Quality of nursing documentation: Paper-based health records versus electronic-based health records.

PubMed

Akhu-Zaheya, Laila; Al-Maaitah, Rowaida; Bany Hani, Salam

2018-02-01

To assess and compare the quality of paper-based and electronic-based health records. The comparison examined three criteria: content, documentation process and structure. Nursing documentation is a significant indicator of the quality of patient care delivery. It can be either paper-based or organised within the system known as the electronic health records. Nursing documentation must be completed at the highest standards, to ensure the safety and quality of healthcare services. However, the evidence is not clear on which one of the two forms of documentation (paper-based versus electronic health records is more qualified. A retrospective, descriptive, comparative design was used to address the study's purposes. A convenient number of patients' records, from two public hospitals, were audited using the Cat-ch-Ing audit instrument. The sample size consisted of 434 records for both paper-based health records and electronic health records from medical and surgical wards. Electronic health records were better than paper-based health records in terms of process and structure. In terms of quantity and quality content, paper-based records were better than electronic health records. The study affirmed the poor quality of nursing documentation and lack of nurses' knowledge and skills in the nursing process and its application in both paper-based and electronic-based systems. Both forms of documentation revealed drawbacks in terms of content, process and structure. This study provided important information, which can guide policymakers and administrators in identifying effective strategies aimed at enhancing the quality of nursing documentation. Policies and actions to ensure quality nursing documentation at the national level should focus on improving nursing knowledge, competencies, practice in nursing process, enhancing the work environment and nursing workload, as well as strengthening the capacity building of nursing practice to improve the quality of nursing care and patients' outcomes. © 2017 John Wiley & Sons Ltd.

Time to dismiss the idea of a structural fix within government? An analysis of intersectoral action for health in Danish municipalities.

PubMed

Holt, Ditte H; Carey, Gemma; Rod, Morten H

2018-06-01

This paper examines the role of organizational structure within government(s) in attempts to implement intersectoral action for health in Danish municipalities. We discuss the implications of structural reorganization and the governance structures that are established in order to ensure coordination and integration between policy sectors. The paper is based on 49 interviews with civil servants from health and non-health sectors of 10 municipalities. Based on participants' experiences, cases have been described and analyzed in an iterative process consulting the literature on Health in All Policies and joined-up government. Continuous and frequent processes of reorganizing were widespread in the municipalities. However, they appeared to have little effect on policy change. The two most common governance structures established to transcend organizational boundaries were the central unit and the intersectoral committee. According to the experiences of participants, paradoxically both of these organizational solutions tend to reproduce the organizational problems they are intended to overcome. Even if structural reorganization may succeed in dissolving some sector boundaries, it will inevitably create new ones. It is time to dismiss the idea that intersectoral action for health can be achieved by means of a structural fix. Rather than rearranging organizational boundaries it may be more useful to seek to manage the silos which exist in any organization, e.g. by promoting awareness of their implications for public health action and by enhancing the boundary spanning skills of public health officers.

Single Wall Carbon Nanotube-Based Structural Health Sensing Materials

NASA Technical Reports Server (NTRS)

Watkins, A. Neal; Ingram, JoAnne L.; Jordan, Jeffrey D.; Wincheski, Russell A.; Smits, Jan M.; Williams, Phillip A.

2004-01-01

Single wall carbon nanotube (SWCNT)-based materials represent the future aerospace vehicle construction material of choice based primarily on predicted strength-to-weight advantages and inherent multifunctionality. The multifunctionality of SWCNTs arises from the ability of the nanotubes to be either metallic or semi-conducting based on their chirality. Furthermore, simply changing the environment around a SWCNT can change its conducting behavior. This phenomenon is being exploited to create sensors capable of measuring several parameters related to vehicle structural health (i.e. strain, pressure, temperature, etc.) The structural health monitor is constructed using conventional electron-beam lithographic and photolithographic techniques to place specific electrode patterns on a surface. SWCNTs are then deposited between the electrodes using a dielectrophoretic alignment technique. Prototypes have been constructed on both silicon and polyimide substrates, demonstrating that surface-mountable and multifunctional devices based on SWCNTs can be realized.

Structural health monitoring system of soccer arena based on optical sensors

NASA Astrophysics Data System (ADS)

Shishkin, Victor V.; Churin, Alexey E.; Kharenko, Denis S.; Zheleznova, Maria A.; Shelemba, Ivan S.

2014-05-01

A structural health monitoring system based on optical sensors has been developed and installed on the indoor soccer arena "Zarya" in Novosibirsk. The system integrates 119 fiber optic sensors: 85 strain, 32 temperature and 2 displacement sensors. In addition, total station is used for measuring displacement in 45 control points. All of the constituents of the supporting structure are subjects for monitoring: long-span frames with under floor ties, connections, purlins and foundation.

Electromechanical impedance-based health diagnosis for tendon and anchorage zone in a nuclear containment structure

NASA Astrophysics Data System (ADS)

Min, Jiyoung; Shim, Hyojin; Yun, Chung-Bang

2012-04-01

For a nuclear containment structure, the structural health monitoring is essential because of its high potential risk and grave social impact. In particular, the tendon and anchorage zone are to be monitored because they are under high tensile or compressive stress. In this paper, a method to monitor the tendon force and the condition of the anchorage zone is presented by using the impedance-based health diagnosis system. First, numerical simulations were conducted for cases with various loose tensile forces on the tendon as well as damages on the bearing plate and concrete structure. Then, experimental studies were carried out on a scaled model of the anchorage system. The relationship between the loose tensile force and the impedance-based damage index was analyzed by a regression analysis. When a structure gets damaged, the damage index increases so that the status of damage can be identified. The results of the numerical and experimental studies indicate a big potential of the proposed impedance-based method for monitoring the tendon and anchorage system.

Structural Analysis Methods for Structural Health Management of Future Aerospace Vehicles

NASA Technical Reports Server (NTRS)

Tessler, Alexander

2007-01-01

Two finite element based computational methods, Smoothing Element Analysis (SEA) and the inverse Finite Element Method (iFEM), are reviewed, and examples of their use for structural health monitoring are discussed. Due to their versatility, robustness, and computational efficiency, the methods are well suited for real-time structural health monitoring of future space vehicles, large space structures, and habitats. The methods may be effectively employed to enable real-time processing of sensing information, specifically for identifying three-dimensional deformed structural shapes as well as the internal loads. In addition, they may be used in conjunction with evolutionary algorithms to design optimally distributed sensors. These computational tools have demonstrated substantial promise for utilization in future Structural Health Management (SHM) systems.

Hardware Specific Integration Strategy for Impedance-Based Structural Health Monitoring of Aerospace Systems

NASA Technical Reports Server (NTRS)

Owen, Robert B.; Gyekenyesi, Andrew L.; Inman, Daniel J.; Ha, Dong S.

2011-01-01

The Integrated Vehicle Health Management (IVHM) Project, sponsored by NASA's Aeronautics Research Mission Directorate, is conducting research to advance the state of highly integrated and complex flight-critical health management technologies and systems. An effective IVHM system requires Structural Health Monitoring (SHM). The impedance method is one such SHM technique for detection and monitoring complex structures for damage. This position paper on the impedance method presents the current state of the art, future directions, applications and possible flight test demonstrations.

Aboriginal and Torres Strait Islander community governance of health research: Turning principles into practice.

PubMed

Gwynn, Josephine; Lock, Mark; Turner, Nicole; Dennison, Ray; Coleman, Clare; Kelly, Brian; Wiggers, John

2015-08-01

Gaps exist in researchers' understanding of the 'practice' of community governance in relation to research with Aboriginal and Torres Strait Islander peoples. We examine Aboriginal community governance of two rural NSW research projects by applying principles-based criteria from two independent sources. One research project possessed a strong Aboriginal community governance structure and evaluated a 2-year healthy lifestyle program for children; the other was a 5-year cohort study examining factors influencing the mental health and well-being of participants. The National Health and Medical Research Council of Australia's 'Values and ethics: guidelines for ethical conduct in Aboriginal and Torres Strait Islander research' and 'Ten principles relevant to health research among Indigenous Australian populations' described by experts in the field. Adopt community-based participatory research constructs. Develop clear governance structures and procedures at the beginning of the study and allow sufficient time for their establishment. Capacity-building must be a key component of the research. Ensure sufficient resources to enable community engagement, conduct of research governance procedures, capacity-building and results dissemination. The implementation of governance structures and procedures ensures research addresses the priorities of the participating Aboriginal and Torres Strait Islander communities, minimises risks and improves outcomes for the communities. Principles-based Aboriginal and Torres Strait Islander community governance of research is very achievable. Next steps include developing a comprehensive evidence base for appropriate governance structures and procedures, and consolidating a suite of practical guides for structuring clear governance in health research. © 2015 National Rural Health Alliance Inc.

Development and Application of a Structural Health Monitoring System Based on Wireless Smart Aggregates

PubMed Central

Ma, Haoyan; Li, Peng; Song, Gangbing; Wu, Jianxin

2017-01-01

Structural health monitoring (SHM) systems can improve the safety and reliability of structures, reduce maintenance costs, and extend service life. Research on concrete SHMs using piezoelectric-based smart aggregates have reached great achievements. However, the newly developed techniques have not been widely applied in practical engineering, largely due to the wiring problems associated with large-scale structural health monitoring. The cumbersome wiring requires much material and labor work, and more importantly, the associated maintenance work is also very heavy. Targeting a practical large scale concrete crack detection (CCD) application, a smart aggregates-based wireless sensor network system is proposed for the CCD application. The developed CCD system uses Zigbee 802.15.4 protocols, and is able to perform dynamic stress monitoring, structural impact capturing, and internal crack detection. The system has been experimentally validated, and the experimental results demonstrated the effectiveness of the proposed system. This work provides important support for practical CCD applications using wireless smart aggregates. PMID:28714927

Development and Application of a Structural Health Monitoring System Based on Wireless Smart Aggregates.

PubMed

Yan, Shi; Ma, Haoyan; Li, Peng; Song, Gangbing; Wu, Jianxin

2017-07-17

Structural health monitoring (SHM) systems can improve the safety and reliability of structures, reduce maintenance costs, and extend service life. Research on concrete SHMs using piezoelectric-based smart aggregates have reached great achievements. However, the newly developed techniques have not been widely applied in practical engineering, largely due to the wiring problems associated with large-scale structural health monitoring. The cumbersome wiring requires much material and labor work, and more importantly, the associated maintenance work is also very heavy. Targeting a practical large scale concrete crack detection (CCD) application, a smart aggregates-based wireless sensor network system is proposed for the CCD application. The developed CCD system uses Zigbee 802.15.4 protocols, and is able to perform dynamic stress monitoring, structural impact capturing, and internal crack detection. The system has been experimentally validated, and the experimental results demonstrated the effectiveness of the proposed system. This work provides important support for practical CCD applications using wireless smart aggregates.

Long-term real-time structural health monitoring using wireless smart sensor

NASA Astrophysics Data System (ADS)

Jang, Shinae; Mensah-Bonsu, Priscilla O.; Li, Jingcheng; Dahal, Sushil

2013-04-01

Improving the safety and security of civil infrastructure has become a critical issue for decades since it plays a central role in the economics and politics of a modern society. Structural health monitoring of civil infrastructure using wireless smart sensor network has emerged as a promising solution recently to increase structural reliability, enhance inspection quality, and reduce maintenance costs. Though hardware and software framework are well prepared for wireless smart sensors, the long-term real-time health monitoring strategy are still not available due to the lack of systematic interface. In this paper, the Imote2 smart sensor platform is employed, and a graphical user interface for the long-term real-time structural health monitoring has been developed based on Matlab for the Imote2 platform. This computer-aided engineering platform enables the control, visualization of measured data as well as safety alarm feature based on modal property fluctuation. A new decision making strategy to check the safety is also developed and integrated in this software. Laboratory validation of the computer aided engineering platform for the Imote2 on a truss bridge and a building structure has shown the potential of the interface for long-term real-time structural health monitoring.

¿Somos iguales? Using a structural violence framework to understand gender and health inequities from an intersectional perspective in the Peruvian Amazon

PubMed Central

Shannon, Geordan D.; Motta, Angelica; Cáceres, Carlos F.; Skordis-Worrall, Jolene; Bowie, Diana; Prost, Audrey

2017-01-01

ABSTRACT Background: In the Peruvian Amazon, historical events of colonization and political marginalization intersect with identities of ethnicity, class and geography in the construction of gender and health inequities. Gender-based inequalities can manifest in poor health outcomes via discriminatory practices, healthcare system imbalances, inequities in health research, and differential exposures and vulnerabilities to diseases. Structural violence is a comprehensive framework to explain the mechanisms by which social forces such as poverty, racism and gender inequity become embodied as individual experiences and health outcomes, and thus may be a useful tool in structuring an intersectional analysis of gender and health inequities in Amazonian Peru. Objective: The aim of this paper is to explore the intersection of gender inequities with other social inequalities in the production of health and disease in Peru’s Amazon using a structural violence approach. Design: Exploratory qualitative research was performed in two Loreto settings – urban Iquitos and the rural Lower Napo River region – between March and November 2015. This included participant observation with prolonged stays in the community, 46 semi-structured individual interviews and three group discussions. Thematic analysis was performed to identify emerging themes related to gender inequalities in health and healthcare and how these intersect with layered social disadvantages in the reproduction of health and illness. We employed a structural violence approach to construct an intersectional analysis of gender and health inequities in Amazonian Peru. Results: Our findings were arranged into five interrelated domains within a gender, structural violence and health model: gender as a symbolic institution, systemic gender-based violence, interpersonal violence, the social determinants of health, and other health outcomes. Each domain represents one aspect of the complex associations between gender, gender inequity and health. Through this model, we were able to explore: gender, health and intersectionality; structural violence; and to highlight particular local gender and health dynamics. Intersecting influences of poverty, ethnicity, geography and gender served as significant barriers to healthcare in both rural and urban settings. PMID:28640664

Distribution of Health Resource Allocation in the Fars Province Using the Scalogram Analysis Technique in 2011.

