews with caregivers from study admission until death, and from palliative care programme and home-care agency databases. Information collected comprised patient and caregiver demographics, utilisation of privately and publicly financed resources, patient clinical status and caregiver burden. The average age of the caregivers was 59.0 years (SD: 13.2), and almost 70% were female. Caregiver burden increased over time in a non-linear fashion from study admission to patient death. Increased monthly unpaid care-giving time costs, monthly public personal support worker costs, emergency department visits and low patient functional status were associated with higher caregiver burden. Greater use of hospice care was associated with lower burden. Female caregivers tended to report more burden compared to men as death approached, and burden was higher when patients were male. Low patient functional status was the strongest predictor of burden. Understanding the influence of modifiable and non-modifiable factors on the experience of burden over the palliative trajectory is essential for the development and targeting of programmes and policies to support family caregivers and reduce burden. Supporting caregivers can have

  2. Cost Analysis of a Home-Based Nurse Care Coordination Program

    PubMed Central

    Marek, Karen Dorman; Stetzer, Frank; Adams, Scott J; Bub, Linda Denison; Schlidt, Andrea; Colorafi, Karen Jiggins

    2014-01-01

    Objectives To determine whether a home-based care coordination program focused on medication self-management would affect the cost of care to the Medicare program and whether the addition of technology, a medication-dispensing machine, would further reduce cost. Design Randomized, controlled, three-arm longitudinal study. Setting Participant homes in a large Midwestern urban area. Participants Older adults identified as having difficulty managing their medications at discharge from Medicare Home Health Care (N = 414). Intervention A team consisting of advanced practice nurses (APNs) and registered nurses (RNs) coordinated care for two groups: home-based nurse care coordination (NCC) plus a pill organizer group and NCC plus a medication-dispensing machine group. Measurements To measure cost, participant claims data from 2005 to 2011 were retrieved from Medicare Part A and B Standard Analytical Files. Results Ordinary least squares regression with covariate adjustment was used to estimate monthly dollar savings. Total Medicare costs were $447 per month lower in the NCC plus pill organizer group (P = .11) than in a control group that received usual care. For participants in the study at least 3 months, total Medicare costs were $491 lower per month in the NCC plus pill organizer group (P = .06) than in the control group. The cost of the NCC plus pill organizer intervention was $151 per month, yielding a net savings of $296 per month or $3,552 per year. The cost of the NCC plus medication-dispensing machine intervention was $251 per month, and total Medicare costs were $409 higher per month than in the NCC plus pill organizer group. Conclusion Nurse care coordination plus a pill organizer is a cost-effective intervention for frail elderly Medicare beneficiaries. The addition of the medication machine did not enhance the cost effectiveness of the intervention. PMID:25482242

  3. Home-based radiology transcription and a productivity pay plan.

    PubMed

    Kerr, K

    1997-01-01

    Shands Hospital in Gainesville, Fla., decided to evaluate the way it provided transcription services in its radiology department. It identified four goals: increased productivity, decreased operating expense, finding much needed space in the radiology department and increasing employee morale. The department performs 165,000 procedures annually, with 66 radiologists, 29 faculty, and 37 residents and fellows on staff. Six FTEs comprised the transcription pool in the radiology department, with transcription their only duty. Transcriptionists were paid an hourly rate based on their years of service, not their productivity. Evaluation and measurement studies were undertaken by the hospital's management systems engineering department. The transcriptionists' hours were then changed to provide coverage during the periods of heaviest dictation. The productivity level of the transcription staff was also measured and various methods of measurement reviewed. The goal was a pure incentive pay plan that would reward employees for every increase in productivity. The incentive pay plan was phased in over a three-month period. Transcriptionists were paid for work performed, with no base pay beyond minimum wage. The move to home-based transcription was planned. The necessary equipment was identified and various issues specific to working at home were addressed. Approximately six months later, the transcriptionists were set up to work at home. The astounding results achieved are presented: 28% increase in productivity, operational cost savings exceeding $25,000 and a space savings of 238 square feet. PMID:10164979

  4. Developmental Characteristics of Home-Based Counselors: A Key to Serving At-Risk Families

    ERIC Educational Resources Information Center

    Lawson, Gerard; Foster, Victoria

    2005-01-01

    Home-based counseling is an incredibly demanding intervention, yet little is known about the counselors providing this important service. This study sought to profile ego development, conceptual complexity, and supervision satisfaction for 120 home-based counselors. Counselors scored at moderate levels on measures of both ego development and…

  5. Family Members Providing Home-Based Palliative Care to Older Adults: The Enactment of Multiple Roles

    ERIC Educational Resources Information Center

    Clemmer, Sarah J.; Ward-Griffin, Catherine; Forbes, Dorothy

    2008-01-01

    Canadians are experiencing increased life expectancy and chronic illness requiring end-of-life care. There is limited research on the multiple roles for family members providing home-based palliative care. Based on a larger ethnographic study of client-family-provider relationships in home-based palliative care, this qualitative secondary analysis…

  6. Latino Parent Home-Based Practices that Bolster Student Academic Persistence

    ERIC Educational Resources Information Center

    Mena, Jasmine A.

    2011-01-01

    Home-based parental involvement practices (i.e., educational encouragement, monitoring, and support) and their impact on students' academic persistence were investigated with a sample of 137, ninth-grade Latino students in a northeast high school. Structural Equation Modeling results indicate that the relationship between home-based parental…

  7. Entrepreneurial Checklist Tool for Beginning Farm and Home-Based Businesses

    ERIC Educational Resources Information Center

    Rafie, A. R.; Nartea, Theresa

    2012-01-01

    Extension educators entertain frequent questions on beginning a farm or starting a home-based business. Retired, unemployed, and displaced workers consider starting a small farm or home-based business. Determining educational needs or individual business aptitude is time consuming. Lengthy and comprehensive skill-based checklists exist for…

  8. Employees’ views on home-based, after-hours telephone triage by Dutch GP cooperatives

    PubMed Central

    2013-01-01

    Background Dutch out-of-hours (OOH) centers find it difficult to attract sufficient triage staff. They regard home-based triage as an option that might attract employees. Specially trained nurses are supposed to conduct triage by telephone from home for after-hours medical care. The central aim of this research is to investigate the views of employees of OOH centers in The Netherlands on home-based telephone triage in after-hours care. Methods The study is a Q methodology study. Triage nurses, general practitioners (GPs) and managers of OOH centers ranked 36 opinion statements on home-based triage. We interviewed 10 participants to help develop and validate the statements for the Q sort, and 77 participants did the Q sort. Results We identified four views on home-based telephone triage. Two generally favor home-based triage, one highlights some concerns and conditions, and one opposes it out of concern for quality. The four views perceive different sources of credibility for nurse triagists working from home. Conclusion Home-based telephone triage is a controversial issue among triage nurses, GPs and managers of OOH centers. By identifying consensus and dissension among GPs, triagists, managers and regulators, this study generates four perspectives on home-based triage. In addition, it reveals the conditions considered important for home-based triage. PMID:24188407

  9. Home-Based Preschool Education: Leaders' Guide for Inservice Training Filmstrips (Educator 1, 2, 3, 4).

    ERIC Educational Resources Information Center

    1973

    This guide is to be used by leaders of inservice training workshops for instructors of parent study groups interested in learning new parenting skills that will foster home-based preschool education. The introduction provides suggestions on how a school might begin a program of school-sponsored, home-based early childhood education. The guidelines…

  10. A Cost-Effectiveness Analysis of a Home-Based HIV Counselling and Testing Intervention versus the Standard (Facility Based) HIV Testing Strategy in Rural South Africa

    PubMed Central

    Tabana, Hanani; Nkonki, Lungiswa; Hongoro, Charles; Doherty, Tanya; Ekström, Anna Mia; Naik, Reshma; Zembe-Mkabile, Wanga; Jackson, Debra; Thorson, Anna

    2015-01-01

    Introduction There is growing evidence concerning the acceptability and feasibility of home-based HIV testing. However, less is known about the cost-effectiveness of the approach yet it is a critical component to guide decisions about scaling up access to HIV testing. This study examined the cost-effectiveness of a home-based HIV testing intervention in rural South Africa. Methods Two alternatives: clinic and home-based HIV counselling and testing were compared. Costs were analysed from a provider’s perspective for the period of January to December 2010. The outcome, HIV counselling and testing (HCT) uptake was obtained from the Good Start home-based HIV counselling and testing (HBHCT) cluster randomised control trial undertaken in KwaZulu-Natal province. Cost-effectiveness was estimated for a target population of 22,099 versus 23,864 people for intervention and control communities respectively. Average costs were calculated as the cost per client tested, while cost-effectiveness was calculated as the cost per additional client tested through HBHCT. Results Based on effectiveness of 37% in the intervention (HBHCT) arm compared to 16% in control arm, home based testing costs US$29 compared to US$38 per person for clinic HCT. The incremental cost effectiveness per client tested using HBHCT was $19. Conclusions HBHCT was less costly and more effective. Home-based HCT could present a cost-effective alternative for rural ‘hard to reach’ populations depending on affordability by the health system, and should be considered as part of community outreach programs. PMID:26275059

  11. Compact handheld low-cost biosensor platform for remote health monitoring

    NASA Astrophysics Data System (ADS)

    Hastanin, J.; Lenaerts, C.; Gailly, P.; Jans, H.; Huang, C.; Lagae, L.; Kokkinos, D.; Fleury-Frenette, K.

    2016-04-01

    In this paper, we present an original concept of plasmonic-related instrumentation platform dedicated to diagnostic biosensing tests out of the laboratory. The developed instrumental platform includes both disposable one-use microfluidic affinity biochip and compact optical readout device for biochip monitoring involving mobile Internet devices for data processing and communication. The biochip includes both microfluidic and optical coupling structures formed into a single plastic slab. The microfluidic path of the biochip operates in passive capillary pumping mode. In the proof-of-concept prototype, we address specifically the sensing format involving Surface Plasmon Resonance phenomenon. The biochip is plugged in the readout device without the use of an index matching fluid. An essential advantage of the developed biochip is that its implementation involves conventional hot embossing and thin film deposition process, perfectly suited for mass production of low-cost microfluidic biochip for biochemical applications.

  12. An eHealth Platform to Manage Chronic Disease in Primary Care: An Innovative Approach.

    PubMed

    Talboom-Kamp, Esther Pwa; Verdijk, Noortje A; Harmans, Lara M; Numans, Mattijs E; Chavannes, Niels H

    2016-01-01

    The number of individuals with chronic illness and multimorbidity is growing due to the rapid ageing of the population and the greater longevity of individuals. This causes an increasing workload in care, which results in a growing need for structural changes of the health care system. In recent years this led to a strong focus on promoting "self-management" in chronically ill patients. Research showed that patients who understand more about their disease, health, and lifestyle have better experiences and health outcomes, and often use less health care resources; the effect is even more when these patients are empowered to and responsible for managing their health and disease. In addition to the skills of patients, health care professionals need to shift to a role of teacher, partner, and professional supervisor of their patients. One way of supervising patients is by the use of electronic health (eHealth), which helps patients manage and control their disease. The application of eHealth solutions can provide chronically ill patients high-quality care, to the satisfaction of both patients and health care professionals, alongside a reduction in health care consumption and costs. PMID:26860333

  13. An eHealth Platform to Manage Chronic Disease in Primary Care: An Innovative Approach

    PubMed Central

    Verdijk, Noortje A; Harmans, Lara M; Numans, Mattijs E; Chavannes, Niels H

    2016-01-01

    The number of individuals with chronic illness and multimorbidity is growing due to the rapid ageing of the population and the greater longevity of individuals. This causes an increasing workload in care, which results in a growing need for structural changes of the health care system. In recent years this led to a strong focus on promoting “self-management” in chronically ill patients. Research showed that patients who understand more about their disease, health, and lifestyle have better experiences and health outcomes, and often use less health care resources; the effect is even more when these patients are empowered to and responsible for managing their health and disease. In addition to the skills of patients, health care professionals need to shift to a role of teacher, partner, and professional supervisor of their patients. One way of supervising patients is by the use of electronic health (eHealth), which helps patients manage and control their disease. The application of eHealth solutions can provide chronically ill patients high-quality care, to the satisfaction of both patients and health care professionals, alongside a reduction in health care consumption and costs. PMID:26860333

  14. A randomized controlled trial of telephone-mentoring with home-based walking preceding rehabilitation in COPD

    PubMed Central

    Cameron-Tucker, Helen Laura; Wood-Baker, Richard; Joseph, Lyn; Walters, Julia A; Schüz, Natalie; Walters, E Haydn