PubMed

Hatam, Nahid; Kafashi, Shahnaz; Kavosi, Zahra

2015-07-01

The importance of health indicators in the recent years has created challenges in resource allocation. Balanced and fair distribution of health resources is one of the main principles in achieving equity. The goal of this cross-sectional descriptive study, conducted in 2010, was to classify health structural indicators in the Fars province using the scalogram technique. Health structural indicators were selected and classified in three categories; namely institutional, human resources, and rural health. The data were obtained from the statistical yearbook of Iran and was analyzed according to the scalogram technique. The distribution map of the Fars province was drawn using ArcGIS (geographic information system). The results showed an interesting health structural indicator map across the province. Our findings revealed that the city of Mohr with 85 and Zarindasht with 36 had the highest and the lowest scores, respectively. This information is valuable to provincial health policymakers to plan appropriately based on factual data and minimize chaos in allocating health resources. Based on such data and reflecting on the local needs, one could develop equity based resource allocation policies and prevent inequality. It is concluded that, as top priority, the provincial policymakers should place dedicated deprivation programs for Farashband, Eghlid and Zaindasht regions.

Lamb Wave-Based Structural Health Monitoring on Composite Bolted Joints under Tensile Load

PubMed Central

Yang, Bin; Xuan, Fu-Zhen; Xiang, Yanxun; Li, Dan; Zhu, Wujun; Tang, Xiaojun; Xu, Jichao; Yang, Kang; Luo, Chengqiang

2017-01-01

Online and offline monitoring of composite bolted joints under tensile load were investigated using piezoelectric transducers. The relationships between Lamb wave signals, pre-tightening force, the applied tensile load, as well as the failure modes were investigated. Results indicated that S0/A0 wave amplitudes decrease with the increasing of load. Relationships between damage features and S0/A0 mode were built based on the finite element (FE) simulation and experimental results. The possibility of application of Lamb wave-based structure health monitoring in bolted joint-like composite structures was thus achieved. PMID:28773014

Exploration of video-based structural health monitoring techniques.

DOT National Transportation Integrated Search

2014-10-01

Structural health monitoring (SHM) has become a viable tool to provide owners with objective data for maintenance and repair. Traditionally, discrete contact sensors such as strain gages or accelerometers have been used : for SHM. However, distribute...

Using a structural competency framework to teach structural racism in pre-health education.

PubMed

Metzl, Jonathan M; Petty, JuLeigh; Olowojoba, Oluwatunmise V

2018-02-01

The inclusion of structural competency training in pre-health undergraduate programs may offer significant benefits to future healthcare professionals. This paper presents the results of a comparative study of an interdisciplinary pre-health curriculum based in structural competency with a traditional premedical curriculum. The authors describe the interdisciplinary pre-health curriculum, titled Medicine, Health, and Society (MHS) at Vanderbilt University. The authors then use a new survey tool, the Structural Foundations of Health Survey, to evaluate structural skills and sensibilities. The analysis compares MHS majors (n = 185) with premed science majors (n = 63) and first-semester freshmen (n = 91), with particular attention to understanding how structural factors shape health. Research was conducted from August 2015 to December 2016. Results suggest that MHS majors identified and analyzed relationships between structural factors and health outcomes at higher rates and in deeper ways than did premed science majors and freshmen, and also demonstrated higher understanding of structural and implicit racism and health disparities. The skills that MHS students exhibited represent proficiencies increasingly stressed by the MCAT, the AAMC, and other educational bodies that emphasize how contextual factors shape expressions of health and illness. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Health monitoring of reinforced concrete structures based on PZT admittance signal

NASA Astrophysics Data System (ADS)

Wang, Dansheng; Zhu, Hongping; Shen, Danyan; Ge, Dongdong

2009-07-01

Reinforced concrete (RC) structure is one of most familiar engineering structure styles in the civil engineering community, which often suffer crack damage during their service life because of some factors such as overloading, excessive use, and bad environmental conditions. Thus early detection of crack damage is of special concern for RC structures. Piezoelectric materials have direct and converse piezoelectric effects and can serve as actuators or sensors. A health monitoring method based on PZT admittance signals is addressed in this paper, which use the electromechanical coupling property of piezoelectric materials. An experimental study on health monitoring of a RC beam is implemented based on the PZT admittance signals. In this experiment, the electrical admittances of distributed PZT sheets are measured when the host beams are suffering from variable loads. From the obtained PZT admittance curves one can find that the presence of incipient crack can be captured and the cracking load of the RC beam can also generally determined. By the experimental study it is concluded that the health monitoring technique is quite effective and sensitive for RC structures, which indicates its favorable application foreground in civil engineering field.

The Benefits of Youth Engagement in HIV-Preventive Structural Change Interventions

ERIC Educational Resources Information Center

Reed, Sarah J.; Miller, Robin Lin

2014-01-01

Youth are infrequently included in planning the health promotion projects designed to benefit them as many of the factors infringing upon youth's health and well-being also limit their engagement in community-based public health promotion projects. This article explores youth engagement in 13 coalitions implementing structural changes meant…

Effects of Piezoelectric (PZT) Sensor Bonding and the Characteristics of the Host Structure on Impedance Based Structural Health Monitoring

NASA Technical Reports Server (NTRS)

Jalloh, Abdul

2005-01-01

This study was conducted to investigate the effects of certain factors on the impedance signal in structural health monitoring. These factors were: the quality of the bond between the sensor and the host structure, and the characteristics of the host structure, such as geometry, mass, and material properties. This work was carried out to answer a set of questions, related to these factors, that were developed by the project team. The project team was comprised of Dr. Doug Ramers and Dr. Abdul Jalloh of the Summer Faculty Fellowship Program, Mr. Arnaldo Colon- Perez, a student intern from the University of Puerto Rico of Turabo, and Mr. John Lassiter and Mr. Bob Engberg of the Structural and Dynamics Test Group at NASA Marshall Space Flight Center (MSFC). This study was based on a review of the literature on structural health monitoring to investigate the factors referred to above because there was not enough time to plan and conduct the appropriate tests at MSFC during the tenure of the Summer Faculty Fellowship Program project members. The surveyed literature documents works on structural health monitoring that were based on laboratory tests that were conducted using bolted trusses and other civil engineering type structures for the most part. These are not the typical types of structures used in designing and building NASA s space vehicles and systems. It was therefore recommended that tests be conducted using NASA type structures, such as pressure vessels, to validate the observations made in this report.

An examination of the factors affecting people's participation in future health examinations based on community health exam interventions.

PubMed

Tu, Shih-Kai; Liao, Hung-En

2014-01-01

Community-based intervention health examinations were implemented at a health care facility to comply with the government's primary health care promotion policy. The theory of planned behavior model was applied to examine the effect that community-based health examinations had on people's health concepts regarding seeking future health examinations. The research participants were individuals who had received a health examination provided at two branches of a hospital in central Taiwan in 2012. The hospital's two branches held a total of 14 free community-based health examination sessions. The hospital provided health examination equipment and staff to perform health examinations during public holidays. We conducted an exploratory questionnaire survey to collect data and implemented cross-sectional research based on anonymous self-ratings to examine the public's intention to receive future community-based or hospital-based health examinations. Including of 807 valid questionnaires, accounting for 89.4% of the total number of questionnaires distributed. The correlation coefficients of the second-order structural model indicate that attitudes positively predict behavioral intentions (γ = .66, p < .05), and subjective norms also positively predict behavioral intentions (γ = .66, p < .01). By contrast, perceived behavioral control has no significant relationship with behavioral intentions (γ = -.71, p > .05). The results of the first-order structural model indicated that the second-order constructs had a high explanatory power for the first-order constructs. People's health concepts regarding health examinations and their desire to continue receiving health examinations must be considered when promoting health examinations in the community. Regarding hospital management and the government's implementation of primary health care, health examination services should address people's medical needs to increase coverage and participation rates and reduce the waste of medical resources.

The Pan American Health Organization and the mainstreaming of human rights in regional health governance.

PubMed

Meier, Benjamin Mason; Ayala, Ana S

2014-01-01

In the absence of centralized human rights leadership in an increasingly fragmented global health policy landscape, regional health offices have stepped forward to advance the rights-based approach to health. Reviewing the efforts of the Pan American Health Organization (PAHO), this article explores the evolution of human rights in PAHO policy, assesses efforts to mainstream human rights in the Pan American Sanitary Bureau (PASB), and analyzes the future of the rights-based approach through regional health governance, providing lessons for other regional health offices and global health institutions. This article explores PAHO's 15-year effort to mainstream human rights through PASB technical units, national capacity-building, the Inter-American human rights system, and the PAHO Directing Council. Through documentary analysis of PAHO policies and semi-structured interviews with key PASB stakeholders, the authors analyze the understandings and actions of policymakers and technical officers in implementing human rights through PAHO governance. Analyzing the themes arising from this narrative, the authors examine the structural role of secretariat leadership, state support, legal expertise, and technical unit commitment in facilitating a rights-based approach to the health in the Americas. Human rights are increasingly framing PAHO efforts, and this analysis of the structures underlying PAHO's approach provides an understanding of the institutional determinants of the rights-based approach to health, highlighting generalizable themes for the mainstreaming of human rights through regional health governance. With this regional-level understanding of health governance, future national-level research can begin to understand the causal forces linking regional human rights work with national policy reforms and public health outcomes. © 2014 American Society of Law, Medicine & Ethics, Inc.

Use of Drop-In Clinic Versus Appointment-Based Care for LGBT Youth: Influences on the Likelihood to Access Different Health-Care Structures.

PubMed

Newman, Bernie S; Passidomo, Kim; Gormley, Kate; Manley, Alecia

2014-06-01

The structure of health-care service delivery can address barriers that make it difficult for lesbian, gay, bisexual, and transgender (LGBT) adolescents to use health services. This study explores the differences among youth who access care in one of two service delivery structures in an LGBT health-care center: the drop-in clinic or the traditional appointment-based model. Analysis of 578 records of LGBT and straight youth (aged 14-24) who accessed health care either through a drop-in clinic or appointment-based care within the first year of offering the drop-in clinic reveals patterns of use when both models are available. We studied demographic variables previously shown to be associated with general health-care access to determine how each correlated with a tendency to use the drop-in structure versus routine appointments. Once the covariates were identified, we conducted a logistic regression analysis to identify its association with likelihood of using the drop-in clinic. Insurance status, housing stability, education, race, and gender identity were most strongly associated with the type of clinic used. Youth who relied on Medicaid, those in unstable housing, and African Americans were most likely to use the drop-in clinic. Transgender youth and those with higher education were more likely to use the appointment-based clinic. Although sexual orientation and HIV status were not related to type of clinic used, youth who were HIV positive used the appointment-based clinic more frequently. Both routes to health care served distinct populations who often experience barriers to accessible, affordable, and knowledgeable care. Further study of the factors related to accessing health care may clarify the extent to which drop-in hours in a youth-friendly context may increase the use of health care by the most socially marginalized youth.

Integrated structural health monitoring

NASA Astrophysics Data System (ADS)

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

2001-07-01

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

Incentives in financing mental health care in Austria.

PubMed

Zechmeister, Ingrid; Oesterle, August; Denk, Peter; Katschnig, Heinz

2002-09-01

In Austria, financing health care -and even more so mental health care- is characterized by a mix of federal and provincial responsibilities, lack of uniformity in service provision and service providers, and diverse funding arrangements. The division between financing structures for health care and social care makes the situation even more complex. This state of affairs results in various, partly counterproductive and sometimes paradoxical financial incentives and disincentives for the providers, recipients and financiers of mental health services. In several provinces of Austria, recent reform plans in mental health care have focused strongly on establishing community-based and patient-oriented mental health care. One of the main challenges in implementing this new policy is the re-allocation of resources. The authors hypothesize that the existing structure of mental health care financing, with its incentives and disincentives, constitutes an obstacle to patient-oriented community-based mental health care. Analyzing the characteristics of the overall mental health care financing system in one Austrian province, Lower Austria, will provide a better understanding of actor-relationships and inherent incentives and highlight implications for the process of deinstitutionalization. The authors used an analytical framework based on the principal-agent theory, empirical evidence, and information on financial, organizational and legal structures to identify the characteristics of actor-relationships and the position of single actors within the system. The article shows how incentives are linked to existing constellations of actors involved in mental health care financing and identifies significant power relations. As a consequence, incentives and disincentives within the financing system result in hospital- centered and supply-oriented mental health care in Lower Austria. The current system of financing mental health care provides an obstacle to the provision of patient-oriented and community-based mental care. This is due to existing constellations and power relations among the actors where, most importantly, patients are the weakest party in the patient-payer-provider triangle. Balancing power relations will be a significant prerequisite for alternative financing systems. IMPLICATIONS FOR HEALTH POLICIES AND FURTHER RESEARCH: If a community and needs-based mental health care system is to be established in Austria, the financing structures have to be changed accordingly. Applying a principal-agent framework is useful for identifying key aspects in mental health care financing in relation to the provision of services. Further research is needed to help develop alternative financing mechanisms that support community-based and patient-oriented mental health care systems.

An analysis of structural incentives in the Arizona Health Care Cost-Containment System

PubMed Central

Vogel, Ronald J.