    2016-01-01

    Purpose With the limited reach of pulmonary rehabilitation (PR) and low levels of daily physical activity in chronic obstructive pulmonary disease (COPD), a need exists to increase daily exercise. This study evaluated telephone health-mentoring targeting home-based walking (tele-rehab) compared to usual waiting time (usual care) followed by group PR. Patients and methods People with COPD were randomized to tele-rehab (intervention) or usual care (controls). Tele-rehab delivered by trained nurse health-mentors supported participants’ home-based walking over 8–12 weeks. PR, delivered to both groups simultaneously, included 8 weeks of once-weekly education and self-management skills, with separate supervised exercise. Data were collected at three time-points: baseline (TP1), before (TP2), and after (TP3) PR. The primary outcome was change in physical capacity measured by 6-minute walk distance (6MWD) with two tests performed at each time-point. Secondary outcomes included changes in self-reported home-based walking, health-related quality of life, and health behaviors. Results Of 65 recruits, 25 withdrew before completing PR. Forty attended a median of 6 (4) education sessions. Seventeen attended supervised exercise (5±2 sessions). Between TP1 and TP2, there was a statistically significant increase in the median 6MWD of 12 (39.1) m in controls, but no change in the tele-rehab group. There were no significant changes in 6MWD between other time-points or groups, or significant change in any secondary outcomes. Participants attending supervised exercise showed a nonsignificant improvement in 6MWD, 12.3 (71) m, while others showed no change, 0 (33) m. The mean 6MWD was significantly greater, but not clinically meaningful, for the second test compared to the first at all time-points. Conclusion Telephone-mentoring for home-based walking demonstrated no benefit to exercise capacity. Two 6-minute walking tests at each time-point may not be necessary. Supervised exercise

  15. A Food in Health Security (FIHS) platform in the Asia-Pacific Region: the way forward.

    PubMed

    Wahlqvist, Mark L; Keatinge, John Donough H; Butler, Colin D; Friel, Sharon; McKay, John; Easdown, Warwick; Kuo, Ken N; Huang, Ching-jang; Pan, Wen-Harn; Yang, Ray-Yu; Lee, Meei-Shyuan; Chang, Hsing-Yi; Chiu, Ya-Wen; Jaron, Dov; Krawinkel, Michael; Barlow, Snow; Walsh, Greg; Chiang, Tung-liang; Huang, Po-Chao; Li, Duo

    2009-01-01

    The advent of multiple global crises, especially those of climate change, economics, energy, water, food and health evident in 2008, is of considerable moment to those who are suffering their consequences and for those with responsibility and interest in the systems affected. A coalition of parties in the Asia Pacific Region who work in the food and health systems met in August, 2009 in Taiwan and instigated a Food in Health Security (FIHS) Network which might join with other like-minded networks in and beyond the region. Sustainable health has many dimensions, among which food and nutrition is often neglected; there is a wide spectrum of nutritionally-related disorders. Malnutrition remains the global concern for agricultural research and development scientists and linkage with the health sector is key to progress. The disconnect between agricultural and health sectors negatively impacts consumer nutrition and health. Ethical and equity affect food and health systems. Food and health security is attainable only when the underlying social inequities are addressed; it is an ethical issue as reflected in the UN Universal declaration of Human Rights which includes the right to food for health and well-being. Food and health security are part of the larger security agenda and merit corresponding attention. Policy recommendations with immediacy are greater investment in combined food and health research; an Asia Pacific security agenda which emphasizes planetary, human, health and food security as relevant to traditional defence security; and community and household security measures which include maternal literacy, communication technology and entrepreneurial opportunity. PMID:19965367

  16. Impact of an mHealth Platform for Pregnancy on Nutrition and Lifestyle of the Reproductive Population: A Survey

    PubMed Central

    Van Dijk, Matthijs R; Huijgen, Nicole A; Willemsen, Sten P; Laven, Joop SE; Steegers, Eric AP

    2016-01-01

    Background Poor nutrition and lifestyle behaviors exert detrimental effects on reproduction and health during the life course. Therefore, lifestyle interventions during the periconceptional period can improve fertility, pregnancy outcome, and health of subsequent generations. Objective This survey investigates the compliance, usability, and initial effectiveness of the Web-based mHealth platform, Smarter Pregnancy. Methods A free subscription to the mHealth platform, Smarter Pregnancy, was provided to couples contemplating pregnancy (n=1275) or already pregnant (n=603). After baseline identification of inadequate nutrition and lifestyle behaviors, a personal online coaching program of 6 months was generated. Using multiple imputation and the generalized estimating equation model with independent correlations, we estimated the changes from inadequate to adequate nutrition and lifestyle behaviors over time. Subgroup analyses were performed for (1) overweight and obese women (body mass index [BMI] ≥25 kg/m2), (2) pregnant women at the start of the program, and (3) couples. Results A 64.86% (1218/1878) compliance rate was observed and 54.7% (range 39.2-73.4%) of participants rated the program usability as positive or very positive. Adequate nutrition and lifestyle behaviors at baseline were 21.57% (405/1878) for vegetable intake, 52.61% (988/1878) for fruit intake, 85.44% (1303/1525) for folic acid use, 86.79% (1630/1878) for no tobacco use, and 64.43% (1210/1878) for no alcohol consumption. After 6 months of coaching, these lifestyle behaviors improved by 26.3% (95% CI 23.0-29.9) for vegetable intake, 38.4% (95% CI 34.5-42.5) for fruit intake, 56.3% (95% CI 48.8-63.6) for folic acid use, 35.1% (95% CI 29.1-41.6) for no tobacco use, and 41.9% (95% CI 35.2-48.9) for no alcohol consumption. The program showed the strongest effectiveness for participating couples. Conclusions This novel Web-based mHealth platform shows high compliance and usability, and users

  17. Integration proposal through standard-based design of an end-to-end platform for p-Health environments.

    PubMed

    Martíínez, I; Trigo, J D; Martínez-Espronceda, M; Escayola, J; Muñoz, P; Serrano, L; García, J

    2009-01-01

    Interoperability among medical devices and compute engines in the personal environment of the patient, and with healthcare information systems in the remote monitoring and management process is a key need that requires developments supported on standard-based design. Even though there have been some international initiatives to combine different standards, the vision of an entire end-to-end standard-based system is the next challenge. This paper presents the implementation guidelines of a ubiquitous platform for Personal Health (p-Health). It is standard-based using the two main medical norms in this context: ISO/IEEE11073 in the patient environment for medical device interoperability, and EN13606 to allow the interoperable communication of the Electronic Healthcare Record of the patient. Furthermore, the proposal of a new protocol for End-to-End Standard Harmonization (E2ESHP) is presented in order to make possible the end-to-end standard integration. The platform has been designed to comply with the last ISO/IEEE11073 and EN13606 available versions, and tested in a laboratory environment as a proof-of-concept to illustrate its feasibility as an end-to-end standard-based solution. PMID:19963613

  18. Home-Based Telehealth Hospitalization for Exacerbation of Chronic Obstructive Pulmonary Disease: Findings from “The Virtual Hospital” Trial

    PubMed Central

    Laursen, Lars C.; Rydahl-Hansen, Susan; Østergaard, Birte; Gerds, Thomas Alexander; Emme, Christina; Schou, Lone; Phanareth, Klaus

    2015-01-01

    Abstract Background: Telehealth interventions for patients with chronic obstructive pulmonary disease (COPD) have focused primarily on stable outpatients. Telehealth designed to handle the acute exacerbation that normally requires hospitalization could also be of interest. The aim of this study was to compare the effect of home-based telehealth hospitalization with conventional hospitalization for exacerbation in severe COPD. Materials and Methods: A two-center, noninferiority, randomized, controlled effectiveness trial was conducted between June 2010 and December 2011. Patients with severe COPD admitted because of exacerbation were randomized 1:1 either to home-based telehealth hospitalization or to continue standard treatment and care at the hospital. The primary outcome was treatment failure defined as re-admission due to exacerbation in COPD within 30 days after initial discharge. The noninferiority margin was set at 20% of the control group's risk of re-admission. Secondary outcomes were mortality, need for manual or mechanical ventilation or noninvasive ventilation, length of hospitalization, physiological parameters, health-related quality of life, user satisfaction, healthcare costs, and adverse events. Results: In total, 57 patients were randomized: 29 participants in the telehealth group and 28 participants in the control group. Testing the incidence of re-admission within 30 days after discharge could not confirm noninferiority (lower 95% confidence limit [CL], −24.8%; p=0.35). Results were also nonsignificant at 90 days (lower 95% CL, −16.2%; p=0.33) and 180 days (lower 95% CL, −16.6%; p =0.33) after discharge. Superiority testing on secondary outcomes showed nonsignificant differences between groups. Healthcare costs have not yet been evaluated. Conclusions: Whether home-based telehealth hospitalization is noninferior to conventional hospitalization requires further investigation. The results indicate that a subgroup of patients with severe COPD

  19. Can Home-Based HIV Rapid Testing Reduce HIV Disparities Among African Americans in Miami?

    PubMed

    Kenya, Sonjia; Okoro, Ikenna S; Wallace, Kiera; Ricciardi, Michael; Carrasquillo, Olveen; Prado, Guillermo

    2016-09-01

    Sixty percent of African Americans have had an HIV test, yet this population disproportionately contributes to AIDS mortality, suggesting that testing is not occurring early enough to achieve optimal outcomes. OraQuick, the first Food and Drug Administration-approved home-based HIV rapid test (HBHRT) could potentially increase testing rates. We assessed whether community health workers (CHWs) paired with HBRHT could improve HIV screening and health care access among African Americans in Miami, Florida. In October-November 2013, 60 African Americans were enrolled and randomized to the experimental condition, which received CHW assistance to complete HBHRT, or the control condition, which were instructed to complete HBHRT independently. Intervention participants were significantly (p ≤ .05) more likely than control participants to complete HBHRT and, if positive, get linked to HIV care (100% vs. 83%) χ(2) (1, N = 60) = 5.46, p ≤ .02. We concluded that CHW-assisted HBHRT may be a promising strategy to improve HIV testing and care among African Americans. PMID:27091604

  20. Mobile voice health monitoring using a wearable accelerometer sensor and a smartphone platform

    PubMed Central

    Mehta, Daryush D.; Zañartu, Matías; Feng, Shengran W.; Cheyne, Harold A.; Hillman, Robert E.

    2012-01-01

    Many common voice disorders are chronic or recurring conditions that are likely to result from faulty and/or abusive patterns of vocal behavior, referred to generically as vocal hyperfunction. An ongoing goal in clinical voice assessment is the development and use of noninvasively derived measures to quantify and track the daily status of vocal hyperfunction so that the diagnosis and treatment of such behaviorally based voice disorders can be improved. This paper reports on the development of a new, versatile, and cost-effective clinical tool for mobile voice monitoring that acquires the high-bandwidth signal from an accelerometer sensor placed on the neck skin above the collarbone. Using a smartphone as the data acquisition platform, the prototype device provides a user-friendly interface for voice use monitoring, daily sensor calibration, and periodic alert capabilities. Pilot data are reported from three vocally normal speakers and three subjects with voice disorders to demonstrate the potential of the device to yield standard measures of fundamental frequency and sound pressure level and model-based glottal airflow properties. The smartphone-based platform enables future clinical studies for the identification of the best set of measures for differentiating between normal and hyperfunctional patterns of voice use. PMID:22875236

  1. Self-delivered home-based mirror therapy for lower limb phantom pain.

    PubMed

    Darnall, Beth D

    2009-01-01

    Home-based patient-delivered mirror therapy is a promising approach in the treatment of phantom limb pain. Previous studies and case reports of mirror therapy have used a therapist-guided, structured protocol of exercises. No case report has described treatment for either upper or lower limb phantom pain by using home-based patient-delivered mirror therapy. The success of this case demonstrates that home-based patient-delivered mirror therapy may be an efficacious, low-cost treatment option that would eliminate many traditional barriers to care. PMID:19096290

  2. The Incidence and Wage Consequences of Home-Based Work in the United States, 1980-2000

    ERIC Educational Resources Information Center

    Oettinger, Gerald S.

    2011-01-01

    This study documents the rapid growth in home-based wage and salary employment and the sharp decline in the home-based wage penalty in the United States between 1980 and 2000. These twin patterns, observed for both men and women in most occupation groups, suggest that employer costs of providing home-based work arrangements have decreased.…

  3. HOME-BASED THERAPY FOR OEDEMATOUS MALNUTRITION WITH READY-TO-USE THERAPEUTIC FOOD

    Technology Transfer Automated Retrieval System (TEKTRAN)

    BACKGROUND: Standard recommendations are that children with oedematous malnutrition receive inpatient therapy with a graduated feeding regimen. Aim: To investigate exclusive home-based therapy for children with oedematous malnutrition. METHODS: Children with oedematous malnutrition, good appetite, a...