1984-01-01

This article analyzes the financial structures of the prevailing public and private health insurance mechanisms. Based on this analysis, it was concluded that the financial structures of health insurance mechanisms are deficient in that they neither produce efficiency in the consumption of health services, nor generate efficiency in the production of health services. On the other hand, closed-end systems of finance, such as the health maintenance organization (HMO) or the new Arizona Health Care Cost-Containment System (AHCCCS), give more promise of achieving such efficiencies. The AHCCCS represents an important innovation in the public financing of health care, and, for policy purposes, should be considered a viable national alternative for the reform of Medicare and Medicaid. PMID:10310943

Acoustic Techniques for Structural Health Monitoring

NASA Astrophysics Data System (ADS)

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

2008-02-01

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

Psychometric Validation of the Parental Bonding Instrument in a U.K. Population-Based Sample: Role of Gender and Association With Mental Health in Mid-Late Life.

PubMed

Xu, Man K; Morin, Alexandre J S; Marsh, Herbert W; Richards, Marcus; Jones, Peter B

2016-08-01

The factorial structure of the Parental Bonding Instrument (PBI) has been frequently studied in diverse samples but no study has examined its psychometric properties from large, population-based samples. In particular, important questions have not been addressed such as the measurement invariance properties across parental and offspring gender. We evaluated the PBI based on responses from a large, representative population-based sample, using an exploratory structural equation modeling method appropriate for categorical data. Analysis revealed a three-factor structure representing "care," "overprotection," and "autonomy" parenting styles. In terms of psychometric measurement validity, our results supported the complete invariance of the PBI ratings across sons and daughters for their mothers and fathers. The PBI ratings were also robust in relation to personality and mental health status. In terms of predictive value, paternal care showed a protective effect on mental health at age 43 in sons. The PBI is a sound instrument for capturing perceived parenting styles, and is predictive of mental health in middle adulthood. © The Author(s) 2016.

Structural adjustment and health: A conceptual framework and evidence on pathways.

PubMed

Kentikelenis, Alexander E

2017-08-01

Economic reform programs designed by the International Monetary Fund and the World Bank-so-called 'structural adjustment programs'-have formed one of the most influential policy agendas of the past four decades. To gain access to financial support from these organizations, countries-often in economic crisis-have reduced public spending, limited the role of the state, and deregulated economic activity. This article identifies the multiple components of structural adjustment, and presents a conceptual framework linking them to health systems and outcomes. Based on a comprehensive review of the academic literature, the article identifies three main pathways through which structural adjustment affects health: policies directly targeting health systems; policies indirectly impacting health systems; and policies affecting the social determinants of health. The cogency of the framework is illustrated by revisiting Greece's recent experience with structural adjustment, drawing on original IMF reports and secondary literature. Overall, the framework offers a lens through which to analyze the health consequences of structural adjustment across time, space and levels of socioeconomic development, and can be utilized in ex ante health impact assessments of these policies. Copyright © 2017 Elsevier Ltd. All rights reserved.

Beyond context to the skyline: thinking in 3D.

PubMed

Hoagwood, Kimberly; Olin, Serene; Cleek, Andrew

2013-01-01

Sweeping and profound structural, regulatory, and fiscal changes are rapidly reshaping the contours of health and mental health practice. The community-based practice contexts described in the excellent review by Garland and colleagues are being fundamentally altered with different business models, regional networks, accountability standards, and incentive structures. If community-based mental health services are to remain viable, the two-dimensional and flat research and practice paradigm has to be replaced with three-dimensional thinking. Failure to take seriously the changes that are happening to the larger healthcare context and respond actively through significant system redesign will lead to the demise of specialty mental health services.

Unpacking the ‘structural’ in a structural approach for HIV prevention among female sex workers: A case study from China

PubMed Central

Huang, Yingying; Muessig, Kathryn E.; Zhang, Ning; Maman, Suzanne

2015-01-01

Interventions for HIV prevention among female sex workers (FSWs) in China focus on HIV/sexually transmitted infection (STI) and individual behaviour change. An occupational health framework facilitates intervention across an array of health issues FSWs face including HIV/STI, violence, reproductive health, stigma and substance use. Through a case study of a community-based Jiaozhou (JZ) FSW programme, we developed a conceptual framework incorporating global discussions of structural approaches to HIV prevention with the specific social and structural contexts identified among FSWs in China. Based on ethnographic fieldwork between August 2010 and May 2013, we describe the evolution of this programme to its current occupational health focus and unpack the intervention strategies. We describe the critical features of the programme that have fostered success among FSWs including high-quality clinical services provided within a welcoming setting, responsive outreach work through staff and trained FSW peers, interpersonal and community-level engagement aimed at changing the local social and structural environments of sex work and tailored health education materials. This intervention differs from other projects in China by adopting a more holistic approach to FSW health that incorporates social issues. It also demonstrates the feasibility of structural interventions among FSWs even within an environment that has strong anti-prostitution policies. PMID:25742611

An Embedded Wireless Sensor Network with Wireless Power Transmission Capability for the Structural Health Monitoring of Reinforced Concrete Structures.

PubMed

Gallucci, Luca; Menna, Costantino; Angrisani, Leopoldo; Asprone, Domenico; Moriello, Rosario Schiano Lo; Bonavolontà, Francesco; Fabbrocino, Francesco

2017-11-07

Maintenance strategies based on structural health monitoring can provide effective support in the optimization of scheduled repair of existing structures, thus enabling their lifetime to be extended. With specific regard to reinforced concrete (RC) structures, the state of the art seems to still be lacking an efficient and cost-effective technique capable of monitoring material properties continuously over the lifetime of a structure. Current solutions can typically only measure the required mechanical variables in an indirect, but economic, manner, or directly, but expensively. Moreover, most of the proposed solutions can only be implemented by means of manual activation, making the monitoring very inefficient and then poorly supported. This paper proposes a structural health monitoring system based on a wireless sensor network (WSN) that enables the automatic monitoring of a complete structure. The network includes wireless distributed sensors embedded in the structure itself, and follows the monitoring-based maintenance (MBM) approach, with its ABCDE paradigm, namely: accuracy, benefit, compactness, durability, and easiness of operations. The system is structured in a node level and has a network architecture that enables all the node data to converge in a central unit. Human control is completely unnecessary until the periodic evaluation of the collected data. Several tests are conducted in order to characterize the system from a metrological point of view and assess its performance and effectiveness in real RC conditions.

Assessing the viability of situationally driven segmentation opportunities in the health care market.

PubMed

Gehrt, K C; Pinto, M B

1993-01-01

The impact of situational factors has typically been investigated in the context of goods marketing. Very few studies have investigated the influence of situational factors on services marketing. This study demonstrates the importance of situational influence on services marketing by delineating a consumer-based, situationally characterized competitive market structure for health care services. The competitive structure of the health care market is delineated in terms of the similarity/substitutability of the three-factor, situational characterizations of ten health care alternatives. The general marketing implications of the market-structure delineation procedure and the health care-specific implications of the findings are discussed.

[National health fund and morbidity-based risk structure equalization with focus on haemophilia].

PubMed

König, T

2010-11-01

The Gesundheitsfonds (national health fund) was established in Germany on January 1st, 2009, in combination with the morbidity-based risk structure equalization (RSA) in order to manage the cash flow between the statutory health insurances. The RSA equalizes income differences due to the varying levels of contributory income of the members of a health insurance (basic wage totals) and expenditure differences due to varying distribution of morbidity risks across different health insurances, as well as the varying numbers of non-contributing insured family members. Additionally, insured persons are allocated to morbidity groups according to a classification model based upon diagnoses and prescriptions anticipating medical expenses in the subsequent year. Haemophilia falls, among 80 disease entities, in the morbidity group which generates the highest risk supplement. Matching of prescribed drugs with disease entities facilitates disease grading and improves the accuracy of risk supplements.

More than culture: structural racism, intersectionality theory, and immigrant health.

PubMed

Viruell-Fuentes, Edna A; Miranda, Patricia Y; Abdulrahim, Sawsan

2012-12-01

Explanations for immigrant health outcomes often invoke culture through the use of the concept of acculturation. The over reliance on cultural explanations for immigrant health outcomes has been the topic of growing debate, with the critics' main concern being that such explanations obscure the impact of structural factors on immigrant health disparities. In this paper, we highlight the shortcomings of cultural explanations as currently employed in the health literature, and argue for a shift from individual culture-based frameworks, to perspectives that address how multiple dimensions of inequality intersect to impact health outcomes. Based on our review of the literature, we suggest specific lines of inquiry regarding immigrants' experiences with day-to-day discrimination, as well as on the roles that place and immigration policies play in shaping immigrant health outcomes. The paper concludes with suggestions for integrating intersectionality theory in future research on immigrant health. Copyright © 2012 Elsevier Ltd. All rights reserved.

Creating academic structures to promote nursing's role in global health policy.

PubMed

Gimbel, S; Kohler, P; Mitchell, P; Emami, A

2017-03-01

We highlight key components of emerging academic structures in global health nursing and explain how this investment can expand nursing's broader engagement in global health policy development. Engaging nursing in global health policy development is vital to ensure the scale-up of effective health programmes. Globally, nurses promote development of interprofessional healthcare teams who are responsible for translating sound global health policy and evidence-based programming into practice. However, the role of nurses within policy forums and on influential decision-making bodies within the global health space remains limited, which reinforces suboptimal global health policy implementation. Investment in globally engaged academic structures is an important way to expand participation of nursing in global health policy development. A review of the current knowledge and substantive findings related to academic structures promoting global health nursing was conducted, and included a directed search of institutional websites, related grey and peer-reviewed literature, and communication with top-tier schools of nursing in the United States, to identify specific developments in global health nursing academic structures. Effective academic structures promoting global health nursing include a framework of four critical components - Research, Education, Policy and Partnership. Academic structure type and core activities vary depending on institutional priorities. Increasingly, global health research, driven by individual nursing investigators, is expanding; however, in order to translate these advances into expanded involvement in global health policy development, academic structures within schools of nursing need to systematically expand educational opportunities, bolster research capacity and promote partnership with policymakers. © 2017 The Authors International Nursing Review published by John Wiley & Sons Ltd on behalf of International Council of Nurses.

Meanings of health: interrogating structure and culture.

PubMed

Dutta, Mohan Jyoti; Basu, Ambar

2008-11-01

Based on the argument that context ought to be centralized in discourses of health communication, this article applies the culture-centered approach to engage in dialogue about issues of health with 18 men in rural West Bengal. The culture-centered approach is based on dialogue between the researcher and the community members, with the goals of listening to the voices of cultural members in suggesting culture-based health solutions. In this project, our discursive engagement with the participants suggests that health is primarily constructed as an absence, framed in the realm of minimal access to healthcare resources. In a situation where the resources are limited, the participants discussed the importance of trust in their relationship with the local provider. Health was also seen as a collective resource that was both an asset of the collective and a responsibility of the collective. Finally, the participants also pointed out the ways in which corruption in the structure introduced a paradox in policy discourse and the material conditions of the participants.

Structural and functional social network attributes moderate the association of self-rated health with mental health in midlife and older adults.

PubMed

Windsor, Tim D; Rioseco, Pilar; Fiori, Katherine L; Curtis, Rachel G; Booth, Heather

2016-01-01

Social relationships are multifaceted, and different social network components can operate via different processes to influence well-being. This study examined associations of social network structure and relationship quality (positive and negative social exchanges) with mental health in midlife and older adults. The focus was on both direct associations of network structure and relationship quality with mental health, and whether these social network attributes moderated the association of self-rated health (SRH) with mental health. Analyses were based on survey data provided by 2001 (Mean age = 65, SD = 8.07) midlife and older adults. We used Latent Class Analysis (LCA) to classify participants into network types based on network structure (partner status, network size, contact frequency, and activity engagement), and used continuous measures of positive and negative social exchanges to operationalize relationship quality. Regression analysis was used to test moderation. LCA revealed network types generally consistent with those reported in previous studies. Participants in more diverse networks reported better mental health than those categorized into a restricted network type after adjustment for age, sex, education, and employment status. Analysis of moderation indicated that those with poorer SRH were less likely to report poorer mental health if they were classified into more diverse networks. A similar moderation effect was also evident for positive exchanges. The findings suggest that both quantity and quality of social relationships can play a role in buffering against the negative implications of physical health decline for mental health.

Public health research support through the European structural funds in central and eastern Europe and the Mediterranean.

PubMed

McCarthy, Mark

2012-04-05

Public health research provides evidence for practice across fields including health care, health promotion and health surveillance. Levels of public health research vary markedly across European Union (EU) countries, and are lowest in the EU's new member states (in Central and Eastern Europe and the Mediterranean). However, these countries now receive most of the EU's Structural Funds, some of which are allocated to research. STEPS, an EU-funded study, sought to assess support for public health research at national and European levels. To identify support through the Structural funds, STEPS drew information from country respondents and internet searches for all twelve EU new member states. The EU allocates annually around €7 billion through the Structural Funds for member states' own use on research. These funds can cover infrastructure, academic employment, and direct research grants. The programmes emphasise links to business. Support for health research includes major projects in biosciences, but direct support for public health research was found in only three countries - Cyprus, Latvia and Lithuania. Public health research is not prioritised in the EU's Structural Funds programme in comparison with biomedicine. For the research dimension of the new European programme for Structural Funds 2014-2002, ministries of health should propose public health research to strengthen the evidence-base for European public health policy and practice.

Adoption of Smart Structures for Prevention of Health Hazards in Buildings

NASA Astrophysics Data System (ADS)

Oke, Ayodeji; Aigbavboa, Clinton; Ngema, Wiseman

2017-11-01

The importance of building quality to the health and well-being of occupants and surrounding neighbors cannot be overemphasized. Smart structures were construed to proffer solution to various issues of sustainable development including social factors that is concerned with health and safety of people. Based on existing literature materials on building quality, smart structures and general aspect of sustainable developments, this study examined the benefits of smart structures in the prevention of various health issues in infrastructural buildings, which has been a concern for stakeholders in the architecture, engineering and construction industry. The criterion for indoor environmental quality was adopted and various health and bodily issues related to building quality were explained. The adoption of smart structure concept will help to manage physical, chemical, biological and psychological factors of building with a view to enhancing better quality of life of occupants.

The cultural production of health inequalities: a cross-sectional, multilevel examination of 52 countries.

PubMed

Mansyur, Carol Leler; Amick, Benjamin C; Harrist, Ronald B; Franzini, Luisa; Roberts, Robert E

2009-01-01

In a 2001 report, the U.S. National Institutes of Health called for more integration of the social sciences into health-related research, including research guided by theories and methods that take social and cultural systems into consideration. Based on a theoretical framework that integrates Hofstede's cultural dimensions with sociological theory, the authors used multilevel modeling to explore the association of culture with structural inequality and health disparities. Their results support the idea that cultural dimensions and social structure, along with economic development, may account for much of the cross-national variation in the distribution of health inequalities. Sensitivity tests also suggest that an interaction between culture and social structure may confound the relationship between income inequality and health. It is necessary to identify important cultural and social structural characteristics before we can achieve an understanding of the complex, dynamic systems that affect health, and develop culturally sensitive interventions and policies. This study takes a step toward identifying some of the relevant cultural and structural influences. More research is needed to explore the pathways leading from the sociocultural environment to health inequalities.

Does standardised structured reporting contribute to quality in diagnostic pathology? The importance of evidence-based datasets.

PubMed

Ellis, D W; Srigley, J

2016-01-01

Key quality parameters in diagnostic pathology include timeliness, accuracy, completeness, conformance with current agreed standards, consistency and clarity in communication. In this review, we argue that with worldwide developments in eHealth and big data, generally, there are two further, often overlooked, parameters if our reports are to be fit for purpose. Firstly, population-level studies have clearly demonstrated the value of providing timely structured reporting data in standardised electronic format as part of system-wide quality improvement programmes. Moreover, when combined with multiple health data sources through eHealth and data linkage, structured pathology reports become central to population-level quality monitoring, benchmarking, interventions and benefit analyses in public health management. Secondly, population-level studies, particularly for benchmarking, require a single agreed international and evidence-based standard to ensure interoperability and comparability. This has been taken for granted in tumour classification and staging for many years, yet international standardisation of cancer datasets is only now underway through the International Collaboration on Cancer Reporting (ICCR). In this review, we present evidence supporting the role of structured pathology reporting in quality improvement for both clinical care and population-level health management. Although this review of available evidence largely relates to structured reporting of cancer, it is clear that the same principles can be applied throughout anatomical pathology generally, as they are elsewhere in the health system.

Sensitivity analysis of bridge health index to element failure and element conditions.

DOT National Transportation Integrated Search

2009-11-01

Bridge Health Index (BHI) is a bridge performance measure based on the condition of the bridge elements. It : is computed as the ratio of remaining value of the bridge structure to the initial value of the structure. Since it : is expressed as a perc...

75 FR 17745 - Tribal Management Grant Program; Announcement Type: New and Competing Continuation Discretionary...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-07

... Points) A. Describe the organizational structure of the Tribe/Tribal organization beyond health care... Tribal Organizations.'' Priority II participation is only applicable to the Health Management Structure... will be issued under this grant program. Project Periods: Varies based on project type from one to...

Ideological and organizational components of differing public health strategies for addressing the social determinants of health.

PubMed

Raphael, Dennis; Brassolotto, Julia; Baldeo, Navindra

2015-12-01

Despite a history of conceptual contributions to reducing health inequalities by addressing the social determinants of health (SDH), Canadian governmental authorities have struggled to put these concepts into action. Ontario's-Canada's most populous province-public health scene shows a similar pattern. In statements and reports, governmental ministries, professional associations and local public health units (PHUs) recognize the importance of these issues, yet there has been varying implementation of these concepts into public health activity. The purpose of this study was to gain insight into the key features responsible for differences in SDH-related activities among local PHUs. We interviewed Medical Officers of Health (MOH) and key staff members from nine local PHUs in Ontario varying in SDH activity as to their understandings of the SDH, public health's role in addressing the SDH, and their units' SDH-related activities. We also reviewed their unit's documents and their organizational structures in relation to acting on the SDH. Three clusters of PHUs are identified based on their SDH-related activities: service-delivery-oriented; intersectoral and community-based; and public policy/public education-focused. The two key factors that differentiate PHUs are specific ideological commitments held by MOHs and staff and the organizational structures established to carry out SDH-related activities. The ideological commitments and the organizational structures of the most active PHUs showed congruence with frameworks adopted by national jurisdictions known for addressing health inequalities. These include a structural analysis of the SDH and a centralized organizational structure that coordinates SDH-related activities. © The Author (2014). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

An Embedded Wireless Sensor Network with Wireless Power Transmission Capability for the Structural Health Monitoring of Reinforced Concrete Structures

PubMed Central

Gallucci, Luca; Menna, Costantino; Angrisani, Leopoldo; Asprone, Domenico

2017-01-01

Maintenance strategies based on structural health monitoring can provide effective support in the optimization of scheduled repair of existing structures, thus enabling their lifetime to be extended. With specific regard to reinforced concrete (RC) structures, the state of the art seems to still be lacking an efficient and cost-effective technique capable of monitoring material properties continuously over the lifetime of a structure. Current solutions can typically only measure the required mechanical variables in an indirect, but economic, manner, or directly, but expensively. Moreover, most of the proposed solutions can only be implemented by means of manual activation, making the monitoring very inefficient and then poorly supported. This paper proposes a structural health monitoring system based on a wireless sensor network (WSN) that enables the automatic monitoring of a complete structure. The network includes wireless distributed sensors embedded in the structure itself, and follows the monitoring-based maintenance (MBM) approach, with its ABCDE paradigm, namely: accuracy, benefit, compactness, durability, and easiness of operations. The system is structured in a node level and has a network architecture that enables all the node data to converge in a central unit. Human control is completely unnecessary until the periodic evaluation of the collected data. Several tests are conducted in order to characterize the system from a metrological point of view and assess its performance and effectiveness in real RC conditions. PMID:29112128

Organizational capacities for health promotion implementation: results from an international hospital study.

PubMed

Röthlin, Florian; Schmied, Hermann; Dietscher, Christina

2015-06-01

In this article, organizational structures in hospitals are discussed as possible capacities for hospital health promotion (HP) implementation, based on data from the PRICES-HPH study. PRICES-HPH is a cross-sectional evaluation study of the International Network of Health Promoting Hospitals & Health Services (HPH-Network) and was conducted in 2008-2012. Data from 159 acute care hospitals were used in the analysis. Twelve organizational structures, which were denoted as possible organizational health promotion capacities in previous literature, were tested for their association with certain strategic HP implementation approaches. Four organizational structures were significantly (p = 0.05) associated with one or more elaborate and comprehensive strategic HP implementation approaches: (1) a health promotion specific quality assessment routine; (2) an official hospital health promotion team; (3) a fulltime hospital health promotion coordinator; and (4) officially documented health promotion policies, strategies or standards. The results add further evidence to the importance of organizational capacity structures for hospital health promotion and identify four tangible structures as likely candidates for organizational HP capacities in hospitals. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Ultrasonic wave-based structural health monitoring embedded instrument.

PubMed

Aranguren, G; Monje, P M; Cokonaj, Valerijan; Barrera, Eduardo; Ruiz, Mariano

2013-12-01

Piezoelectric sensors and actuators are the bridge between electronic and mechanical systems in structures. This type of sensor is a key element in the integrity monitoring of aeronautic structures, bridges, pressure vessels, wind turbine blades, and gas pipelines. In this paper, an all-in-one system for Structural Health Monitoring (SHM) based on ultrasonic waves is presented, called Phased Array Monitoring for Enhanced Life Assessment. This integrated instrument is able to generate excitation signals that are sent through piezoelectric actuators, acquire the received signals in the piezoelectric sensors, and carry out signal processing to check the health of structures. To accomplish this task, the instrument uses a piezoelectric phased-array transducer that performs the actuation and sensing of the signals. The flexibility and strength of the instrument allow the user to develop and implement a substantial part of the SHM technique using Lamb waves. The entire system is controlled using configuration software and has been validated through functional, electrical loading, mechanical loading, and thermal loading resistance tests.

Health Monitoring of Composite Material Structures using a Vibrometry Technique

NASA Technical Reports Server (NTRS)

Schulz, Mark J.

1997-01-01

Large composite material structures such as aircraft and Reusable Launch Vehicles (RLVS) operate in severe environments comprised of vehicle dynamic loads, aerodynamic loads, engine vibration, foreign object impact, lightning strikes, corrosion, and moisture absorption. These structures are susceptible to damage such as delamination, fiber breaking/pullout, matrix cracking, and hygrothermal strain. To ensure human safety and load-bearing integrity, these structures must be inspected to detect and locate often invisible damage and faults before becoming catastrophic. Moreover, nearly all future structures will need some type of in-service inspection technique to increase their useful life and reduce maintenance and overall costs. Possible techniques for monitoring the health and indicating damage on composite structures include: c-scan, thermography, acoustic emissions using piezoceramic actuators or fiber-optic wires with gratings, laser ultrasound, shearography, holography, x-ray, and others. These techniques have limitations in detecting damage that is beneath the surface of the structure, far away from a sensor location, or during operation of the vehicle. The objective of this project is to develop a more global method for damage detection that is based on structural dynamics principles, and can inspect for damage when the structure is subjected to vibratory loads to expose faults that may not be evident by static inspection. A Transmittance Function Monitoring (TFM) method is being developed in this project for ground-based inspection and operational health monitoring of large composite structures as a RLV. A comparison of the features of existing health monitoring approaches and the proposed TFM method is given.

QSAR modeling based on structure-information for properties of interest in human health.

PubMed

Hall, L H; Hall, L M

2005-01-01

The development of QSAR models based on topological structure description is presented for problems in human health. These models are based on the structure-information approach to quantitative biological modeling and prediction, in contrast to the mechanism-based approach. The structure-information approach is outlined, starting with basic structure information developed from the chemical graph (connection table). Information explicit in the connection table (element identity and skeletal connections) leads to significant (implicit) structure information that is useful for establishing sound models of a wide range of properties of interest in drug design. Valence state definition leads to relationships for valence state electronegativity and atom/group molar volume. Based on these important aspects of molecules, together with skeletal branching patterns, both the electrotopological state (E-state) and molecular connectivity (chi indices) structure descriptors are developed and described. A summary of four QSAR models indicates the wide range of applicability of these structure descriptors and the predictive quality of QSAR models based on them: aqueous solubility (5535 chemically diverse compounds, 938 in external validation), percent oral absorption (%OA, 417 therapeutic drugs, 195 drugs in external validation testing), AMES mutagenicity (2963 compounds including 290 therapeutic drugs, 400 in external validation), fish toxicity (92 substituted phenols, anilines and substituted aromatics). These models are established independent of explicit three-dimensional (3-D) structure information and are directly interpretable in terms of the implicit structure information useful to the drug design process.

Survey of social health insurance structure in selected countries; providing framework for basic health insurance in Iran

PubMed Central

Mohammadi, Effat; Raissi, Ahmad Reza; Barooni, Mohsen; Ferdoosi, Massoud; Nuhi, Mojtaba

2014-01-01

Introduction and Objectives: Health system reforms are the most strategic issue that has been seriously considered in healthcare systems in order to reduce costs and increase efficiency and effectiveness. The costs of health system finance in our country, lack of universal coverage in health insurance, and related issues necessitate reforms in our health system financing. The aim of this research was to prepare a structure of framework for social health insurance in Iran and conducting a comparative study in selected countries with social health insurance. Materials and Methods: This comparative descriptive study was conducted in three phases. The first phase of the study examined the structure of health social insurance in four countries – Germany, South Korea, Egypt, and Australia. The second phase was to develop an initial model, which was designed to determine the shared and distinguishing points of the investigated structures, for health insurance in Iran. The third phase was to validate the final research model. The developed model by the Delphi method was given to 20 professionals in financing of the health system, health economics and management of healthcare services. Their comments were collected in two stages and its validity was confirmed. Findings: The study of the structure of health insurance in the selected countries shows that health social insurance in different countries have different structures. Based on the findings of the present study, the current situation of the health system, and the conducted surveys, the following framework is suitable for the health social insurance system in Iran. The Health Social Insurance Organization has a unique service by having five funds of governmental employees, companies and NGOs, self-insured, villagers, and others, which serves as a nongovernmental organization under the supervision of public law and by decision- and policy-making of the Health Insurance Supreme Council. Membership in this organization is based on the nationality or residence, which the insured by paying the insurance premiums within 6-10% of their income and employment status, are entitled to use the services. Providing services to the insured are performed by indirect forms. Payments to the service providers for the fee of inpatient and outpatient services are conservative and the related diagnostic groups system. Conclusions: Paying attention to the importance of modification of the fragmented health insurance system and financing the country's healthcare can reduce much of the failure of the health system, including the access of the public to health services. The countries according to the degree of development, governmental, and private insurance companies and existing rules must use the appropriate structure, comprehensive approach to the structure, and financing of the health social insurance on the investigated basis and careful attention to the intersections and differentiation. Studied structures, using them in the proposed approach and taking advantages of the perspectives of different beneficiaries about discussed topics can be important and efficient in order to achieve the goals of the health social insurance. PMID:25540789

Survey of social health insurance structure in selected countries; providing framework for basic health insurance in Iran.