  4. Data Safe Havens and Trust: Toward a Common Understanding of Trusted Research Platforms for Governing Secure and Ethical Health Research

    PubMed Central

    Nicholls, Jacqueline; Dobbs, Christine; Sethi, Nayha; Cunningham, James; Ainsworth, John; Heaven, Martin; Peacock, Trevor; Peacock, Anthony; Jones, Kerina; Laurie, Graeme; Kalra, Dipak

    2016-01-01

    In parallel with the advances in big data-driven clinical research, the data safe haven concept has evolved over the last decade. It has led to the development of a framework to support the secure handling of health care information used for clinical research that balances compliance with legal and regulatory controls and ethical requirements while engaging with the public as a partner in its governance. We describe the evolution of 4 separately developed clinical research platforms into services throughout the United Kingdom-wide Farr Institute and their common deployment features in practice. The Farr Institute is a case study from which we propose a common definition of data safe havens as trusted platforms for clinical academic research. We use this common definition to discuss the challenges and dilemmas faced by the clinical academic research community, to help promote a consistent understanding of them and how they might best be handled in practice. We conclude by questioning whether the common definition represents a safe and trustworthy model for conducting clinical research that can stand the test of time and ongoing technical advances while paying heed to evolving public and professional concerns. PMID:27329087

  5. Research and Deployment a Hospital Open Software Platform for e-Health on the Grid System at VAST/IAMI

    NASA Astrophysics Data System (ADS)

    van Tuyet, Dao; Tuan, Ngo Anh; van Lang, Tran

    Grid computing has been an increasing topic in recent years. It attracts the attention of many scientists from many fields. As a result, many Grid systems have been built for serving people's demands. At present, many tools for developing the Grid systems such as Globus, gLite, Unicore still developed incessantly. Especially, gLite - the Grid Middleware - was developed by the Europe Community scientific in recent years. Constant growth of Grid technology opened the way for new opportunities in term of information and data exchange in a secure and collaborative context. These new opportunities can be exploited to offer physicians new telemedicine services in order to improve their collaborative capacities. Our platform gives physicians an easy method to use telemedicine environment to manage and share patient's information (such as electronic medical record, images formatted DICOM) between remote locations. This paper presents the Grid Infrastructure based on gLite; some main components of gLite; the challenge scenario in which new applications can be developed to improve collaborative work between scientists; the process of deploying Hospital Open software Platform for E-health (HOPE) on the Grid.

  6. Data Safe Havens and Trust: Toward a Common Understanding of Trusted Research Platforms for Governing Secure and Ethical Health Research.

    PubMed

    Lea, Nathan Christopher; Nicholls, Jacqueline; Dobbs, Christine; Sethi, Nayha; Cunningham, James; Ainsworth, John; Heaven, Martin; Peacock, Trevor; Peacock, Anthony; Jones, Kerina; Laurie, Graeme; Kalra, Dipak

    2016-01-01

    In parallel with the advances in big data-driven clinical research, the data safe haven concept has evolved over the last decade. It has led to the development of a framework to support the secure handling of health care information used for clinical research that balances compliance with legal and regulatory controls and ethical requirements while engaging with the public as a partner in its governance. We describe the evolution of 4 separately developed clinical research platforms into services throughout the United Kingdom-wide Farr Institute and their common deployment features in practice. The Farr Institute is a case study from which we propose a common definition of data safe havens as trusted platforms for clinical academic research. We use this common definition to discuss the challenges and dilemmas faced by the clinical academic research community, to help promote a consistent understanding of them and how they might best be handled in practice. We conclude by questioning whether the common definition represents a safe and trustworthy model for conducting clinical research that can stand the test of time and ongoing technical advances while paying heed to evolving public and professional concerns. PMID:27329087

  7. Tile-Ippokratis: The Experience of an Ehealth Platform for the Provision of Health Care Services in the Island of Chios and Cyprus

    PubMed Central

    Papadopoulos, Homer

    2010-01-01

    Tile-Ippokratis proposed an integrated platform for the provision of low-cost ehealth services to citizens in southeast Mediterranean area (Island of Chios and Cyprus). The aim of the paper is to present the architecture, the design, and the evaluation results of this platform. The platform based on already evaluated state-of-the-art mobile ehealth systems and using wireless and terrestrial telecommunication networks is able to provide the following health care services: (i) telecollaboration and teleconsultation services between health care personnel and between health care personnel and patients and (ii) ehealth services for “at risk” citizens such as elderly and patients with chronic diseases (Island of Chios) and postsurgery patients (Cyprus). The ehealth systems supported capabilities for vital signal measurements (ECG 1 lead, SPO2, HR, BP, weight, and temperature), an Electronic Patient Record (EPR) infrastructure, and video conference, along with communication gateways for data transmission over ADSL, GPRS, and WLAN networks. PMID:20871664

  8. An Innovative Home-Based Interdisciplinary Service-Learning Experience

    ERIC Educational Resources Information Center

    McWilliams, Andrew; Rosemond, Cherie; Roberts, Ellen; Calleson, Diane; Busby-Whitehead, Jan

    2008-01-01

    The University of North Carolina Mobile Student Health Action Coalition (UNC MSHAC) at Chapel Hill, North Carolina is a voluntary service-learning program in which interdisciplinary teams of graduate level health professional students provide monthly home visits to isolated, community-dwelling elders with complex medical and social issues.…

  9. Public policy, health system, and community actions against illness as platforms for response to NCDs in Tanzania: a narrative review

    PubMed Central

    Metta, Emmy; Msambichaka, Beverly; Mwangome, Mary; Nyato, Daniel J.; Dieleman, Marjolein; Haisma, Hinke; Klatser, Paul; Geubbels, Eveline

    2014-01-01

    Background Most low- and middle- income countries are facing a rise of the burden of non-communicable diseases (NCDs) alongside the persistent burden of infectious diseases. This narrative review aims to provide an inventory of how the existing policy environment, health system, and communities are addressing the NCDs situation in Tanzania and identify gaps for advancing the NCD research and policy agenda. Methodology A literature search was performed on PubMed and Google scholar with full text retrieval from HINARI of English language articles published between 2000 and 2012. Documents were read to extract information on what Tanzanian actors were doing that contributed to NCDs prevention, treatment, and control, and a narration was written out of these. Reference lists of all retrieved articles were searched for additional relevant articles. Websites of organizations active in the field of NCDs including the Government of Tanzania and WHO were searched for reports and grey literature. Results Lack of a specific and overarching NCD policy has slowed and fragmented the implementation of existing strategies to prevent and control NCDs and their determinants. The health system is not prepared to deal with the rising NCD burden although there are random initiatives to improve this situation. How the community is responding to these emerging conditions is still unknown, and the current health-seeking behavior and perceptions on the risk factors may not favor control of NCDs and their risk factors. Conclusion and recommendation There is limited information on the burden and determinants of NCDs to inform the design of an integrative and multisectorial policy. Evidence on effective interventions for NCD services in primary care levels and on community perceptions on NCDs and their care seeking is virtually absent. Research and public health interventions must be anchored in the policy, health system, and community platforms for a holistic response. PMID:24848655

  10. District decision-making for health in low-income settings: a feasibility study of a data-informed platform for health in India, Nigeria and Ethiopia.

    PubMed

    Avan, Bilal Iqbal; Berhanu, Della; Umar, Nasir; Wickremasinghe, Deepthi; Schellenberg, Joanna

    2016-09-01

    Low-resource settings often have limited use of local data for health system planning and decision-making. To promote local data use for decision-making and priority setting, we propose an adapted framework: a data-informed platform for health (DIPH) aimed at guiding coordination, bringing together key data from the public and private sectors on inputs and processes. In working to transform this framework from a concept to a health systems initiative, we undertook a series of implementation research activities including background assessment, testing and scaling up of the intervention. This first paper of four reports the feasibility of the approach in a district health systems context in five districts of India, Nigeria and Ethiopia. We selected five districts using predefined criteria and in collaboration with governments. After scoping visits, an in-depth field visit included interviews with key health stakeholders, focus group discussions with service-delivery staff and record review. For analysis, we used five dimensions of feasibility research based on the TELOS framework: technology and systems, economic, legal and political, operational and scheduling feasibility. We found no standardized process for data-based district level decision-making, and substantial obstacles in all three countries. Compared with study areas in Ethiopia and Nigeria, the health system in Uttar Pradesh is relatively amenable to the DIPH, having relative strengths in infrastructure, technological and technical expertise, and financial resources, as well as a district-level stakeholder forum. However, a key challenge is the absence of an effective legal framework for engagement with India's extensive private health sector. While priority-setting may depend on factors beyond better use of local data, we conclude that a formative phase of intervention development and pilot-testing is warranted as a next step. PMID:27591204

  11. District decision-making for health in low-income settings: a feasibility study of a data-informed platform for health in India, Nigeria and Ethiopia

    PubMed Central

    Avan, Bilal Iqbal; Berhanu, Della; Umar, Nasir; Wickremasinghe, Deepthi; Schellenberg, Joanna

    2016-01-01

    Low-resource settings often have limited use of local data for health system planning and decision-making. To promote local data use for decision-making and priority setting, we propose an adapted framework: a data-informed platform for health (DIPH) aimed at guiding coordination, bringing together key data from the public and private sectors on inputs and processes. In working to transform this framework from a concept to a health systems initiative, we undertook a series of implementation research activities including background assessment, testing and scaling up of the intervention. This first paper of four reports the feasibility of the approach in a district health systems context in five districts of India, Nigeria and Ethiopia. We selected five districts using predefined criteria and in collaboration with governments. After scoping visits, an in-depth field visit included interviews with key health stakeholders, focus group discussions with service-delivery staff and record review. For analysis, we used five dimensions of feasibility research based on the TELOS framework: technology and systems, economic, legal and political, operational and scheduling feasibility. We found no standardized process for data-based district level decision-making, and substantial obstacles in all three countries. Compared with study areas in Ethiopia and Nigeria, the health system in Uttar Pradesh is relatively amenable to the DIPH, having relative strengths in infrastructure, technological and technical expertise, and financial resources, as well as a district-level stakeholder forum. However, a key challenge is the absence of an effective legal framework for engagement with India’s extensive private health sector. While priority-setting may depend on factors beyond better use of local data, we conclude that a formative phase of intervention development and pilot-testing is warranted as a next step. PMID:27591204

  12. MO-E-18C-05: Global Health Catalyst: A Novel Platform for Enhancing Access to Medical Physics Education and Research Excellence (AMPERE)

    SciTech Connect

    Ngwa, W; Moreau, M; Asana, L

    2014-06-15

    Purpose: To develop a platform for catalyzing collaborative global Cancer Care Education and Research (CaRE), with a prime focus on enhancing Access to Medical Physics Education and Research Excellence (AMPERE) Methods: An analysis of over 50 global health collaborations between partners in the U.S. and low and middle income countries (LMIC) in Africa was carried out to assess the models of collaborations in Education and Research and relative success. A survey was carried out with questions including: the nature of the collaboration, how it was initiated, impact of culture and other factors, and recommendations for catalyzing/enhancing such collaborations. An online platform called Global Health Catalyst was developed for enhancing AMPERE. Results: The analysis yielded three main models for global health collaborations with survey providing key recommendations on how to enhance such collaborations. Based on this, the platform was developed, and customized to allow Medical Physicists and other Radiation oncology (RadOnc) professionals interested in participating in Global health to readily do so e.g. teach an online course module, participate in training Medical Physicists or other RadOnc health professionals in LMIC, co-mentor students, residents or postdocs, etc. The growing list of features on the platform also include: a feature to enable people to easily find each other, form teams, operate more effectively as partners from different disciplines, institutions, nations and cultural backgrounds, share tools and technologies, obtain seed funding to develop curricula and/or embark upon new areas of investigation, and participate in humanitarian outreach: remote treatment planning assistance, and participation in virtual Chart Rounds, etc. Conclusion: The developed Global Health Catalyst platform could enable any Medical Physicist or RadoOnc professional interested in global health to readily participate in the Education/training of next generation Rad

  13. Data Resource Profile: The sentinel panel of districts: Tanzania's national platform for health impact evaluation.

    PubMed

    Kabadi, Gregory S; Geubbels, Eveline; Lyatuu, Isaac; Smithson, Paul; Amaro, Richard; Meku, Sylvia; Schellenberg, Joanna A; Masanja, Honorati

    2015-02-01

    The Sentinel Panel of Districts (SPD) consists of 23 districts selected to provide nationally representative data on demographic and health indicators in Tanzania. The SPD has two arms: SAVVY and FBIS. SAVVY (SAmple Vital registration with Verbal autopsY) is a demographic surveillance system that provides nationally representative estimates of mortalities based on age, sex, residence and zone. SAVVY covers over 805 000 persons, or about 2% of the Tanzania mainland population, and uses repeat household census every 4-5 years, with ongoing reporting of births, deaths and causes of deaths. The FBIS (Facility-Based Information System) collects routine national health management information system data. These health service use data are collected monthly at all public and private health facilities in SPD districts, i.e. about 35% of all facilities in Mainland Tanzania. Both SAVVY and FBIS systems are capable of generating supplementary information from nested periodic surveys. Additional information about the design of the SPD is available online: access to some of SPD's aggregate data can be requested by sending an e-mail to [hmasanja@ihi.or.tz]. PMID:25433703

  14. Adolescents' Views about an Internet Platform for Adolescents with Mental Health Problems

    ERIC Educational Resources Information Center

    Havas, Jano; de Nooijer, Jascha; Crutzen, Rik; Feron, Frans

    2011-01-01

    Purpose: The purpose of this paper is to examine the needs and views of adolescents regarding the development of online support for mental health problems. Design/methodology/approach: Semi-structured qualitative focus group interviews were conducted with ten groups of Dutch adolescents (n=106), aged 12-19 years, from four urban secondary schools…

  15. Home-based telehealth to deliver evidence-based psychotherapy in veterans with PTSD.

    PubMed

    Strachan, Martha; Gros, Daniel F; Yuen, Erica; Ruggiero, Kenneth J; Foa, Edna B; Acierno, Ron

    2012-03-01

    Although medical service delivery via home-based telehealth technology (HBT) is gaining wider acceptance in managing chronic illnesses such as diabetes or chronic obstructive pulmonary disease, few studies have tested HBT applications of psychotherapy. Clinicians, administrators, and researchers question whether delivering psychotherapeutic services to patients in their homes via video-conferencing technology compromises patient safety, potency of treatment, or data security. Despite these concerns, HBT service delivery may increase access to evidence-based psychotherapies for veterans with posttraumatic stress disorder (PTSD), who may be less willing or less able to receive weekly treatment at a VA medical center or outpatient clinic due to symptom severity or other similar barriers to care. Indeed, although combat-exposed service members endorse high rates of psychiatric disorders, few appear to initiate mental health services or receive an adequate dose of treatment. Thus, using HBT technologies to administer evidence-based therapies remains uncharted territory in both the clinical and research arenas. This manuscript describes an ongoing four year randomized controlled trial comparing in-person Prolonged Exposure (PE) - a specialized evidence-based psychotherapy for PTSD - and PE delivered via HBT, with a particular focus on the selection, application, and strengths/weaknesses of HBT procedures. PMID:22101225

  16. Effect of an IT-supported home-based exercise programme on metabolic syndrome in India.

    PubMed

    Radhakrishnan, Jeyasundar; Swaminathan, Narasimman; Pereira, Natasha; Henderson, Keiran; Brodie, David

    2014-05-14

    Summary We studied the effectiveness of a home-based exercise programme with information technology (IT) support in people with metabolic syndrome in India. Ninety-four participants with metabolic syndrome (mean age 50 years) were randomized into two groups. Both groups received a 12-week home exercise programme and Group 2 received additional IT support for health education. Before and after the exercise programme, participants were measured for arterial stiffness using applanation tonometry, exercise capacity using an incremental shuttle walk test and quality of life (QoL) using the SF-36 questionnaire. Sixty-one participants completed the post intervention tests. There was a significant reduction in systolic blood pressure, mean pressure and aortic systolic pressure in both groups. Pulse wave velocity, aortic pulse pressure and aortic diastolic pressure showed significant reductions only in Group 2. There were no significant changes in QoL measures, except vitality in Group 2. There was significant improvement in fasting blood glucose in Group 2, cholesterol in Group 1 and triglycerides in both groups. The participants' exercise capacity did not change significantly, although the mean duration of regular exercise was 7.2 weeks for Group 1 and 10.0 weeks for Group 2 (P = 0.019). Metabolic syndrome was reversed in 16% of the participants in both groups. IT support, through mobile text messages and phone calls, may be helpful in metabolic syndrome. Longer-term studies are now required. PMID:24829259

  17. Economic Value of Dispensing Home-Based Preoperative Chlorhexidine Bathing Cloths to Prevent Surgical Site Infection

    PubMed Central

    Bailey, Rachel R.; Stuckey, Dianna R.; Norman, Bryan A.; Duggan, Andrew P.; Bacon, Kristina M.; Connor, Diana L.; Lee, Ingi; Muder, Robert R.; Lee, Bruce Y.

    2012-01-01

    OBJECTIVE To estimate the economic value of dispensing preoperative home-based chlorhexidine bathing cloth kits to orthopedic patients to prevent surgical site infection (SSI). METHODS A stochastic decision-analytic computer simulation model was developed from the hospital’s perspective depicting the decision of whether to dispense the kits preoperatively to orthopedic patients. We varied patient age, cloth cost, SSI-attributable excess length of stay, cost per bed-day, patient compliance with the regimen, and cloth antimicrobial efficacy to determine which variables were the most significant drivers of the model’s outcomes. RESULTS When all other variables remained at baseline and cloth efficacy was at least 50%, patient compliance only had to be half of baseline (baseline mean, 15.3%; range, 8.23%–20.0%) for chlorhexidine cloths to remain the dominant strategy (ie, less costly and providing better health outcomes). When cloth efficacy fell to 10%, 1.5 times the baseline bathing compliance also afforded dominance of the preoperative bath. CONCLUSIONS The results of our study favor the routine distribution of bathing kits. Even with low patient compliance and cloth efficacy values, distribution of bathing kits is an economically beneficial strategy for the prevention of SSI. PMID:21515977

  18. Patient Compliance in Home-Based Self-Care Telehealth Projects.

    PubMed

    Maeder, Anthony; Poultney, Nathan; Morgan, Gary; Lippiatt, Robert

    2015-12-01

    This paper presents the findings of a literature review on patient compliance in home-based self-care telehealth monitoring situations, intended to establish a knowledge base for this aspect which is often neglected alongside more conventional clinical, economic and service evaluations. A systematic search strategy led to 72 peer-reviewed published scientific papers being selected as most relevant to the topic, 58 of which appeared in the last 10 years. Patient conditions in which most evidence for compliance was found were blood pressure, heart failure and stroke, diabetes, asthma, chronic obstructive pulmonary disease and other respiratory diseases. In general, good compliance at the start of a study was found to drop off over time, most rapidly in the period immediately after the start. Success factors identified in the study included the extent of patient health education, telehealth system implementation style, user training and competence in system usage, active human support from the healthcare provider and maintaining strong participant motivation. PMID:26556057

  19. Rehabilitation outcome in home-based versus supervised exercise programs for chronically dizzy patients.

    PubMed

    Kao, Chung-Lan; Chen, Liang-Kung; Chern, Chang-Ming; Hsu, Li-Chi; Chen, Chih-Chun; Hwang, Shinn-Jang

    2010-01-01

    We aimed to evaluate the effectiveness of vestibular rehabilitation (VR) exercise between supervised and home-based programs in young and senior age groups of patients with chronic dizziness. Dizziness Handicap Inventory (DHI), Dynamic gait index (DGI), Tinetti fall risk performance scales and Timed "Up and Go" test (TUG) were administered to patients on their initial and follow-up visits for forty-one patients suffering from chronic dizziness. Twenty-eight patients received three 30-min vestibular training exercise sessions per week. Thirteen patients who could not visit our clinic on regular basis were instructed to do the same set of exercises at home, with the same duration and frequency. All scales were evaluated again on their follow-up visits 2 months later. Patients in both groups showed statistically significant improvement in DHI and Tinetti scales. A higher percentage of patients in the supervised-exercise-program (SP) group showed clinically significant outcome improvements. Age was not a predictive factor for rehabilitation outcome. We concluded that for all ages of chronically dizzy patients, 2 months of VR can reduce handicap, improve balance function and a consequent improvement of life quality. Health care professionals need to be educated about the importance of rehabilitation program for treatment of chronic dizziness. PMID:20022390

  20. A Feasibility Study of Home-Based Contingency Management with Adolescent Smokers of Rural Appalachia

    PubMed Central

    Reynolds, Brady; Harris, Millie; Slone, Stacey A.; Shelton, Brent J.; Dallery, Jesse; Stoops, William; Lewis, Russell

    2015-01-01

    Cigarette smoking among adolescents remains a significant public health concern. This problem is compounded in regions such as rural Appalachia where rates of smoking are consistently higher than national averages and access to treatments is limited. The current research evaluated a home-based contingency management program completed over the Internet with adolescent smokers recruited from rural Appalachia. Participants (N = 62) submitted three video recordings per day showing their breath carbon monoxide (CO) levels using a handheld CO monitor. Participants were assigned to either an active treatment condition (AT: n = 31) in which reductions in breath CO were reinforced or a control treatment condition (CT: n = 31) in which providing timely video recordings were reinforced with no requirement to reduce breath CO. Results revealed that participants in the AT condition reduced their breath CO levels significantly more so during treatment than participants in the CT condition. Within-group comparisons revealed that participants in both conditions significantly reduced their breath CO, self-reported smoking, and nicotine dependence ratings during treatment. However, only participants in the AT condition significantly reduced urinary cotinine levels during treatment, and only participants in this condition maintained all reductions until six-week post treatment. Participants in the CT condition only maintained self-reported smoking reductions until post-treatment assessments. These results support the feasibility and initial efficacy of this incentive-based approach to smoking cessation with adolescent smokers living in rural locations. PMID:26280592

  1. Comparison of Veteran experiences of low-cost, home-based diet and exercise interventions.

    PubMed

    Holtz, Bree; Krein, Sarah L; Bentley, Douglas R; Hughes, Maria E; Giardino, Nicholas D; Richardson, Caroline R

    2014-01-01

    Obesity is a significant health problem among Veterans who receive care from the Department of Veterans Affairs, as it is for so many other Americans. Veterans from Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) experience a myriad of chronic conditions, which can make it difficult to maintain a physically active lifestyle. This pilot study tested the feasibility and user satisfaction with three low-cost, home-based diet and exercise programs, as well as point-of-decision prompts among these Veterans. The three programs target mechanisms that have been shown to improve healthy behavior change, including (1) online mediated social support, (2) objective monitoring of physical activity, and (3) structured high-intensity workouts. This was a randomized crossover trial; each participant used two of the three programs, and all used the point-of-decision prompts. Our qualitative results identified five overall themes related to social support, objective monitoring, structured activity, awareness and understanding, and the point-of-decision prompts. In general, participants were satisfied with and lost weight with each of the interventions. This study demonstrated that these low-cost interventions could be successful with the OIF/OEF Veteran population. A larger and longer study is planned to further investigate the effectiveness of these interventions. PMID:24805901

  2. A feasibility study of home-based contingency management with adolescent smokers of rural Appalachia.

    PubMed

    Reynolds, Brady; Harris, Millie; Slone, Stacey A; Shelton, Brent J; Dallery, Jesse; Stoops, William; Lewis, Russell

    2015-12-01

    Cigarette smoking among adolescents remains a significant public health concern. This problem is compounded in regions such as rural Appalachia where rates of smoking are consistently higher than national averages and access to treatments is limited. The current research evaluated a home-based contingency management program completed over the Internet with adolescent smokers recruited from rural Appalachia. Participants (N = 62) submitted 3 video recordings per day showing their breath carbon monoxide (CO) levels using a handheld CO monitor. Participants were assigned to either an active treatment condition (AT; n = 31) in which reductions in breath CO were reinforced or a control treatment condition (CT; n = 31) in which providing timely video recordings were reinforced with no requirement to reduce breath CO. Results revealed that participants in the AT condition reduced their breath CO levels significantly more so during treatment than participants in the CT condition. Within-group comparisons revealed that participants in both conditions significantly reduced their breath CO, self-reported smoking, and nicotine dependence ratings during treatment. However, only participants in the AT condition significantly reduced urinary cotinine levels during treatment, and only participants in this condition maintained all reductions until 6-week post treatment. Participants in the CT condition only maintained self-reported smoking reductions until posttreatment assessments. These results support the feasibility and initial efficacy of this incentive-based approach to smoking cessation with adolescent smokers living in rural locations. PMID:26280592