PubMed

Mohammadi, Effat; Raissi, Ahmad Reza; Barooni, Mohsen; Ferdoosi, Massoud; Nuhi, Mojtaba

2014-01-01

Health system reforms are the most strategic issue that has been seriously considered in healthcare systems in order to reduce costs and increase efficiency and effectiveness. The costs of health system finance in our country, lack of universal coverage in health insurance, and related issues necessitate reforms in our health system financing. The aim of this research was to prepare a structure of framework for social health insurance in Iran and conducting a comparative study in selected countries with social health insurance. This comparative descriptive study was conducted in three phases. The first phase of the study examined the structure of health social insurance in four countries - Germany, South Korea, Egypt, and Australia. The second phase was to develop an initial model, which was designed to determine the shared and distinguishing points of the investigated structures, for health insurance in Iran. The third phase was to validate the final research model. The developed model by the Delphi method was given to 20 professionals in financing of the health system, health economics and management of healthcare services. Their comments were collected in two stages and its validity was confirmed. The study of the structure of health insurance in the selected countries shows that health social insurance in different countries have different structures. Based on the findings of the present study, the current situation of the health system, and the conducted surveys, the following framework is suitable for the health social insurance system in Iran. The Health Social Insurance Organization has a unique service by having five funds of governmental employees, companies and NGOs, self-insured, villagers, and others, which serves as a nongovernmental organization under the supervision of public law and by decision- and policy-making of the Health Insurance Supreme Council. Membership in this organization is based on the nationality or residence, which the insured by paying the insurance premiums within 6-10% of their income and employment status, are entitled to use the services. Providing services to the insured are performed by indirect forms. Payments to the service providers for the fee of inpatient and outpatient services are conservative and the related diagnostic groups system. Paying attention to the importance of modification of the fragmented health insurance system and financing the country's healthcare can reduce much of the failure of the health system, including the access of the public to health services. The countries according to the degree of development, governmental, and private insurance companies and existing rules must use the appropriate structure, comprehensive approach to the structure, and financing of the health social insurance on the investigated basis and careful attention to the intersections and differentiation. Studied structures, using them in the proposed approach and taking advantages of the perspectives of different beneficiaries about discussed topics can be important and efficient in order to achieve the goals of the health social insurance.

Combining model based and data based techniques in a robust bridge health monitoring algorithm.

DOT National Transportation Integrated Search

2014-09-01

Structural Health Monitoring (SHM) aims to analyze civil, mechanical and aerospace systems in order to assess : incipient damage occurrence. In this project, we are concerned with the development of an algorithm within the : SHM paradigm for applicat...

Social determinants of health in Canada: Are healthy living initiatives there yet? A policy analysis

PubMed Central

2012-01-01

Introduction Preventative strategies that focus on addressing the social determinants of health to improve healthy eating and physical activity have become an important strategy in British Columbia and Ontario for combating chronic diseases. What has not yet been examined is the extent to which healthy living initiatives implemented under these new policy frameworks successfully engage with and change the social determinants of health. Methods Initiatives active between January 1, 2006 and September 1, 2011 were found using provincial policy documents, web searches, health organization and government websites, and databases of initiatives that attempted to influence to nutrition and physical activity in order to prevent chronic diseases or improve overall health. Initiatives were reviewed, analyzed and grouped using the descriptive codes: lifestyle-based, environment-based or structure-based. Initiatives were also classified according to the mechanism by which they were administered: as direct programs (e.g. directly delivered), blueprints (or frameworks to tailor developed programs), and building blocks (resources to develop programs). Results 60 initiatives were identified in Ontario and 61 were identified in British Columbia. In British Columbia, 11.5% of initiatives were structure-based. In Ontario, of 60 provincial initiatives identified, 15% were structure-based. Ontario had a higher proportion of direct interventions than British Columbia for all intervention types. However, in both provinces, as the intervention became more upstream and attempted to target the social determinants of health more directly, the level of direct support for the intervention lessened. Conclusions The paucity of initiatives in British Columbia and Ontario that address healthy eating and active living through action on the social determinants of health is problematic. In the context of Canada's increasingly neoliberal political and economic policy, the public health sector may face significant barriers to addressing upstream determinants in a meaningful way. If public health cannot directly affect broader societal conditions, interventions should be focused around advocacy and education about the social determinants of health. It is necessary that health be seen for what it is: a political matter. As such, the health sector needs to take a more political approach in finding solutions for health inequities. PMID:22889402

Patterns in PARTNERing across Public Health Collaboratives.

PubMed

Bevc, Christine A; Retrum, Jessica H; Varda, Danielle M

2015-10-05

Inter-organizational networks represent one of the most promising practice-based approaches in public health as a way to attain resources, share knowledge, and, in turn, improve population health outcomes. However, the interdependencies and effectiveness related to the structure, management, and costs of these networks represents a critical item to be addressed. The objective of this research is to identify and determine the extent to which potential partnering patterns influence the structure of collaborative networks. This study examines data collected by PARTNER, specifically public health networks (n = 162), to better understand the structured relationships and interactions among public health organizations and their partners, in relation to collaborative activities. Combined with descriptive analysis, we focus on the composition of public health collaboratives in a series of Exponential Random Graph (ERG) models to examine the partnerships between different organization types to identify the attribute-based effects promoting the formation of network ties within and across collaboratives. We found high variation within and between these collaboratives including composition, diversity, and interactions. The findings of this research suggest common and frequent types of partnerships, as well as opportunities to develop new collaborations. The result of this analysis offer additional evidence to inform and strengthen public health practice partnerships.

Telematics and smart cards in integrated health information system.

PubMed

Sicurello, F; Nicolosi, A

1997-01-01

Telematics and information technology are the base on which it will be possible to build an integrated health information system to support population and improve their quality of life. This system should be based on record linkage of all data based on the interactions of the patients with the health structures, such as general practitioners, specialists, health institutes and hospitals, pharmacies, etc. The record linkage can provide the connection and integration of various records, thanks to the use of telematic technology (either urban or geographical local networks, such as the Internet) and electronic data cards. Particular emphasis should be placed on the introduction of smart cards, such as portable health cards, which will contain a standardized data set and will be sufficient to access different databases found in various health services. The inter-operability of the social-health records (including multimedia types) and the smart cards (which are one of the most important prerequisites for the homogenization and wide diffusion of these cards at an European level) should be strongly taken into consideration. In this framework a project is going to be developed aiming towards the integration of various data bases distributed territorially, from the reading of the software and the updating of the smart cards to the complete management of the patients' evaluation records, to the quality of the services offered and to the health planning. The applications developed will support epidemiological investigation software and data analysis. The inter-connection of all the databases of the various structures involved will take place through a coordination center, the most important system of which we will call "record linkage" or "integrated database". Smart cards will be distributed to a sample group of possible users and the necessary smart card management tools will be installed in all the structures involved. All the final users (the patients) in the whole network of services involved will be monitored for the duration of the project. The system users will also include general practitioners, social workers, physicians, health operators, pharmacists, laboratory workers and administrative personnel of the municipality and of the health structures concerned.

A Tensor-Based Structural Damage Identification and Severity Assessment

PubMed Central

Anaissi, Ali; Makki Alamdari, Mehrisadat; Rakotoarivelo, Thierry; Khoa, Nguyen Lu Dang

2018-01-01

Early damage detection is critical for a large set of global ageing infrastructure. Structural Health Monitoring systems provide a sensor-based quantitative and objective approach to continuously monitor these structures, as opposed to traditional engineering visual inspection. Analysing these sensed data is one of the major Structural Health Monitoring (SHM) challenges. This paper presents a novel algorithm to detect and assess damage in structures such as bridges. This method applies tensor analysis for data fusion and feature extraction, and further uses one-class support vector machine on this feature to detect anomalies, i.e., structural damage. To evaluate this approach, we collected acceleration data from a sensor-based SHM system, which we deployed on a real bridge and on a laboratory specimen. The results show that our tensor method outperforms a state-of-the-art approach using the wavelet energy spectrum of the measured data. In the specimen case, our approach succeeded in detecting 92.5% of induced damage cases, as opposed to 61.1% for the wavelet-based approach. While our method was applied to bridges, its algorithm and computation can be used on other structures or sensor-data analysis problems, which involve large series of correlated data from multiple sensors. PMID:29301314

A case-based, problem-based learning approach to prepare master of public health candidates for the complexities of global health.

PubMed

Leon, Juan S; Winskell, Kate; McFarland, Deborah A; del Rio, Carlos

2015-03-01

Global health is a dynamic, emerging, and interdisciplinary field. To address current and emerging global health challenges, we need a public health workforce with adaptable and collaborative problem-solving skills. In the 2013-2014 academic year, the Hubert Department of Global Health at the Rollins School of Public Health-Emory University launched an innovative required core course for its first-year Master of Public Health students in the global health track. The course uses a case-based, problem-based learning approach to develop global health competencies. Small teams of students propose solutions to these problems by identifying learning issues and critically analyzing and synthesizing new information. We describe the course structure and logistics used to apply this approach in the context of a large class and share lessons learned.

Health Care Delivery.

ERIC Educational Resources Information Center

Starfield, Barbara

1987-01-01

The article reviews emerging health care delivery options for handicapped children. Cost structures, quality of care, and future prospects are considered for Health Maintenance Organizations, Preferred Provider Organizations, Tax Supported Direct Service Programs, Hospital-Based Services, and Ambulatory Care Organizations. (Author/DB)

Vancouver Coastal Health's Second Generation Health Strategy: A need for a reboot?

PubMed

Masuda, Jeffrey R; Chan, Sophy

2017-03-01

In this commentary, we consider the motivations and implications of Vancouver Coastal Health's place-based population health strategy called the Downtown Eastside Second Generation Health Strategy (2GHS) in light of a broader historical view of shifting values in population and public health and structural health reforms in Canada over the past three decades. We argue that the tone and content of the 2GHS signals a shift towards a neoliberal clientelist model of health that treats people as patients and the DTES as a site of clinical encounter rather than as a community in its own right. In its clinical emphasis, the 2GHS fails to recognize the political dimension of health and well-being in the DTES, a community that faces compounding health risks associated with colonialism, gentrification, human displacement, the criminalization of poverty, sex work, and the street economy. Furthermore, we suggest that in its emphasis on allocating funding based on a rationalist model of health system access, the 2GHS undermines well-established insights and best practices from community-driven health initiatives. Our aim is to provide a provocation that will encourage public health policy-makers to embrace community-based leadership as well as the broader structural health determinants that are at the root of the current circumstances of people in the DTES and other marginalized communities in Canada.

Ability of Impedance-Based Health Monitoring To Detect Structural Damage of Propulsion System Components Assessed

NASA Technical Reports Server (NTRS)

Martin, Richard E.; Gyekenyesi, Andrew L.; Sawicki, Jerzy T.; Baaklini, George Y.

2005-01-01

Impedance-based structural-health-monitoring uses piezoelectric (PZT) patches that are bonded onto or embedded in a structure. Each individual patch behaves as both an actuator of the surrounding structural area as well as a sensor of the structural response. The size of the excited area varies with the geometry and material composition of the structure, and an active patch is driven by a sinusoidal voltage sweep. When a PZT patch is subjected to an electric field, it produces a mechanical strain; and when it is stressed, it produces an electric charge. Since the patch is bonded to the structure, driving a patch deforms and vibrates the structure. The structure then produces a localized dynamic response. This structural system response is transferred back to the PZT patch, which in turn produces an electrical response. The electromechanical impedance method is based on the principle of electromechanical coupling between the active sensor and the structure, which allows researchers to assess local structural dynamics directly by interrogating a distributed sensor array. Because of mechanical coupling between the sensor and the host structure, this mechanical effect is picked up by the sensor and, through electromechanical coupling inside the active element, is reflected in electrical impedance measured at the sensor s terminals.

Strengthening institutional and organizational capacity for social health protection of the informal sector in lesser-developed countries: a study of policy barriers and opportunities in Cambodia.

PubMed

Annear, Peter Leslie; Ahmed, Shakil; Ros, Chhun Eang; Ir, Por

2013-11-01

Reaching out to the poor and the informal sector is a major challenge for achieving universal coverage in lesser-developed countries. In Cambodia, extensive coverage by health equity funds for the poor has created the opportunity to consolidate various non-government health financing schemes under the government's proposed social health protection structure. This paper identifies the main policy and operational challenges to strengthening existing arrangements for the poor and the informal sector, and considers policy options to address these barriers. Conducted in conjunction with the Cambodian Ministry of Health in 2011-12, the study reviewed policy documents and collected qualitative data through 18 semi-structured key informant interviews with government, non-government and donor officials. Data were analysed using the Organizational Assessment for Improving and Strengthening Health Financing conceptual framework. We found that a significant shortfall related to institutional, organisational and health financing issues resulted in fragmentation and constrained the implementation of social health protection schemes, including health equity funds, community-based health insurance, vouchers and others. Key documents proposed the establishment of a national structure for the unification of the informal-sector schemes but left unresolved issues related to structure, institutional capacity and the third-party status of the national agency. This study adds to the evidence base on appropriate and effective institutional and organizational arrangements for social health protection in the informal sector in developing countries. Among the key lessons are: the need to expand the fiscal space for health care; a commitment to equity; specific measures to protect the poor; building national capacity for administration of universal coverage; and working within the specific national context. Copyright © 2013 Elsevier Ltd. All rights reserved.

User recommendation in healthcare social media by assessing user similarity in heterogeneous network.