  3. Outcomes of a Mobile Health Coaching Platform: 12-Week Results of a Single-Arm Longitudinal Study

    PubMed Central

    Walsh, James K

    2016-01-01

    Background The number of mobile health coaching applications is expanding at a rapid rate. An application that uses a guiding intelligence to deliver an individualized structured program has the potential to provide a significant benefit. However, there are few studies of this approach that examine multiple clinical outcomes in a longitudinal manner. Objective The objective of the study was to conduct a 12-week evaluation of participants using the YouPlus Health mobile coaching platform, specifically examining the effects on body weight, waist measurement, blood pressure, lipid profile, glycohemoglobin (A1C), and maximum volume of oxygen consumption (VO2 max). Methods A quasi-experimental research design was used. This included a single-arm pre and post intervention assessment of outcomes. Participants underwent a 12-week intervention in which they received the entirety of the mobile health coaching program via an application on their mobile phones and were evaluated in the same physician’s office setting every two weeks. Data regarding app usage was continuously collected and maintained in a database. Results 10 subjects were enrolled in and completed the pilot study. The mean weight loss was 13.5 lbs. which represented 7.3% of baseline (P=.005). Mean waist circumference was reduced by 7.2 cm or 6.6% of baseline (P=.005). Both systolic (SBP) and diastolic (DBP) blood pressure measures were significantly lower after 12 weeks of intervention. Mean SBP fell 18.6 mmHg (P=.005) and mean DBP declined 6.4 mmHg (P=.005). VO2 max increased by an average of 3.13 ml/kg/min from baseline to study end (P=.005). From baseline to end-of-study HDL levels increased significantly by 4.0 mg/dL (P=.04) Total cholesterol, LDL, triglycerides, and glycohemoglobin (A1C) trended in the desired direction but did not meet statistical significance. All of the participants in the study completed the necessary in-app tutorials and also completed the in-app questions and received feedback

  4. Translating Behavioral Interventions Onto mHealth Platforms: Developing Text Message Interventions for Smoking and Alcohol

    PubMed Central

    2015-01-01

    The development of mHealth applications is often driven by the investigators and developers with relatively little input from the targeted population. User input is commonly limited to “like/dislike” post- intervention consumer satisfaction ratings or device or application specific user analytics such as usability. However, to produce successful mHealth applications with lasting effects on health behaviors it is crucial to obtain user input from the start of each project and throughout development. The aim of this tutorial is to illustrate how qualitative methods in an iterative process of development have been used in two separate behavior change interventions (targeting smoking and alcohol) delivered through mobile technologies (ie, text messaging). A series of focus groups were conducted to assist in translating a face-to-face smoking cessation intervention onto a text message (short message service, SMS) delivered format. Both focus groups and an advisory panel were used to shape the delivery and content of a text message delivered intervention for alcohol risk reduction. An in vivo method of constructing message content was used to develop text message content that was consistent with the notion of texting as “fingered speech”. Formative research conducted with the target population using a participatory framework led to important changes in our approach to intervention structure, content development, and delivery. Using qualitative methods and an iterative approach that blends consumer-driven and investigator-driven aims can produce paradigm-shifting, novel intervention applications that maximize the likelihood of use by the target audience and their potential impact on health behaviors. PMID:25714907

  5. Creating a Powerful Platform to Explore Health in a Correctional Population: A Record Linkage Study

    PubMed Central

    McIsaac, Kathryn E.; Farrell MacDonald, Shanna; Chong, Nelson; Moser, Andrea; Moineddin, Rahim; Colantonio, Angela; Nathens, Avery; Matheson, Flora I.

    2016-01-01

    We used record linkage to create a data repository of health information of persons who were federally incarcerated in Ontario and Canada. We obtained records from 56,867 adults who were federally incarcerated between January 1, 1998 and December 31, 2011 from the Correctional Service of Canada; 15,248 records belonged to individuals residing in Ontario, Canada. We linked these records to the Registered Persons Database (RPDB) which contained records from 18,116,996 individuals eligible for health care in Ontario. Out of 56,867 OMS records, 22,844 (40.2%) were linked to the RPDB. Looking only at those incarcerated in Ontario, 98%, (14 953 of 15248) records were linked to RPDB. Most records of persons in Ontario-based facilities were linked deterministically. Linkage rates were lower for women, minority groups, and substance users. In conclusion, record linkage enabled the creation of a valuable data repository: there are no electronic medical records for correctional populations in Canada, making it more difficult to profile their health. PMID:27532612

  6. Managing Everyday Life: A Qualitative Study of Patients’ Experiences of a Web-Based Ulcer Record for Home-Based Treatment

    PubMed Central

    Trondsen, Marianne V.

    2014-01-01

    Chronic skin ulcers are a significant challenge for patients and health service resources, and ulcer treatment often requires the competence of a specialist. Although e-health interventions are increasingly valued for ulcer care by giving access to specialists at a distance, there is limited research on patients’ use of e-health services for home-based ulcer treatment. This article reports an exploratory qualitative study of the first Norwegian web-based counselling service for home-based ulcer treatment, established in 2011 by the University Hospital of North Norway (UNN). Community nurses, general practitioners (GPs) and patients are offered access to a web-based record system to optimize ulcer care. The web-based ulcer record enables the exchange and storage of digital photos and clinical information, by the use of which, an ulcer team at UNN, consisting of specialized nurses and dermatologists, is accessible within 24 h. This article explores patients’ experiences of using the web-based record for their home-based ulcer treatment without assistance from community nurses. Semi-structured interviews were conducted with a total of four patients who had used the record. The main outcomes identified were: autonomy and flexibility; safety and trust; involvement and control; and motivation and hope. These aspects improved the patients’ everyday life during long-term ulcer care and can be understood as stimulating patient empowerment.

  7. Integrated, Home-based Treatment for MDR-TB and HIV in Rural South Africa: An Alternate Model of Care

    PubMed Central

    Brust, James C.M.; Shah, N. Sarita; Scott, Michelle; Chaiyachati, Krisda; Lygizos, Melissa; van der Merwe, Theo L.; Bamber, Sheila; Radebe, Zanele; Loveday, Marian; Moll, Anthony P.; Margot, Bruce; Lalloo, Umesh G.; Friedland, Gerald H.; Gandhi, Neel R.

    2012-01-01

    SUMMARY Treatment outcomes for multidrug-resistant tuberculosis (MDR-TB) in South Africa have suffered as centralized, inpatient treatment programs struggle to cope with rising prevalence and HIV co-infection rates. A new treatment model is needed to expand treatment capacity and improve MDR-TB and HIV outcomes. We describe the design and preliminary results of an integrated, home-based MDR-TB/HIV treatment program created in rural KwaZulu-Natal. In 2008, a decentralized center was established to provide outpatient MDR-TB and HIV treatment. Nurses, community health workers, and family supporters have been trained to administer injections, provide adherence support, and monitor adverse reactions in patients’ homes. Physicians assess clinical response, adherence, and adverse reaction severity to MDR-TB and HIV therapy at monthly follow-up visits. Treatment outcomes are assessed by monthly cultures and CD4 and viral load every 6 months. Eighty patients initiated MDR-TB therapy from 2/2008–4/2010; 66 were HIV co-infected. Retention has been high (only 5% defaults, 93% of visits attended) and preliminary outcomes have been favorable (77% cured/still on treatment, 82% undetectable viral load). Few patients have required escalation of care (9%), had severe adverse events (8%), or died (6%). Integrated, home-based treatment for MDR-TB and HIV is a promising treatment model to expand capacity and achieve improved outcomes in rural, resource-poor, and high-HIV prevalent settings. PMID:22668560

  8. Multi-site videoconferencing for home-based education of older people with chronic conditions: the Telehealth Literacy Project.

    PubMed

    Banbury, Annie; Parkinson, Lynne; Nancarrow, Susan; Dart, Jared; Gray, Len; Buckley, Jennene

    2014-10-01

    We examined the acceptability of multi-site videoconferencing as a method of providing group education to older people in their homes. There were 9 groups comprising 52 participants (mean age 73 years) with an average of four chronic conditions. Tablet computers or PCs were installed in participant's homes and connected to the Internet by the National Broadband Network (high-speed broad band network) or by the 4G wireless network. A health literacy and self-management programme was delivered by videoconference for 5 weeks. Participants were able to view and interact with all group members and the facilitator on their devices. During the study, 44 group videoconferences were conducted. Evaluation included 16 semi-structured interviews, 3 focus groups and a journal detailing project implementation. The participants reported enjoying home-based group education by videoconference and found the technology easy to use. Using home-based groups via videoconference was acceptable for providing group education, and considered particularly valuable for people living alone and/or with limited mobility. Audio difficulties were the most commonly reported problem. Participants connected with 4G experienced more problems (audio and visual) than participants on the National Broadband Network and those living in multi-dwelling residences reported more problems than those living in single-dwelling residences. Older people with little computer experience can be supported to use telehealth equipment. Telehealth has the potential to improve access to education about chronic disease self-management. PMID:25399994

  9. A platform for leveraging next generation sequencing for routine microbiology and public health use.

    PubMed

    Rusu, Laura I; Wyres, Kelly L; Reumann, Matthias; Queiroz, Carlos; Bojovschi, Alexe; Conway, Tom; Garg, Saurabh; Edwards, David J; Hogg, Geoff; Holt, Kathryn E

    2015-01-01

    Even with the advent of next-generation sequencing (NGS) technologies which have revolutionised the field of bacterial genomics in recent years, a major barrier still exists to the implementation of NGS for routine microbiological use (in public health and clinical microbiology laboratories). Such routine use would make a big difference to investigations of pathogen transmission and prevention/control of (sometimes lethal) infections. The inherent complexity and high frequency of data analyses on very large sets of bacterial DNA sequence data, the ability to ensure data provenance and automatically track and log all analyses for audit purposes, the need for quick and accurate results, together with an essential user-friendly interface for regular non-technical laboratory staff, are all critical requirements for routine use in a public health setting. There are currently no systems to answer positively to all these requirements, in an integrated manner. In this paper, we describe a system for sequence analysis and interpretation that is highly automated and tackles the issues raised earlier, and that is designed for use in diagnostic laboratories by healthcare workers with no specialist bioinformatics knowledge. PMID:25870761

  10. Effectiveness and Limitations of Unsupervised Home-Based Balance Rehabilitation with Nintendo Wii in People with Multiple Sclerosis

    PubMed Central

    Pau, Massimiliano; Coghe, Giancarlo; Corona, Federica; Leban, Bruno; Marrosu, Maria Giovanna; Cocco, Eleonora

    2015-01-01

    Balance training represents a critical part of the rehabilitation process of individuals living with multiple sclerosis (MS) since impaired postural control is a distinctive symptom of the disease. In recent years, the use of the Nintendo Wii system has become widespread among rehabilitation specialists for this purpose, but few studies have verified the effectiveness of such an approach using quantitative measures of balance. In this study, we analyzed the postural sway features of a cohort of twenty-seven individuals with MS before and after 5 weeks of unsupervised home-based balance training with the Wii system. Center of pressure (COP) time-series were recorded using a pressure platform and processed to calculate sway area, COP path length, displacements, and velocities in mediolateral (ML) and anteroposterior (AP) directions. Although the results show a significant reduction in sway area, COP displacements, and velocity, such improvements are essentially restricted to the ML direction, as the Wii platform appears to properly stimulate the postural control system in the frontal plane but not in the sagittal one. Available Wii games, although somewhat beneficial, appear not fully suitable for rehabilitation in MS owing to scarce flexibility and adaptability to MS needs and thus specific software should be developed. PMID:26583146

  11. Effectiveness and Limitations of Unsupervised Home-Based Balance Rehabilitation with Nintendo Wii in People with Multiple Sclerosis.

    PubMed

    Pau, Massimiliano; Coghe, Giancarlo; Corona, Federica; Leban, Bruno; Marrosu, Maria Giovanna; Cocco, Eleonora

    2015-01-01

    Balance training represents a critical part of the rehabilitation process of individuals living with multiple sclerosis (MS) since impaired postural control is a distinctive symptom of the disease. In recent years, the use of the Nintendo Wii system has become widespread among rehabilitation specialists for this purpose, but few studies have verified the effectiveness of such an approach using quantitative measures of balance. In this study, we analyzed the postural sway features of a cohort of twenty-seven individuals with MS before and after 5 weeks of unsupervised home-based balance training with the Wii system. Center of pressure (COP) time-series were recorded using a pressure platform and processed to calculate sway area, COP path length, displacements, and velocities in mediolateral (ML) and anteroposterior (AP) directions. Although the results show a significant reduction in sway area, COP displacements, and velocity, such improvements are essentially restricted to the ML direction, as the Wii platform appears to properly stimulate the postural control system in the frontal plane but not in the sagittal one. Available Wii games, although somewhat beneficial, appear not fully suitable for rehabilitation in MS owing to scarce flexibility and adaptability to MS needs and thus specific software should be developed. PMID:26583146

  12. Closing the treatment gap for mental, neurological and substance use disorders by strengthening existing health care platforms: strategies for delivery and integration of evidence-based interventions.

    PubMed

    Shidhaye, Rahul; Lund, Crick; Chisholm, Dan

    2015-01-01

    This paper outlines the main elements and features of a mental health care delivery platform and its delivery channels. These include evidence-based interventions that can be delivered via this platform as well as broader health system strengthening strategies for more effective and efficient delivery of services. The focus is broadly on health systems perspective rather than strictly disorder-oriented intervention analysis. A set of evidence-based interventions within the WHO pyramid framework of self-care, primary care, and specialist care have been identified; the main challenge lies in the translation of that evidence into practice. The delivery of these interventions requires an approach that puts into practice key principles of public health, adopts systems thinking, promotes whole-of-government involvement and is focused on quality improvement. Key strategies for effective translation of evidence into action include collaborative stepped care, strengthening human resources, and integrating mental health into general health care. In order to pursue these principles and strategies using a platform-wide approach, policy makers need to engage with a wide range of stakeholders and make use of the best available evidence in a transparent manner. PMID:26719762

  13. myPace: an integrative health platform for supporting weight loss and maintenance behaviors.

    PubMed

    Barnett, Julie; Harricharan, Michelle; Fletcher, Dave; Gilchrist, Becky; Coughlan, Jane

    2015-01-01

    Obesity is a major health concern caused by unhealthy eating behaviors. Digital weight loss interventions have adopted mobile technology primarily in order to support self-monitoring. However, many available apps are not designed as a part of dietetic practice; therefore, a distinct gap in the research exists relating to technology that supports the patient-practitioner relationship. This paper presents myPace, which is a complete weight loss and management system that is deployed via a smartphone and a PC. It connects dietitians and patients between face-to-face consultations and extends the relationship through patients' regular progress updates and dietitians' tailored and timely advice, for sustained behavior change. The prototype was developed from research into behavior change for weight loss, which furthermore was underpinned by theory and tenets of human support models, such as the supportive accountability framework. We report on an early-phase system design goals via a formative research process, which aimed to implement theoretical principles and match practical dietetic practice. To that end, only the clinical end user's perspective was sought through a coaching think-aloud protocol on the first iteration of the prototype and interviews with dietitians. Findings show that the system has many positive design features, but which require further development in order for the system to be fully acceptable within dietetic practice and motivate patient engagement. PMID:25438329

  14. Educating Hispanic Women About Breast Cancer Prevention: Evaluation of a Home-Based Promotora-Led Intervention

    PubMed Central

    Coronado, Gloria D.; Espinoza, Noah; Islas, Ilda; Ibarra, Genoveva; Thompson, Beti

    2010-01-01

    Abstract Objectives Trained community health promoters (i.e., promotoras) conducted home-based group educational interventions (home health parties) to educate Hispanic women from the Lower Yakima Valley of Washington state about breast cancer and mammography screening. Methods Women aged 40–79 participating in the parties completed baseline and follow-up surveys 6 months postintervention (n = 70). Changes in general cancer knowledge, breast cancer screening practices, and intentions to be screened among participants from baseline to follow-up were measured using McNemar's test for marginal homogeneity to evaluate the effectiveness of the parties. Results The average age of the sample was 50.0 years (standard deviation [SD] 10.0), 84% reported less than an eighth grade education, and 54% were covered by the state's Basic Health Care Plan. Significant changes between baseline and follow-up were observed with respect to (1) believing that risk of cancer could not be reduced (41% vs. 15%, respectively, p = 0.001), (2) ever having a mammogram (83% vs. 91%, p = 0.014), (3) discussing a mammogram with a doctor (37% vs. 67%, p < 0.001), and (4) intending to have a mammogram within the next few months among women who did not report having a mammogram between baseline and follow-up (61% vs. 81%, p = 0.046). Conclusions Participation in home-based group educational interventions delivered by promotoras may be associated with improved breast cancer screening practices among Hispanic women. PMID:20849288

  15. Study protocol: home-based telehealth stroke care: a randomized trial for veterans

    PubMed Central

    2010-01-01

    Background Stroke is one of the most disabling and costly impairments of adulthood in the United States. Stroke patients clearly benefit from intensive inpatient care, but due to the high cost, there is considerable interest in implementing interventions to reduce hospital lengths of stay. Early discharge rehabilitation programs require coordinated, well-organized home-based rehabilitation, yet lack of sufficient information about the home setting impedes successful rehabilitation. This trial examines a multifaceted telerehabilitation (TR) intervention that uses telehealth technology to simultaneously evaluate the home environment, assess the patient's mobility skills, initiate rehabilitative treatment, prescribe exercises tailored for stroke patients and provide periodic goal oriented reassessment, feedback and encouragement. Methods We describe an ongoing Phase II, 2-arm, 3-site randomized controlled trial (RCT) that determines primarily the effect of TR on physical function and secondarily the effect on disability, falls-related self-efficacy, and patient satisfaction. Fifty participants with a diagnosis of ischemic or hemorrhagic stroke will be randomly assigned to one of two groups: (a) TR; or (b) Usual Care. The TR intervention uses a combination of three videotaped visits and five telephone calls, an in-home messaging device, and additional telephonic contact as needed over a 3-month study period, to provide a progressive rehabilitative intervention with a treatment goal of safe functional mobility of the individual within an accessible home environment. Dependent variables will be measured at baseline, 3-, and 6-months and analyzed with a linear mixed-effects model across all time points. Discussion For patients recovering from stroke, the use of TR to provide home assessments and follow-up training in prescribed equipment has the potential to effectively supplement existing home health services, assist transition to home and increase efficiency. This may

  16. Reducing Children's Susceptibility to Alcohol Use: Effects of a Home-Based Parenting Program.

    PubMed

    Jackson, Christine; Ennett, Susan T; Reyes, H Luz McNaughton; Hayes, Kim A; Dickinson, Denise M; Choi, Seulki; Bowling, J Michael

    2016-07-01

    This 4-year efficacy trial tested whether a home-based, self-administered parenting program could have a long-term effect on children's cognitive susceptibility to alcohol use, and it tested hypothesized moderators and mediators of any such program effect. Using a two-group randomized controlled design, 1076 children (540 treatment; 536 control; mean age of 9.2 years at baseline) completed telephone interviews prior to randomization and follow-up interviews 12, 24, 36, and 48 months post-baseline. Mothers of children randomized to treatment received a 5-month-long parenting program during year 1, followed by two 1-month-long boosters in years 2 and 3. Exposure to the program was significantly inversely associated with susceptibility to alcohol use 48 months post-baseline (b = -0.03, p = .04), with no variation in program effects by parental alcohol use or mother's race/ethnicity or education, suggesting broad public health relevance of the parenting program. Path analyses of simple indirect effects through each hypothesized mediator showed that program exposure positively influenced parental communication to counter pro-drinking influences in the family and media domains and parental rule setting 36 months post-baseline; these variables, in turn, predicted reduced susceptibility to alcohol use 48 months post-baseline. Parallel (multiple) mediation analysis showed that the program had a significant indirect effect on susceptibility through parental rule setting. Together, the findings indicate that internalization of protective alcohol-related expectancies and intentions is possible among children whose mothers provide early exposure to alcohol-specific socialization. Additional research is needed to link alcohol-specific socialization during childhood with adolescent drinking outcomes. PMID:27154767

  17. Transgenic rice seed synthesizing diverse flavonoids at high levels: a new platform for flavonoid production with associated health benefits.

    PubMed

    Ogo, Yuko; Ozawa, Kenjiro; Ishimaru, Tsutomu; Murayama, Tsugiya; Takaiwa, Fumio

    2013-08-01

    Flavonoids possess diverse health-promoting benefits but are nearly absent from rice, because most of the genes encoding enzymes for flavonoid biosynthesis are not expressed in rice seeds. In the present study, a transgenic rice plant producing several classes of flavonoids in seeds was developed by introducing multiple genes encoding enzymes involved in flavonoid synthesis, from phenylalanine to the target flavonoids, into rice. Rice accumulating naringenin was developed by introducing phenylalanine ammonia lyase (PAL) and chalcone synthase (CHS) genes. Rice producing other classes of flavonoids, kaempferol, genistein, and apigenin, was developed by introducing, together with PAL and CHS, genes encoding flavonol synthase/flavanone-3-hydroxylase, isoflavone synthase, and flavone synthases, respectively. The endosperm-specific GluB-1 promoter or embryo- and aleurone-specific 18-kDa oleosin promoters were used to express these biosynthetic genes in seed. The target flavonoids of naringenin, kaempferol, genistein, and apigenin were highly accumulated in each transgenic rice, respectively. Furthermore, tricin was accumulated by introducing hydroxylase and methyltransferase, demonstrating that modification to flavonoid backbones can be also well manipulated in rice seeds. The flavonoids accumulated as both aglycones and several types of glycosides, and flavonoids in the endosperm were deposited into PB-II-type protein bodies. Therefore, these rice seeds provide an ideal platform for the production of particular flavonoids due to efficient glycosylation, the presence of appropriate organelles for flavonoid accumulation, and the small effect of endogenous enzymes on the production of flavonoids by exogenous enzymes. PMID:23551455

  18. Development of an Electronic Claim System Based on an Integrated Electronic Health Record Platform to Guarantee Interoperability

    PubMed Central

    Kim, Hwa Sun; Cho, Hune

    2011-01-01

    Objectives We design and develop an electronic claim system based on an integrated electronic health record (EHR) platform. This system is designed to be used for ambulatory care by office-based physicians in the United States. This is achieved by integrating various medical standard technologies for interoperability between heterogeneous information systems. Methods The developed system serves as a simple clinical data repository, it automatically fills out the Centers for Medicare and Medicaid Services (CMS)-1500 form based on information regarding the patients and physicians' clinical activities. It supports electronic insurance claims by creating reimbursement charges. It also contains an HL7 interface engine to exchange clinical messages between heterogeneous devices. Results The system partially prevents physician malpractice by suggesting proper treatments according to patient diagnoses and supports physicians by easily preparing documents for reimbursement and submitting claim documents to insurance organizations electronically, without additional effort by the user. To show the usability of the developed system, we performed an experiment that compares the time spent filling out the CMS-1500 form directly and time required create electronic claim data using the developed system. From the experimental results, we conclude that the system could save considerable time for physicians in making claim documents. Conclusions The developed system might be particularly useful for those who need a reimbursement-specialized EHR system, even though the proposed system does not completely satisfy all criteria requested by the CMS and Office of the National Coordinator for Health Information Technology (ONC). This is because the criteria are not sufficient but necessary condition for the implementation of EHR systems. The system will be upgraded continuously to implement the criteria and to offer more stable and transparent transmission of electronic claim data. PMID

  19. Cardiac status assessment with a multi-signal device for improved home-based congestive heart failure management.

    PubMed

    Muehlsteff, Jens; Carvalho, Paulo; Henriques, Jorge; Paiva, Rui P; Reiter, Harald

    2011-01-01

    State-of-the-Art disease management for Congestive Heart Failure (CHF) patients is still based on easy-to-acquire measures such as heart rate (HR), weight and blood pressure (BP). However, these measures respond late to changes of the patient health status and provide limited information to personalize and adapt medication therapy. This paper describes our concept called "Cardiac Status Assessment" we have been investigating within the European project "HeartCycle" towards next-generation home-based disease management of CHF. In our concept we analyze non-invasive surrogate measures of the cardio-vascular function in particular systolic time intervals and pulse wave characteristics to estimate Cardiac Output (CO) and Systemic Vascular Resistance (SVR) both are established clinical measures. We discuss the underlying concept, a developed measurement system and first results. PMID:22254450

  20. Predictors and processes associated with home-based family therapists' professional quality of life.

    PubMed

    Macchi, C R; Johnson, Matthew D; Durtschi, Jared A

    2014-07-01

    This study examined whether home-based family therapists' (HBFT) workload and clinical experience were associated with therapists' professional quality of life directly and indirectly through self-care activities and frequency of clinical supervision. Hypotheses were tested using structural equation modeling with a sample of 225 home-based therapists. Results suggested that therapists' workload and HBFT experience significantly predicted therapists' professional quality of life. These associations between therapists' workload and HBFT experience were partially mediated through participation in self-care and frequency of clinical supervision. Implications for improving therapists' quality of life are discussed as a function of therapists' workload, clinical experience, self-care, and supervision. PMID:24749929