PubMed

Jiang, Ling; Yang, Christopher C

2017-09-01

The rapid growth of online health social websites has captured a vast amount of healthcare information and made the information easy to access for health consumers. E-patients often use these social websites for informational and emotional support. However, health consumers could be easily overwhelmed by the overloaded information. Healthcare information searching can be very difficult for consumers, not to mention most of them are not skilled information searcher. In this work, we investigate the approaches for measuring user similarity in online health social websites. By recommending similar users to consumers, we can help them to seek informational and emotional support in a more efficient way. We propose to represent the healthcare social media data as a heterogeneous healthcare information network and introduce the local and global structural approaches for measuring user similarity in a heterogeneous network. We compare the proposed structural approaches with the content-based approach. Experiments were conducted on a dataset collected from a popular online health social website, and the results showed that content-based approach performed better for inactive users, while structural approaches performed better for active users. Moreover, global structural approach outperformed local structural approach for all user groups. In addition, we conducted experiments on local and global structural approaches using different weight schemas for the edges in the network. Leverage performed the best for both local and global approaches. Finally, we integrated different approaches and demonstrated that hybrid method yielded better performance than the individual approach. The results indicate that content-based methods can effectively capture the similarity of inactive users who usually have focused interests, while structural methods can achieve better performance when rich structural information is available. Local structural approach only considers direct connections between nodes in the network, while global structural approach takes the indirect connections into account. Therefore, the global similarity approach can deal with sparse networks and capture the implicit similarity between two users. Different approaches may capture different aspects of the similarity relationship between two users. When we combine different methods together, we could achieve a better performance than using each individual method. Copyright © 2017 Elsevier B.V. All rights reserved.

Adverse event detection (AED) system for continuously monitoring and evaluating structural health status

NASA Astrophysics Data System (ADS)

Yun, Jinsik; Ha, Dong Sam; Inman, Daniel J.; Owen, Robert B.

2011-03-01

Structural damage for spacecraft is mainly due to impacts such as collision of meteorites or space debris. We present a structural health monitoring (SHM) system for space applications, named Adverse Event Detection (AED), which integrates an acoustic sensor, an impedance-based SHM system, and a Lamb wave SHM system. With these three health-monitoring methods in place, we can determine the presence, location, and severity of damage. An acoustic sensor continuously monitors acoustic events, while the impedance-based and Lamb wave SHM systems are in sleep mode. If an acoustic sensor detects an impact, it activates the impedance-based SHM. The impedance-based system determines if the impact incurred damage. When damage is detected, it activates the Lamb wave SHM system to determine the severity and location of the damage. Further, since an acoustic sensor dissipates much less power than the two SHM systems and the two systems are activated only when there is an acoustic event, our system reduces overall power dissipation significantly. Our prototype system demonstrates the feasibility of the proposed concept.

Diagnostic tool for structural health monitoring: effect of material nonlinearity and vibro-impact process

NASA Astrophysics Data System (ADS)

Hiwarkar, V. R.; Babitsky, V. I.; Silberschmidt, V. V.

2013-07-01

Numerous techniques are available for monitoring structural health. Most of these techniques are expensive and time-consuming. In this paper, vibration-based techniques are explored together with their use as diagnostic tools for structural health monitoring. Finite-element simulations are used to study the effect of material nonlinearity on dynamics of a cracked bar. Additionally, several experiments are performed to study the effect of vibro-impact behavior of crack on its dynamics. It was observed that a change in the natural frequency of the cracked bar due to crack-tip plasticity and vibro-impact behavior linked to interaction of crack faces, obtained from experiments, led to generation of higher harmonics; this can be used as a diagnostic tool for structural health monitoring.

Protecting Teens: Beyond Race, Income and Family Structure.

ERIC Educational Resources Information Center

Blum, Robert W.; Beuhring, Trisha; Rinehart, Peggy Mann

This monograph discusses how to protect adolescents by addressing health behaviors. Data come from the Add Health Survey, a comprehensive school-based study of adolescents' health-related behaviors. Secondary students answered surveys about their lives, health, friendships, self-esteem, and expectations for the future. School administrators…

Analysis of Online Information Searching for Cardiovascular Diseases on a Consumer Health Information Portal

PubMed Central

Jadhav, Ashutosh; Sheth, Amit; Pathak, Jyotishman

2014-01-01

Since the early 2000’s, Internet usage for health information searching has increased significantly. Studying search queries can help us to understand users “information need” and how do they formulate search queries (“expression of information need”). Although cardiovascular diseases (CVD) affect a large percentage of the population, few studies have investigated how and what users search for CVD. We address this knowledge gap in the community by analyzing a large corpus of 10 million CVD related search queries from MayoClinic.com. Using UMLS MetaMap and UMLS semantic types/concepts, we developed a rule-based approach to categorize the queries into 14 health categories. We analyzed structural properties, types (keyword-based/Wh-questions/Yes-No questions) and linguistic structure of the queries. Our results show that the most searched health categories are ‘Diseases/Conditions’, ‘Vital-Sings’, ‘Symptoms’ and ‘Living-with’. CVD queries are longer and are predominantly keyword-based. This study extends our knowledge about online health information searching and provides useful insights for Web search engines and health websites. PMID:25954380

Integrating national community-based health worker programmes into health systems: a systematic review identifying lessons learned from low-and middle-income countries.

PubMed

Zulu, Joseph Mumba; Kinsman, John; Michelo, Charles; Hurtig, Anna-Karin

2014-09-22

Despite the development of national community-based health worker (CBHW) programmes in several low- and middle-income countries, their integration into health systems has not been optimal. Studies have been conducted to investigate the factors influencing the integration processes, but systematic reviews to provide a more comprehensive understanding are lacking. We conducted a systematic review of published research to understand factors that may influence the integration of national CBHW programmes into health systems in low- and middle-income countries. To be included in the study, CBHW programmes should have been developed by the government and have standardised training, supervision and incentive structures. A conceptual framework on the integration of health innovations into health systems guided the review. We identified 3410 records, of which 36 were finally selected, and on which an analysis was conducted concerning the themes and pathways associated with different factors that may influence the integration process. Four programmes from Brazil, Ethiopia, India and Pakistan met the inclusion criteria. Different aspects of each of these programmes were integrated in different ways into their respective health systems. Factors that facilitated the integration process included the magnitude of countries' human resources for health problems and the associated discourses about how to address these problems; the perceived relative advantage of national CBHWs with regard to delivering health services over training and retaining highly skilled health workers; and the participation of some politicians and community members in programme processes, with the result that they viewed the programmes as legitimate, credible and relevant. Finally, integration of programmes within the existing health systems enhanced programme compatibility with the health systems' governance, financing and training functions. Factors that inhibited the integration process included a rapid scale-up process; resistance from other health workers; discrimination of CBHWs based on social, gender and economic status; ineffective incentive structures; inadequate infrastructure and supplies; and hierarchical and parallel communication structures. CBHW programmes should design their scale-up strategy differently based on current contextual factors. Further, adoption of a stepwise approach to the scale-up and integration process may positively shape the integration process of CBHW programmes into health systems.

An Optical Interferometric Triaxial Displacement Sensor for Structural Health Monitoring: Characterization of Sliding and Debonding for a Delamination Process

PubMed Central

Chen, Yizheng; Zhuang, Yiyang; Du, Yang; Gerald, Rex E.; Tang, Yan

2017-01-01

This paper presents an extrinsic Fabry–Perot interferometer-based optical fiber sensor (EFPI) for measuring three-dimensional (3D) displacements, including interfacial sliding and debonding during delamination. The idea employs three spatially arranged EFPIs as the sensing elements. In our sensor, the three EFPIs are formed by three endfaces of three optical fibers and their corresponding inclined mirrors. Two coincident roof-like metallic structures are used to support the three fibers and the three mirrors, respectively. Our sensor was calibrated and then used to monitor interfacial sliding and debonding between a long square brick of mortar and its support structure (i.e., a steel base plate) during the drying/curing process. This robust and easy-to-manufacture triaxial EFPI-based 3D displacement sensor has great potential in structural health monitoring, the construction industry, oil well monitoring, and geotechnology. PMID:29165351

An Optical Interferometric Triaxial Displacement Sensor for Structural Health Monitoring: Characterization of Sliding and Debonding for a Delamination Process.

PubMed

Zhu, Chen; Chen, Yizheng; Zhuang, Yiyang; Du, Yang; Gerald, Rex E; Tang, Yan; Huang, Jie

2017-11-22

This paper presents an extrinsic Fabry-Perot interferometer-based optical fiber sensor (EFPI) for measuring three-dimensional (3D) displacements, including interfacial sliding and debonding during delamination. The idea employs three spatially arranged EFPIs as the sensing elements. In our sensor, the three EFPIs are formed by three endfaces of three optical fibers and their corresponding inclined mirrors. Two coincident roof-like metallic structures are used to support the three fibers and the three mirrors, respectively. Our sensor was calibrated and then used to monitor interfacial sliding and debonding between a long square brick of mortar and its support structure (i.e., a steel base plate) during the drying/curing process. This robust and easy-to-manufacture triaxial EFPI-based 3D displacement sensor has great potential in structural health monitoring, the construction industry, oil well monitoring, and geotechnology.

20180312 - Structure-based QSAR Models to Predict Systemic Toxicity Points of Departure (SOT)

EPA Science Inventory

Human health risk assessment associated with environmental chemical exposure is limited by the tens of thousands of chemicals with little or no experimental in vivo toxicity data. Data gap filling techniques, such as quantitative structure activity relationship (QSAR) models base...

Damage of composite structures: Detection technique, dynamic response and residual strength

NASA Astrophysics Data System (ADS)

Lestari, Wahyu

2001-10-01

Reliable and accurate health monitoring techniques can prevent catastrophic failures of structures. Conventional damage detection methods are based on visual or localized experimental methods and very often require prior information concerning the vicinity of the damage or defect. The structure must also be readily accessible for inspections. The techniques are also labor intensive. In comparison to these methods, health-monitoring techniques that are based on the structural dynamic response offers unique information on failure of structures. However, systematic relations between the experimental data and the defect are not available and frequently, the number of vibration modes needed for an accurate identification of defects is much higher than the number of modes that can be readily identified in the experiment. These motivated us to develop an experimental data based detection method with systematic relationships between the experimentally identified information and the analytical or mathematical model representing the defective structures. The developed technique use changes in vibrational curvature modes and natural frequencies. To avoid misinterpretation of the identified information, we also need to understand the effects of defects on the structural dynamic response prior to developing health-monitoring techniques. In this thesis work we focus on two type of defects in composite structures, namely delamination and edge notch like defect. Effects of nonlinearity due to the presence of defect and due to the axial stretching are studied for beams with delamination. Once defects are detected in a structure, next concern is determining the effects of the defects on the strength of the structure and its residual stiffness under dynamic loading. In this thesis, energy release rate due to dynamic loading in a delaminated structure is studied, which will be a foundation toward determining the residual strength of the structure.

Evidence-based characteristics of nurse-managed health centers for quality and outcomes.

PubMed

Holt, Jeana; Zabler, Bev; Baisch, Mary Jo

2014-01-01

There are approximately 250 nurse-managed health centers (NMHC) in the United States, but there are few consistent descriptions of their functions and even fewer reports of their outcomes. Because NMHCs have been identified as a unique and effectual health care delivery care model (Patient Protection and Affordable Care Act), a description of their characteristics and a framework for outcome evaluation are required for their continued evolution and expansion. This study identifies the principal characteristics of U.S. NMHCs described in the professional literature through an integrative review and classifies these characteristics through a multistage qualitative analysis in relation to Donabedian's structure-process-outcomes model, a well-established model for evaluating quality in health care. This study yielded an evidence-based definition of NMHCs that is more reflective of current NMHC practice across settings and recognizes the full scope of nursing practice that is considered one solution to the health care crisis in the country. Using the results from this study, NMHCs will be able to structure self-evaluations of quality care and compare their quality related to structure, processes, and outcomes with other primary health care delivery systems. Copyright © 2014 Elsevier Inc. All rights reserved.

The Organization of Mental Health Services in Cuba.

ERIC Educational Resources Information Center

Camayd-Freixas, Yohel; Uriarte, Miren

1980-01-01

Reviews the status and organization of the Cuban mental health system. Focuses on the deliberate and systematic interdependence of mental health, public health, and socio-political structures; inpatient treatment modes and rehabilitation programs; use of social networks to support discharged patients; community-based care; and primary to tertiary…

Basic principles of information technology organization in health care institutions.

PubMed

Mitchell, J A

1997-01-01

This paper focuses on the basic principles of information technology (IT) organization within health sciences centers. The paper considers the placement of the leader of the IT effort within the health sciences administrative structure and the organization of the IT unit. A case study of the University of Missouri-Columbia Health Sciences Center demonstrates how a role-based organizational model for IT support can be effective for determining the boundary between centralized and decentralized organizations. The conclusions are that the IT leader needs to be positioned with other institutional leaders who are making strategic decisions, and that the internal IT structure needs to be a role-based hybrid of centralized and decentralized units. The IT leader needs to understand the mission of the organization and actively use change-management techniques.

Primary Health Care and tuberculosis: services evaluation.

PubMed

Wysocki, Anneliese Domingues; Ponce, Maria Amélia Zanon; Brunello, Maria Eugênia Firmino; Beraldo, Aline Ale; Vendramini, Silvia Helena Figueiredo; Scatena, Lúcia Marina; Ruffino, Antonio; Villa, Tereza Cristina Scatena

2017-01-01

In order to control tuberculosis, the Brazilian Ministry of Health recommends the decentralization of control actions directed to the Primary Health Care, and there are few studies on the performance of the Tuberculosis Control Program in decentralized contexts. To evaluate the performance of Primary Health Care services in tuberculosis treatment. This is an evaluative study with cross-sectional approach conducted in 2011. Two hundred and thirty-nine health professionals from Primary Health Care units were interviewed using a structured instrument based on the evaluation reference of the health services quality (structure - process - results). The performance of these services was analyzed applying techniques of descriptive statistics, validation, and construction of indicators and by determining the reduced variable "Z". The indicators "participation of professionals in tuberculosis patients' care" (structure) and "reference and counterreference" (process) had the best evaluations, whereas "professional training" (structure) and "external actions for tuberculosis control" (process) had the worst results. The decentralization of tuberculosis control actions has been taking place in a vertical manner in Primary Health Care. The challenge of controlling tuberculosis involves overcoming constraints related to the engagement, training, and turnover rates among health professionals, which is a coordination between services and monitoring of control actions in Primary Health Care.