  1. Heart rate dynamics after controlled training followed by a home-based exercise program.

    PubMed

    Hautala, Arto J; Mäkikallio, Timo H; Kiviniemi, Antti; Laukkanen, Raija T; Nissilä, Seppo; Huikuri, Heikki V; Tulppo, Mikko P

    2004-07-01

    Daily aerobic training results in autonomic control of the heart toward vagal dominance. The constancy of vagal dominance after controlled training followed by a home-based training program in accordance with contemporary guidelines is not known. We set out here to study whether the vagal dominance induced by 8 weeks of controlled aerobic training is preserved after a 10-month home-based training program. For the controlled study, healthy men were randomized as training (n=18) and control subjects (n=6). The training was started by a supervised 8-week period with six training sessions a week [45 (15) min each] at an intensity of 70-80% of maximum heart rate, followed by a home-based training program for 10 months in accordance with the American College of Sports Medicine recommendations. Cardiovascular autonomic function was assessed by analyzing HR variability over a 24-h period and separately during the night hours (midnight-6 a.m.). Maximal running performance improved during the controlled training 16 (7)% (range 4-31%, P<0.001) and remained 8 (8)% (range -3 to 23%, P<0.001) above the baseline level after the home-based training program. At night, the vagally mediated high-frequency (HF) power of R-R intervals increased during the controlled training from 6.7 (1.3) to 7.3 (1.1) ln ms2 ( P<0.001) and remained higher than the baseline after the home-based training [7.0 (1.3) ln ms2, P<0.05]. The changes in running performance correlated with the changes in HF power at night (r=0.41, P<0.05) and over 24 h (r=0.44, P<0.05) after the home-based training program. Similarly, the changes in body mass index correlated with the changes in HF power over 24 h (r=-0.44, P<0.05) after the home-based training program. The high vagal outflow to the heart after the home-based training is associated with good physical performance and body mass control. PMID:15083365

  2. Confidentiality or continuity? Family caregivers' experiences with care for HIV/AIDS patients in home-based care in Lesotho.

    PubMed

    Makoae, Mokhantso G; Jubber, Ken

    2008-04-01

    In the context of poor access to antiretroviral therapies in sub-Saharan Africa, the minimum treatment package intended to treat opportunistic infections common with HIV infection is inadequate but appealing, since it presumes universal coverage of medical care for patients living with HIV and AIDS. The overall objective of this study was to analyse the challenges which family caregivers encountered in home-based care when they tried to access medical treatment for home-based AIDS patients in the context of confidentiality and limited medical care. A qualitative study using in-depth interviews with a sample of 21 family caregivers -16 females and 5 males aged between 23 and 85 years was conducted with the assistance of health personnel in two hospitals in Lesotho. Using the concept of continuity of care, this article discusses the experiences of family caregivers about home care, including their experiences of adherence to confidentiality by health care professionals and non-disclosure of AIDS as the context of illness, the circumstances under which the caregivers initiated caregiving and sought medical care, and how these factors could be stressors in caregiving. There was continuity of care where the caregivers obtained hospital support. However, when confidentiality was adhered to the caregivers were frustrated by lack of information, disrupted treatment, exclusion of their perspectives in medical care, failure to secure hospitalisation, ambiguous goals and non-responsiveness, so that continuity of care was jeopardised. Thus it can be concluded that professional-assisted disclosure benefited the patients because it facilitated continuity of care through the caregivers. PMID:18496618

  3. PREDIRCAM eHealth Platform for Individualized Telemedical Assistance for Lifestyle Modification in the treatment of Obesity, Diabetes, and Cardiometabolic Risk Prevention: A Pilot Study (PREDIRCAM 1)

    PubMed Central

    González, Cintia; Herrero, Pau; Cubero, José M.; Iniesta, José M.; Hernando, M. Elena; García-Sáez, Gema; Alvaro J., Serrano; Martinez-Sarriegui, Iñaki; Perez-Gandia, Carmen; Gómez, Enrique J.; Rubinat, Esther; Alcantara, Valeria; Brugués, Eulalia; Chico, Ana; Mato, Eugenia; Bell, Olga; Corcoy, Rosa; de Leiva, Alberto

    2013-01-01

    Background Healthy diet and regular physical activity are powerful tools in reducing diabetes and cardiometabolic risk. Various international scientific and health organizations have advocated the use of new technologies to solve these problems. The PREDIRCAM project explores the contribution that a technological system could offer for the continuous monitoring of lifestyle habits and individualized treatment of obesity as well as cardiometabolic risk prevention. Methods PREDIRCAM is a technological platform for patients and professionals designed to improve the effectiveness of lifestyle behavior modifications through the intensive use of the latest information and communication technologies. The platform consists of a web-based application providing communication interface with monitoring devices of physiological variables, application for monitoring dietary intake, ad hoc electronic medical records, different communication channels, and an intelligent notification system. A 2-week feasibility study was conducted in 15 volunteers to assess the viability of the platform. Results The website received 244 visits (average time/session: 17 min 45 s). A total of 435 dietary intakes were recorded (average time for each intake registration, 4 min 42 s ± 2 min 30 s), 59 exercises were recorded in 20 heart rate monitor downloads, 43 topics were discussed through a forum, and 11 of the 15 volunteers expressed a favorable opinion toward the platform. Food intake recording was reported as the most laborious task. Ten of the volunteers considered long-term use of the platform to be feasible. Conclusions The PREDIRCAM platform is technically ready for clinical evaluation. Training is required to use the platform and, in particular, for registration of dietary food intake. PMID:23911170

  4. A systematic review of measures of self-reported adherence to unsupervised home-based rehabilitation exercise programmes, and their psychometric properties

    PubMed Central

    Bollen, Jessica C; Dean, Sarah G; Siegert, Richard J; Howe, Tracey E; Goodwin, Victoria A

    2014-01-01

    Background Adherence is an important factor contributing to the effectiveness of exercise-based rehabilitation. However, there appears to be a lack of reliable, validated measures to assess self-reported adherence to prescribed but unsupervised home-based rehabilitation exercises. Objectives A systematic review was conducted to establish what measures were available and to evaluate their psychometric properties. Data sources MEDLINE, EMBASE, PsycINFO CINAHL (June 2013) and the Cochrane library were searched (September 2013). Reference lists from articles meeting the inclusion criteria were checked to ensure all relevant papers were included. Study selection To be included articles had to be available in English; use a self-report measure of adherence in relation to a prescribed but unsupervised home-based exercise or physical rehabilitation programme; involve participants over the age of 18. All health conditions and clinical populations were included. Data extraction Descriptive data reported were collated on a data extraction sheet. The measures were evaluated in terms of eight psychometric quality criteria. Results 58 studies were included, reporting 61 different measures including 29 questionnaires, 29 logs, two visual analogue scales and one tally counter. Only two measures scored positively for one psychometric property (content validity). The majority of measures had no reported validity or reliability testing. Conclusions The results expose a gap in the literature for well-developed measures that capture self-reported adherence to prescribed but unsupervised home-based rehabilitation exercises. PMID:24972606

  5. [Vitalink: a digital platform to share patient health records in primary care. Report of the pilot projects for sharing medication schemes].

    PubMed

    Zwaenepoel, L; Hulshagen, L

    2014-03-01

    Vitalink is a digital platform to share health patient data among health care professionals in primary care. The Flemish community started the development of this platform in collaboration with representatives of professional associations primary care. Sharing medication charts online was the first Vitalink project. In December 2012 four pilot regions in Flanders (Turnhout, Limburg, Aalst and Halle) tested medication chart sharing through Vitalink. Due to difficulties with software development effective sharing started only in April 2013. The test phase was ended in October 2013. Each pilot region made an evaluation report. Conclusions were similar: the realization business cases were limited. Integration in end user software was insufficiently performant. Moreover, interpretation of downloaded medication charts was found out to differ among participating software applications. Because of these problems exchange of patient records among primary care actors was limited. Therefore research questions could not be conclusively answered. Nevertheless the Vitalink pilot project can be considered successful in some ways. Collaboration and communication among health care professionals and their associations was ameliorated. The awareness of digital data sharing in primary care is growing. Pilot projects created buy in among patients, physicians, pharmacists and nurses. Uniform lay-out guidelines were established in deliberation with all participating actors. Since November 2013 Vitalink is in production. Medication charts, summarized electronic health records and vaccination data can be uploaded to the platform and health care professionals that are registered can consult them. End user software must still be developed to make broad use of the platform feasible. Meanwhile further deliberation with software vendors and professional associations can be organized in order to achieve the implementation and integration of user friendly Vitalink modules. PMID:24804390

  6. Clinic-based training in comparison to home-based training after first-time lumbar disc surgery: a randomised controlled trial.

    PubMed

    Johansson, Ann-Christin; Linton, Steven J; Bergkvist, Leif; Nilsson, Olle; Cornefjord, Michael

    2009-03-01

    The effectiveness of physiotherapy after first-time lumbar disc surgery is still largely unknown. Studies in this field are heterogeneous and behavioural treatment principles have only been evaluated in one earlier study. The aim of this randomised study was to compare clinic-based physiotherapy with a behavioural approach to a home-based training programme regarding back disability, activity level, behavioural aspects, pain and global health measures. A total of 59 lumbar disc patients without any previous spine surgery or comorbidity participated in the study. Clinic-based physiotherapy with a behavioural approach was compared to home-based training 3 and 12 months after surgery. Additionally, the home training group was followed up 3 months after surgery by a structured telephone interview evaluating adherence to the exercise programme. Outcome measures were: Oswestry Disability Index (ODI), physical activity level, kinesiophobia, coping, pain, quality of life and patient satisfaction. Treatment compliance was high in both groups. There were no differences between the two groups regarding back pain disability measured by ODI 3 and 12 months after surgery. However, back pain reduction and increase in quality of life were significantly higher in the home-based training group. The patients in the clinic-based training group had significantly higher activity levels 12 months after surgery and were significantly more satisfied with physiotherapy care 3 months after surgery compared to the home-based training group. Rehabilitation after first-time lumbar disc surgery can be based on home training as long as the patients receive both careful instructions from a physiotherapist and strategies for active pain coping, and have access to the physiotherapist if questions regarding training arise. This might be a convenient treatment arrangement for most patients. PMID:19020904

  7. A Pilot Study on the Impact of a Home-Based Parenting Intervention: Parents Plus

    ERIC Educational Resources Information Center

    Byrne, Ellie; Holland, Sally; Jerzembek, Gabi

    2010-01-01

    This article reports on a pilot study undertaken in order to explore the impact of a home-based parenting intervention (Parents Plus), on parents and families. Parents Plus is part of a Welsh Early Years strategy called Flying Start and aims to promote positive parent-child interactions. This article explores the medium-term to long-term impact of…

  8. An Evaluation of Migrant Head Start Programs. Preliminary Report on Home Base Findings.

    ERIC Educational Resources Information Center

    Reyes (J.A.) Associates, Inc., Washington, DC.

    The report provides Indian and Migrant Program Division managers and specialists in each of the 5 Head Start component areas with a comprehensive picture of the 43 home base learning centers operating between October 1978 and May 1979, with a total enrollment of 3,108 migrant children. Using data collected from the Head Start and center directors,…

  9. Developing Student Knowledge and Skills for Home-Based Social Work Practice

    ERIC Educational Resources Information Center

    Allen, Susan F.; Tracy, Elizabeth M.