Planning and Facilitating Debriefs of Experiential Learning Activities in Skills-Based Health Education

ERIC Educational Resources Information Center

Johns, Judith A.; Moyer, Matthew T.; Gasque, Lisa M.

2017-01-01

Purpose: This paper highlights the importance of conducting structured, student-centered discussions, known as debriefs, following experiential learning activities in health education. Drawing upon Kolb's experiential learning theory and literature from scholars in simulation-based training, the authors outline key considerations for planning and…

Understanding the organization of public health delivery systems: an empirical typology.

PubMed

Mays, Glen P; Scutchfield, F Douglas; Bhandari, Michelyn W; Smith, Sharla A

2010-03-01

Policy discussions about improving the U.S. health care system increasingly recognize the need to strengthen its capacities for delivering public health services. A better understanding of how public health delivery systems are organized across the United States is critical to improvement. To facilitate the development of such evidence, this article presents an empirical method of classifying and comparing public health delivery systems based on key elements of their organizational structure. This analysis uses data collected through a national longitudinal survey of local public health agencies serving communities with at least 100,000 residents. The survey measured the availability of twenty core public health activities in local communities and the types of organizations contributing to each activity. Cluster analysis differentiated local delivery systems based on the scope of activities delivered, the range of organizations contributing, and the distribution of effort within the system. Public health delivery systems varied widely in organizational structure, but the observed patterns of variation suggested that systems adhere to one of seven distinct configurations. Systems frequently migrated from one configuration to another over time, with an overall trend toward offering a broader scope of services and engaging a wider range of organizations. Public health delivery systems exhibit important structural differences that may influence their operations and outcomes. The typology developed through this analysis can facilitate comparative studies to identify which delivery system configurations perform best in which contexts.

Italian public health care organizations: specialization, institutional deintegration, and public networks relationships.

PubMed

Del Vecchio, Mario; De Pietro, Carlo

2011-01-01

The Italian National Health Service (INHS) has undergone profound changes over the past three decades. With establishment of the INHS in 1978--a tax-based public health care system with universal coverage--one of the underlying principles was integration. The recognition of health and health care as requiring integrated answers led to the creation of a single public organization, the Local Health Unit, responsible for the health status of the population of its catchment area. At the beginning of the 1990s, the scenario radically changed. The creation of hospital trusts, the development of quasi-market mechanisms and management control tools, the adoption of a prospective payment system for reimbursing health care providers--all were signs of deintegration and institutional unbundling. Two structural changes have deeply sustained this deintegration: patients' empowerment and the increased possibilities for outsourcing practices. In more recent years, a new reintegration effort has occurred, often led by regional governments and based on institutional cooperation and network relationships. However, the earlier structural changes require innovative approaches and solutions if public health care organizations want to retain their leading role.

Theory-based practice in a major medical centre.

PubMed

Alligood, Martha Raile

2011-11-01

This project was designed to improve care quality and nursing staff satisfaction. Nursing theory structures thought and action as demonstrated by evidence of improvement in complex health-care settings. Nursing administrators selected Modelling and Role-Modelling (MRM) for the theory-based practice goal in their strategic plan. An action research approach structured implementation of MRM in a 1-year consultation project in 2001-2002. Quality of health care improved according to national quality assessment ratings, as well as patient satisfaction and nurse satisfaction. Modelling and Role-Modelling demonstrated capacity to structure nursing thought and action in patient care in a major medical centre. Uniformity of patient care language was valued by nurses as well as by allied health providers who wished to learn the holistic MRM style of practice. The processes of MRM and action research contributed to project success. A positive health-care change project was carried out in a large medical centre with action research. Introducing MRM theory-based practice was a beneficial decision by nursing administration that improved care and nurse satisfaction. Attention to nursing practice stimulated career development among the nurses to pursue bachelors, masters, and doctoral degrees. © 2011 Blackwell Publishing Ltd.

A Case-Based, Problem-Based Learning Approach to Prepare Master of Public Health Candidates for the Complexities of Global Health

PubMed Central

Winskell, Kate; McFarland, Deborah A.; del Rio, Carlos

2015-01-01

Global health is a dynamic, emerging, and interdisciplinary field. To address current and emerging global health challenges, we need a public health workforce with adaptable and collaborative problem-solving skills. In the 2013–2014 academic year, the Hubert Department of Global Health at the Rollins School of Public Health–Emory University launched an innovative required core course for its first-year Master of Public Health students in the global health track. The course uses a case-based, problem-based learning approach to develop global health competencies. Small teams of students propose solutions to these problems by identifying learning issues and critically analyzing and synthesizing new information. We describe the course structure and logistics used to apply this approach in the context of a large class and share lessons learned. PMID:25706029

Test-bed for the remote health monitoring system for bridge structures using FBG sensors

NASA Astrophysics Data System (ADS)

Lee, Chin-Hyung; Park, Ki-Tae; Joo, Bong-Chul; Hwang, Yoon-Koog

2009-05-01

This paper reports on test-bed for the long-term health monitoring system for bridge structures employing fiber Bragg grating (FBG) sensors, which is remotely accessible via the web, to provide real-time quantitative information on a bridge's response to live loading and environmental changes, and fast prediction of the structure's integrity. The sensors are attached on several locations of the structure and connected to a data acquisition system permanently installed onsite. The system can be accessed through remote communication using an optical cable network, through which the evaluation of the bridge behavior under live loading can be allowed at place far away from the field. Live structural data are transmitted continuously to the server computer at the central office. The server computer is connected securely to the internet, where data can be retrieved, processed and stored for the remote web-based health monitoring. Test-bed revealed that the remote health monitoring technology will enable practical, cost-effective, and reliable condition assessment and maintenance of bridge structures.

From causes to solutions - insights from lay knowledge about health inequalities

PubMed Central

2011-01-01

Background This paper reports on a qualitative study of lay knowledge about health inequalities and solutions to address them. Social determinants of health are responsible for a large proportion of health inequalities (unequal levels of health status) and inequities (unfair access to health services and resources) within and between countries. Despite an expanding evidence base supporting action on social determinants, understanding of the impact of these determinants is not widespread and political will appears to be lacking. A small but growing body of research has explored how ordinary people theorise health inequalities and the implications for taking action. The findings are variable, however, in terms of an emphasis on structure versus individual agency and the relationship between being 'at risk' and acceptance of social/structural explanations. Methods This paper draws on findings from a qualitative study conducted in Adelaide, South Australia, to examine these questions. The study was an integral part of mixed-methods research on the links between urban location, social capital and health. It comprised 80 in-depth interviews with residents in four locations with contrasting socio-economic status. The respondents were asked about the cause of inequalities and actions that could be taken by governments to address them. Results Although generally willing to discuss health inequalities, many study participants tended to explain the latter in terms of individual behaviours and attitudes rather than social/structural conditions. Moreover, those who identified social/structural causes tended to emphasise individualized factors when describing typical pathways to health outcomes. This pattern appeared largely independent of participants' own experience of advantage or disadvantage, and was reinforced in discussion of strategies to address health inequalities. Conclusions Despite the explicit emphasis on social/structural issues expressed in the study focus and framing of the research questions, participants did not display a high level of knowledge about the nature and causes of place-based health inequalities. By extending the scope of lay theorizing to include a focus on solutions, this study offers additional insights for public health. Specifically it suggests that a popular constituency for action on the social determinants of health is unlikely to eventuate from the current popular understandings of possible policy levers. PMID:21281478

From causes to solutions--insights from lay knowledge about health inequalities.

PubMed

Putland, Christine; Baum, Fran E; Ziersch, Anna M

2011-01-31

This paper reports on a qualitative study of lay knowledge about health inequalities and solutions to address them. Social determinants of health are responsible for a large proportion of health inequalities (unequal levels of health status) and inequities (unfair access to health services and resources) within and between countries. Despite an expanding evidence base supporting action on social determinants, understanding of the impact of these determinants is not widespread and political will appears to be lacking. A small but growing body of research has explored how ordinary people theorise health inequalities and the implications for taking action. The findings are variable, however, in terms of an emphasis on structure versus individual agency and the relationship between being 'at risk' and acceptance of social/structural explanations. This paper draws on findings from a qualitative study conducted in Adelaide, South Australia, to examine these questions. The study was an integral part of mixed-methods research on the links between urban location, social capital and health. It comprised 80 in-depth interviews with residents in four locations with contrasting socio-economic status. The respondents were asked about the cause of inequalities and actions that could be taken by governments to address them. Although generally willing to discuss health inequalities, many study participants tended to explain the latter in terms of individual behaviours and attitudes rather than social/structural conditions. Moreover, those who identified social/structural causes tended to emphasise individualized factors when describing typical pathways to health outcomes. This pattern appeared largely independent of participants' own experience of advantage or disadvantage, and was reinforced in discussion of strategies to address health inequalities. Despite the explicit emphasis on social/structural issues expressed in the study focus and framing of the research questions, participants did not display a high level of knowledge about the nature and causes of place-based health inequalities. By extending the scope of lay theorizing to include a focus on solutions, this study offers additional insights for public health. Specifically it suggests that a popular constituency for action on the social determinants of health is unlikely to eventuate from the current popular understandings of possible policy levers.

An Agent-Based Data Mining System for Ontology Evolution

NASA Astrophysics Data System (ADS)

Hadzic, Maja; Dillon, Darshan

We have developed an evidence-based mental health ontological model that represents mental health in multiple dimensions. The ongoing addition of new mental health knowledge requires a continual update of the Mental Health Ontology. In this paper, we describe how the ontology evolution can be realized using a multi-agent system in combination with data mining algorithms. We use the TICSA methodology to design this multi-agent system which is composed of four different types of agents: Information agent, Data Warehouse agent, Data Mining agents and Ontology agent. We use UML 2.1 sequence diagrams to model the collaborative nature of the agents and a UML 2.1 composite structure diagram to model the structure of individual agents. The Mental Heath Ontology has the potential to underpin various mental health research experiments of a collaborative nature which are greatly needed in times of increasing mental distress and illness.

Innovation and effectiveness: changing the scope of school nurses in New Zealand secondary schools.

PubMed

Kool, Bridget; Thomas, David; Moore, Dennis; Anderson, Angelika; Bennetts, Phillipa; Earp, Karlynne; Dawson, Dianne; Treadwell, Nicky

2008-04-01

To describe the changing role of school nurses in eight New Zealand (NZ) secondary schools from low socio-economic areas with high Pacific Island and Māori rolls. An evaluation of a pilot addressing under-achievement in low-decile schools in Auckland, NZ (2002-05). Annual semi-structured school nurse interviews and analysis of routinely collected school health service data were undertaken. Two patterns of school nurse operation were identified: an embracing pattern, where nurses embraced the concept of providing school-based health services; and a Band-Aid pattern, where only the basics for student health care were provided by school nurses. School nurses with an embracing pattern of practice provided more effective school-based health services. School health services are better served by nurses with structured postgraduate education that fosters the development of a nurse-practitioner role. Co-ordination of school nurses either at a regional or national level is required.

Investigation of piezoelectric impedance-based health monitoring of structure interface debonding

NASA Astrophysics Data System (ADS)

Xiao, Li; Chen, Guofeng; Chen, Xiaoming; Qu, Wenzhong

2016-04-01

Various damages might occur during the solid rocket motor (SRM) manufacturing/operational phase, and the debonding of propellant/insulator/composite case interfaces is one of damage types which determine the life of a motor. The detection of such interface debonding damage will be beneficial for developing techniques for reliable nondestructive evaluation (NDE) and structural health monitoring (SHM). Piezoelectric sensors are widely used for structural health monitoring technique. In particular, electromechanical impedance (EMI) techniques give simple and low-cost solutions for detecting damage in various structures. In this work, piezoelectric EMI structural health monitoring technique is applied to identify the debonding condition of propellant/insulator interface structure using finite element method and experimental investigation. A three-dimensional coupled field finite element model is developed using the software ANSYS and the harmonic analysis is conducted for high-frequency impedance analysis procedure. In the experimental study, the impedance signals were measured from PZT and MFC sensors outside attached to composite case monitoring the different debonding conditions between the propellant and insulator. Root mean square deviation (RMSD) based damage index is conducted to quantify the changes i n impedance for different de bonding conditions and frequency range. Simulation and experimental results confirmed that the EMI technique can be used effectively for detecting the debonding damage in SRM and is expected to be useful for future application of real SRM's SHM.

Automated real-time structure health monitoring via signature pattern recognition

NASA Astrophysics Data System (ADS)

Sun, Fanping P.; Chaudhry, Zaffir A.; Rogers, Craig A.; Majmundar, M.; Liang, Chen

1995-05-01

Described in this paper are the details of an automated real-time structure health monitoring system. The system is based on structural signature pattern recognition. It uses an array of piezoceramic patches bonded to the structure as integrated sensor-actuators, an electric impedance analyzer for structural frequency response function acquisition and a PC for control and graphic display. An assembled 3-bay truss structure is employed as a test bed. Two issues, the localization of sensing area and the sensor temperature drift, which are critical for the success of this technique are addressed and a novel approach of providing temperature compensation using probability correlation function is presented. Due to the negligible weight and size of the solid-state sensor array and its ability to sense incipient-type damage, the system can eventually be implemented on many types of structures such as aircraft, spacecraft, large-span dome roof and steel bridges requiring multilocation and real-time health monitoring.