    2008-01-01

    Providing social work services for clients in their homes is often a distinguishing feature of social work practice. The home environment affects the intervention process at each stage of contact with a family. Home-based practice requires specific skills to deal with clients' presenting concerns as well as safety, boundary, confidentiality, and…

  10. Home Start: How a Home-Based Preschool Program Raised Black Achievements.

    ERIC Educational Resources Information Center

    Scott, Ralph

    This presentation discusses longitudinal results of a home-based program for low SES black and white children whose parents received weekly visits designed to chart children's individualized enrichment when they were from 2 to 5 years of age. The program drew upon school and community resource personnel when appropriate, to provide parents with…

  11. School- And Home-Based Drug Prevention: Environmental, Parent, and Child Risk Reduction

    ERIC Educational Resources Information Center

    Hahn, Ellen J.; Hall, Lynne A.; Rayens, Mary Kay; Myers, April V.; Bonnel, Galadriel

    2007-01-01

    The study purpose was to test the effect of a school- and home-based alcohol, tobacco, and other drug (ATOD) prevention program on reducing environmental, parent, and child risk factors for ATOD use. The design was a three-group pretest-posttest with interviews at baseline and 1 and 6 months post-intervention. The sample was 126 parents and their…

  12. Dutch Home-Based Pre-Reading Intervention with Children at Familial Risk of Dyslexia

    ERIC Educational Resources Information Center

    van Otterloo, Sandra G.; van der Leij, Aryan

    2009-01-01

    Children (5 and 6 years old, n = 30) at familial risk of dyslexia received a home-based intervention that focused on phoneme awareness and letter knowledge in the year prior to formal reading instruction. The children were compared to a no-training at-risk control group (n = 27), which was selected a year earlier. After training, we found a small…

  13. Home-based therapy for severe acute malnutrition with ready-to-use food

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Severe acute malnutrition is a devastating condition afflicting children under 5 years in many developing countries, but concentrated in sub-Saharan Africa. This paper examines the development of home-based lipid-nutrient therapeutic foods for the treatment of acute malnutrition in sub-Saharan Afric...

  14. Recurrent Vascular Headache: Home-Based Behavioral Treatment versus Abortive Pharmacological Treatment.

    ERIC Educational Resources Information Center

    Holroyd, Kenneth A.; And Others

    1988-01-01

    Compared the effectiveness of a home-based behavioral intervention (relaxation and thermal biofeedback training) with an abortive pharmacological intervention (with compliance training) for treating recurrent migraine and migraine/tension headaches. Both interventions yielded reductions in headache activity, psychosomatic symptoms, and daily life…

  15. Home-Based School Teachers in Afghanistan: Teaching for Tarbia and Student Well-Being

    ERIC Educational Resources Information Center

    Kirk, Jackie; Winthrop, Rebecca

    2008-01-01

    Teachers in community-based or home-based schools in Afghanistan play a critical role in extending access to education to children who are unable to access the government schools, especially girls. These teachers--men and women--are nominated by the community to teach, without necessarily having teaching experience or even completing their own…

  16. Parent Perspective on the Home-Based Interim Alternative Educational Setting: A Phenomenological Study

    ERIC Educational Resources Information Center

    Jones, Gregory L.

    2011-01-01

    The purpose of this study was to explore and describe the perspectives of parents of expelled disabled students placed in home-based interim alternative educational settings (IAES). The study consisted of three parent participants whose disabled children, by virtue of their violations of the school district's discipline policy, were…

  17. Early Home-Based Intervention in the Netherlands for Children at Familial Risk of Dyslexia

    ERIC Educational Resources Information Center

    van Otterloo, Sandra G.; van der Leij, Aryan; Henrichs, Lotte F.

    2009-01-01

    Dutch children at higher familial risk of reading disability received a home-based intervention programme before formal reading instruction started to investigate whether this would reduce the risk of dyslexia. The experimental group (n = 23) received a specific training in phoneme awareness and letter knowledge. A control group (n = 25) received…

  18. Lessons Learned from Home Visiting with Home-Based Child Care Providers

    ERIC Educational Resources Information Center

    McCabe, Lisa A.; Peterson, Shira M.; Baker, Amy C.; Dumka, Marsha; Brach, Mary Jo; Webb, Diana

    2011-01-01

    Caring for Quality and Partners in Family Child Care are home visiting programs designed to improve the quality of home-based child care. This article describes the experiences of two different home visitors to demonstrate how programs such as these can help providers improve the overall quality of care, increase children's development, and lead…

  19. A Home-Based Orientation and Mobility Program for Infants and Toddlers.

    ERIC Educational Resources Information Center

    Joffee, E.

    1988-01-01

    A home-based orientation and mobility program was developed for blind/visually impaired infants and toddlers. Three stages in functional mobility were identified focusing on the development of gross motor skills, related conceptual activities, auditory awareness, orientation skills, and mobility skills. The program included parent education and a…

  20. Rural Alberta Home-Based Businesses: A Profile of Workshop Participants.

    ERIC Educational Resources Information Center

    Capjack, M. Linda; Fetterman, Nelma I.

    1992-01-01

    Of 252 rural Alberta attendees of home-based business workshops, 60 were in business. Of these, 65 percent produced sewing, textile, or food-related products; 73 percent contributed less than 5 percent of family income; 72 percent worked at home because a hobby became profitable; and the majority were married women over 40. (SK)

  1. Small and Home-Based Businesses: Measures of Success and the Contribution of Local Development Services

    ERIC Educational Resources Information Center

    Brooks, Lara; Whitacre, Brian; Shideler, Dave; Muske, Glenn; Woods, Mike

    2012-01-01

    Small and home-based businesses have long been identified by Extension educators as an important component of economic development, particularly in rural areas. The services available to these businesses can take many forms, including management training, accessibility of local funding, providing incubation facilities, or setting up mentoring…

  2. Home-Based Comprehensive Assessment of Rural Elderly Persons: The CARE Project

    ERIC Educational Resources Information Center

    Cravens, David D.; Mehr, David R.; Campbell, James D.; Armer, Jane; Kruse, Robin L.; Rubenstein, Laurence Z.

    2005-01-01

    Context: Home-based comprehensive geriatric assessment (CGA) has been effective in urban areas but has had little study in rural areas. CGA involves medical history taking, a physical exam, and evaluation of functional status, mental status, cognitive status, gait and balance, medications, vision, extent of social supports, and home safety. We…

  3. Treatment Integrity in a Home-Based Pre-Reading Intervention Programme

    ERIC Educational Resources Information Center

    van Otterloo, Sandra G.; van der Leij, Aryan; Veldkamp, Esther

    2006-01-01

    Treatment integrity is an underexposed issue in the phonological awareness intervention research. The current study assessed the integrity of treatment of the families (N = 32) participating in the experimental condition of a home-based pre-reading intervention study. The participating kindergartners were all genetically at risk for developing…

  4. The Social Context of Mother-Infant Relations: A Study of Home Based Education.

    ERIC Educational Resources Information Center

    Fein, Greta G.

    This paper describes the results of a longitudinal study which compared the effects of three types of home-based, parent-oriented, infant education curricula. One curriculum stressed language, another stressed play, and a third stressed social development. Mothers and children from 108 middle and working class families received home visits…

  5. GetHealthyHarlem.org: Developing a Web Platform for Health Promotion and Wellness Driven by and for the Harlem Community

    PubMed Central

    Khan, Sharib A.; Ancker, Jessica S.; Li, Jianhua; Kaufman, David; Hutchinson, Carly; Cohall, Alwyn; Kukafka, Rita

    2009-01-01

    GetHealthyHarlem.org is a community website developed on an open-source platform to facilitate collaborative development of health content through participatory action research (PAR) principles. The website was developed to enable the Harlem community to create a shared health and wellness knowledgebase, to enable discourse about local and culturally relevant health information, and to foster social connections between community members and health promotion organizations. The site is gaining active use with more than 9,500 unique site visits in the six months since going live in November, 2008. In ongoing research studies, we are using the website to explore how the PAR model can be applied to the development of a community health website. PMID:20351872

  6. Home-Based Telemanagement in Advanced COPD: Who Uses it Most? Real-Life Study in Lombardy.

    PubMed

    Vitacca, Michele; Fumagalli, Lia Paola; Borghi, Gabriella; Colombo, Fausto; Castelli, Alberto; Scalvini, Simonetta; Masella, Cristina

    2016-08-01

    Current evidence indicates that the benefits of tele-health may not be uniform across all patients. Therefore, to understand what specific variables influence use of home-based telemanagement in COPD, we conducted this retrospective study.  A 6-month home-based telemanagement program (HTP) was offered to 1,074 COPD patients over a 4-year period. Multivarible linear regression analysis was used to identify predictors of HTP use/week (phone calls and specialist consultations) among all variables: clinical (body mass index, co-morbidities, HTP prescription not following an exacerbation, long-term oxygen therapy use, COPD severity, hospital readmissions, exacerbations and death), socio-demographic (sex, age, place of abode), smoking history, arterial blood gases (ABG), and specialist/general practitioner (GP) urgent need. Logistic regression was conducted to predict relapses/hospitalizations risk as well as the disease impact (COPD Assessment Test, CAT) at the end of the program.  Presence of relapses (p < 0.001), ABGs (p < 0.001) and GP request (p < 0.001) were significantly associated with higher HTP-use. Smoking history (OR 1.542 [IC 95% 1.069-2.217], p = 0.020), specialist (OR 2.895 [2.144-3.910], p < 0.001) and GP consultations (OR 6.575 [4.521-9.561], p < 0.001) were the only independent risk factors for relapse. No predictor of hospitalization was found. High final CAT score was inversely related to oxygen therapy use (p = 0.001) and HTP prescription (p < 0.001), and positively related to presence of co-morbidities (p = 0.001) and baseline CAT (p < 0.001).  This HTP in Lombardy shows that relapsers, people requiring several ABGs and urgent GP visits are the patient subgroup most likely to consume telemanagement services (scheduled and unscheduled). We propose a patient 'identikit' to improve prioritization for HTP prescriptions. PMID:26765586

  7. Attitudes towards acceptance of an innovative home-based and remote sensing rehabilitation protocol among cardiovascular patients in Shantou, China

    PubMed Central

    Fang, Jia-Ying; Li, Ji-Lin; Li, Zhong-Han; Xu, Duan-Min; Chen, Chang; Xie, Bin; Chen, Helen; Au, William W

    2016-01-01

    Background Cardiac rehabilitation (CR) protocols have diversified to include home-based cardiac tele-rehabilitation (HBCTR) as an alternative to hospital-based or center-based CR. To adopt the use of home-based cardiac tele-rehabilitation, it is necessary to assess cardiac patients' attitudes towards acceptance of such e-health technology, especially in China where knowledge of such technology is deficient. Methods Interviews were conducted in the First Affiliated Hospital of Shantou University Medical College, Shantou, China. After percutaneous coronary interventional (PCI) surgery, patients completed the survey. Results Among the 150 patients, only 13% had ever heard of HBCTR. After an introduction of our HBCTR program, 60% of patients were willing to participate in the program. From our multivariate analysis of questionnaire data, age (OR: 0.92, 95% CI: 0.86–0.98; P = 0.007), average family monthly income (OR: 0.13, 95% CI: 0.05–0.34; P < 0.001), education level (OR: 0.24, 95% CI: 0.10–0.59; P = 0.002) and physical exercise time (OR: 0.19, 95% CI: 0.06–0.56; P = 0.003) were independent predictors for acceptance of HBCTR. From the reasons for participation, patients selected: enhanced safety and independence (28.3%), ability to self-monitor physical conditions daily (25.4%), and having automatic and emergency alert (23.1%). Reasons for refusal were: too cumbersome operation (34.3%) and unnecessary protocol (19.4%). Conclusions Most patients lacked knowledge about HBCTR but volunteered to participate after they have learned about the program. Several personal and life-style factors influenced their acceptance of the program. These indicate that both improvement of technology and better understanding of the program will enhance active participation. PMID:27403142

  8. Associations of Caregiver Stress with Working Conditions, Caregiving Practices, and Child Behaviour in Home-Based Child Care

    ERIC Educational Resources Information Center

    Rusby, Julie C.; Jones, Laura Backen; Crowley, Ryann; Smolkowski, Keith

    2013-01-01

    Home-based child caregivers face unique stressors related to the nature of their work. One hundred and fifty-five home-based child care providers in Oregon, USA, participated in this cross-sectional correlational study. We investigated associations between indicators of caregiver stress and child care working conditions, the quality of caregiver…

  9. Parental Perceptions of Child Care Quality in Centre-Based and Home-Based Settings: Associations with External Quality Ratings

    ERIC Educational Resources Information Center

    Lehrer, Joanne S.; Lemay, Lise; Bigras, Nathalie

    2015-01-01

    The current study examined how parental perceptions of child care quality were related to external quality ratings and considered how parental perceptions of quality varied according to child care context (home-based or centre-based settings). Parents of 179 4-year-old children who attended child care centres (n = 141) and home-based settings…

  10. The Role of Clinical and Geographic Factors in the Use of Hospital versus Home-Based Cardiac Rehabilitation

    ERIC Educational Resources Information Center

    Brual, Janette; Gravely, Shannon; Suskin, Neville; Stewart, Donna E.; Grace, Sherry L.

    2012-01-01

    Cardiac rehabilitation (CR) is most often provided in a hospital setting. Home-based models of care have been developed to overcome geographic, among other, barriers in patients at a lower risk. This study assessed whether clinical and geographic factors were related to the use of either a hospital-based or a home-based program. Secondary analysis…