The Structures of Life

ERIC Educational Resources Information Center

National Institute of General Medical Sciences (NIGMS), 2007

2007-01-01

This booklet reveals how structural biology provides insight into health and disease and is useful in developing new medications. It contains a general introduction to proteins, coverage of the techniques used to determine protein structures, and a chapter on structure-based drug design. The booklet features "Student Snapshots," designed to…

The Application of Web-based Computer-assisted Instruction Courseware within Health Assessment

NASA Astrophysics Data System (ADS)

Xiuyan, Guo

Health assessment is a clinical nursing course and places emphasis on clinical skills. The application of computer-assisted instruction in the field of nursing teaching solved the problems in the traditional lecture class. This article stated teaching experience of web-based computer-assisted instruction, based upon a two-year study of computer-assisted instruction courseware use within the course health assessment. The computer-assisted instruction courseware could develop teaching structure, simulate clinical situations, create teaching situations and facilitate students study.

Laser based structural health monitoring for civil, mechanical, and aerospace systems

NASA Astrophysics Data System (ADS)

Sohn, Hoon

2012-04-01

This paper provides an overview of ongoing laser ultrasonics based structural health monitoring (SHM) activities being performed by the author. Particular focus is given to (1) the development of a fully noncontact laser ultrasonic system that can easily visualize defects with high spatial resolution, (2) laser based wireless power and data transmission schemes for remote guided waves and impedance measurements, (3) minimization of false alarms due to varying operational and environmental conditions, and (4) extension to embedded laser ultrasonic excitation and sensing. SHM examples ranging from bridges to airplanes, as well as nuclear power plants, high-speed rails and wind turbines are also presented.

Comparing model-based adaptive LMS filters and a model-free hysteresis loop analysis method for structural health monitoring

NASA Astrophysics Data System (ADS)

Zhou, Cong; Chase, J. Geoffrey; Rodgers, Geoffrey W.; Xu, Chao

2017-02-01

The model-free hysteresis loop analysis (HLA) method for structural health monitoring (SHM) has significant advantages over the traditional model-based SHM methods that require a suitable baseline model to represent the actual system response. This paper provides a unique validation against both an experimental reinforced concrete (RC) building and a calibrated numerical model to delineate the capability of the model-free HLA method and the adaptive least mean squares (LMS) model-based method in detecting, localizing and quantifying damage that may not be visible, observable in overall structural response. Results clearly show the model-free HLA method is capable of adapting to changes in how structures transfer load or demand across structural elements over time and multiple events of different size. However, the adaptive LMS model-based method presented an image of greater spread of lesser damage over time and story when the baseline model is not well defined. Finally, the two algorithms are tested over a simpler hysteretic behaviour typical steel structure to quantify the impact of model mismatch between the baseline model used for identification and the actual response. The overall results highlight the need for model-based methods to have an appropriate model that can capture the observed response, in order to yield accurate results, even in small events where the structure remains linear.

Space-time latent component modeling of geo-referenced health data.

PubMed

Lawson, Andrew B; Song, Hae-Ryoung; Cai, Bo; Hossain, Md Monir; Huang, Kun

2010-08-30

Latent structure models have been proposed in many applications. For space-time health data it is often important to be able to find the underlying trends in time, which are supported by subsets of small areas. Latent structure modeling is one such approach to this analysis. This paper presents a mixture-based approach that can be applied to component selection. The analysis of a Georgia ambulatory asthma county-level data set is presented and a simulation-based evaluation is made. Copyright (c) 2010 John Wiley & Sons, Ltd.

Review on pressure sensors for structural health monitoring

NASA Astrophysics Data System (ADS)

Sikarwar, Samiksha; Satyendra; Singh, Shakti; Yadav, Bal Chandra

2017-12-01

This paper reports the state of art in a variety of pressure and the detailed study of various matrix based pressure sensors. The performances of the bridges, buildings, etc. are threatened by earthquakes, material degradations, and other environmental effects. Structural health monitoring (SHM) is crucial to protect the people and also for assets planning. This study is a contribution in developing the knowledge about self-sensing smart materials and structures for the construction industry. It deals with the study of self-sensing as well as mechanical and electrical properties of different matrices based on pressure sensors. The relationships among the compression, tensile strain, and crack length with electrical resistance change are also reviewed.

Factor structure and internal reliability of an exercise health belief model scale in a Mexican population.

PubMed

Villar, Oscar Armando Esparza-Del; Montañez-Alvarado, Priscila; Gutiérrez-Vega, Marisela; Carrillo-Saucedo, Irene Concepción; Gurrola-Peña, Gloria Margarita; Ruvalcaba-Romero, Norma Alicia; García-Sánchez, María Dolores; Ochoa-Alcaraz, Sergio Gabriel

2017-03-01

Mexico is one of the countries with the highest rates of overweight and obesity around the world, with 68.8% of men and 73% of women reporting both. This is a public health problem since there are several health related consequences of not exercising, like having cardiovascular diseases or some types of cancers. All of these problems can be prevented by promoting exercise, so it is important to evaluate models of health behaviors to achieve this goal. Among several models the Health Belief Model is one of the most studied models to promote health related behaviors. This study validates the first exercise scale based on the Health Belief Model (HBM) in Mexicans with the objective of studying and analyzing this model in Mexico. Items for the scale called the Exercise Health Belief Model Scale (EHBMS) were developed by a health research team, then the items were applied to a sample of 746 participants, male and female, from five cities in Mexico. The factor structure of the items was analyzed with an exploratory factor analysis and the internal reliability with Cronbach's alpha. The exploratory factor analysis reported the expected factor structure based in the HBM. The KMO index (0.92) and the Barlett's sphericity test (p < 0.01) indicated an adequate and normally distributed sample. Items had adequate factor loadings, ranging from 0.31 to 0.92, and the internal consistencies of the factors were also acceptable, with alpha values ranging from 0.67 to 0.91. The EHBMS is a validated scale that can be used to measure exercise based on the HBM in Mexican populations.

The value of structured data elements from electronic health records for identifying subjects for primary care clinical trials.

PubMed

Ateya, Mohammad B; Delaney, Brendan C; Speedie, Stuart M

2016-01-11

An increasing number of clinical trials are conducted in primary care settings. Making better use of existing data in the electronic health records to identify eligible subjects can improve efficiency of such studies. Our study aims to quantify the proportion of eligibility criteria that can be addressed with data in electronic health records and to compare the content of eligibility criteria in primary care with previous work. Eligibility criteria were extracted from primary care studies downloaded from the UK Clinical Research Network Study Portfolio. Criteria were broken into elemental statements. Two expert independent raters classified each statement based on whether or not structured data items in the electronic health record can be used to determine if the statement was true for a specific patient. Disagreements in classification were discussed until 100 % agreement was reached. Statements were also classified based on content and the percentages of each category were compared to two similar studies reported in the literature. Eligibility criteria were retrieved from 228 studies and decomposed into 2619 criteria elemental statements. 74 % of the criteria elemental statements were considered likely associated with structured data in an electronic health record. 79 % of the studies had at least 60 % of their criteria statements addressable with structured data likely to be present in an electronic health record. Based on clinical content, most frequent categories were: "disease, symptom, and sign", "therapy or surgery", and "medication" (36 %, 13 %, and 10 % of total criteria statements respectively). We also identified new criteria categories related to provider and caregiver attributes (2.6 % and 1 % of total criteria statements respectively). Electronic health records readily contain much of the data needed to assess patients' eligibility for clinical trials enrollment. Eligibility criteria content categories identified by our study can be incorporated as data elements in electronic health records to facilitate their integration with clinical trial management systems.

Investigation of an expert health monitoring system for aeronautical structures based on pattern recognition and acousto-ultrasonics

NASA Astrophysics Data System (ADS)

Tibaduiza-Burgos, Diego Alexander; Torres-Arredondo, Miguel Angel

2015-08-01

Aeronautical structures are subjected to damage during their service raising the necessity for periodic inspection and maintenance of their components so that structural integrity and safe operation can be guaranteed. Cost reduction related to minimizing the out-of-service time of the aircraft, together with the advantages offered by real-time and safe-life service monitoring, have led to a boom in the design of inexpensive and structurally integrated transducer networks comprising actuators, sensors, signal processing units and controllers. These kinds of automated systems are normally referred to as smart structures and offer a multitude of new solutions to engineering problems and multi-functional capabilities. It is thus expected that structural health monitoring (SHM) systems will become one of the leading technologies for assessing and assuring the structural integrity of future aircraft. This study is devoted to the development and experimental investigation of an SHM methodology for the detection of damage in real scale complex aeronautical structures. The work focuses on each aspect of the SHM system and highlights the potentialities of the health monitoring technique based on acousto-ultrasonics and data-driven modelling within the concepts of sensor data fusion, feature extraction and pattern recognition. The methodology is experimentally demonstrated on an aircraft skin panel and fuselage panel for which several damage scenarios are analysed. The detection performance in both structures is quantified and presented.

Structural damage detection for in-service highway bridge under operational and environmental variability

NASA Astrophysics Data System (ADS)

Jin, Chenhao; Li, Jingcheng; Jang, Shinae; Sun, Xiaorong; Christenson, Richard

2015-03-01

Structural health monitoring has drawn significant attention in the past decades with numerous methodologies and applications for civil structural systems. Although many researchers have developed analytical and experimental damage detection algorithms through vibration-based methods, these methods are not widely accepted for practical structural systems because of their sensitivity to uncertain environmental and operational conditions. The primary environmental factor that influences the structural modal properties is temperature. The goal of this article is to analyze the natural frequency-temperature relationships and detect structural damage in the presence of operational and environmental variations using modal-based method. For this purpose, correlations between natural frequency and temperature are analyzed to select proper independent variables and inputs for the multiple linear regression model and neural network model. In order to capture the changes of natural frequency, confidence intervals to detect the damages for both models are generated. A long-term structural health monitoring system was installed on an in-service highway bridge located in Meriden, Connecticut to obtain vibration and environmental data. Experimental testing results show that the variability of measured natural frequencies due to temperature is captured, and the temperature-induced changes in natural frequencies have been considered prior to the establishment of the threshold in the damage warning system. This novel approach is applicable for structural health monitoring system and helpful to assess the performance of the structure for bridge management and maintenance.

A close inspection and vibration sensing aerial robot for steel structures with an EPM-based landing device

NASA Astrophysics Data System (ADS)

Takeuchi, Kazuya; Masuda, Arata; Akahori, Shunsuke; Higashi, Yoshiyuki; Miura, Nanako

2017-04-01

This paper proposes an aerial robot that can land on and cling to a steel structure using electric permanent magnets to be- have as a vibration sensor probe for use in vibration-based structural health monitoring. In the last decade, structural health monitoring techniques have been studied intensively to tackle with serious social issues that most of the infrastructures in advanced countries are being deteriorated. In the typical concept of the structural health monitoring, vibration sensors like accelerometers are installed in the structure to continuously collect the dynamical response of the operating structure to find a symptom of the structural damage. It is unreasonable, however, to permanently deploy the sensors to numerous infrastructures because most of the infrastructures except for those of primary importance do not need continuous measurement and evaluation. In this study, the aerial robot plays a role of a mobile detachable sensor unit. The design guidelines of the aerial robot that performs the vibration measurement from the analysis model of the robot is shown. Experiments to evaluate the frequency response function of the acceleration measured by the robot with respect to the acceleration at the point where the robot adheres are carried out. And the experimental results show that the prototype robot can measure the acceleration of the host structure accurately up to 150 Hz.

The influence of empowerment and incivility on the mental health of new graduate nurses.

PubMed

Wing, Travis; Regan, Sandra; Spence Laschinger, Heather K

2015-07-01

To test a model based on Kanter's theory of structural empowerment, which examines the relationships between new graduate nurses' perceptions of structural empowerment, workplace incivility and mental health symptoms. The initial years of practice can be particularly stressful for new graduate nurses, who may be particularly vulnerable to uncivil behaviour as a result of their status in the work environment. Disempowerment and incivility in the workplace may compound the mental health symptoms experienced by new graduate nurses. A predictive, non-experimental design was used to examine the relationship between structural empowerment, workplace incivility and mental health symptoms in a sample of new graduate nurses working in hospital settings in Ontario (n = 394). High levels of structural empowerment were significantly associated with fewer negative mental health symptoms in new graduates. However, co-worker incivility and supervisor incivility partially mediated the effect of structural empowerment on new graduate nurses' mental health symptoms. The findings suggest that empowering workplaces contribute to lower mental health symptoms in new graduate nurses, an effect that is diminished by incivility. Strategies that foster empowering work conditions and reduce uncivil behaviour are needed to promote positive mental health in new graduate nurses. © 2013 John Wiley & Sons Ltd.

[Structural Equation Modeling of Quality of Work Life in Clinical Nurses based on the Culture-Work-Health Model].

PubMed

Kim, Miji; Ryu, Eunjung

2015-12-01

The purpose of this study was to construct and test a structural equation model of quality of work life for clinical nurses based on Peterson and Wilson's Culture-Work-Health model (CWHM). A structured questionnaire was completed by 523 clinical nurses to analyze the relationships between concepts of CWHM-organizational culture, social support, employee health, organizational health, and quality of work life. Among these conceptual variables of CWHM, employee health was measured by perceived health status, and organizational health was measured by presenteeism. SPSS21.0 and AMOS 21.0 programs were used to analyze the efficiency of the hypothesized model and calculate the direct and indirect effects of factors affecting quality of work life among clinical nurses. The goodness-of-fit statistics of the final modified hypothetical model are as follows: χ²=586.03, χ²/df=4.19, GFI=.89, AGFI=.85, CFI=.91, TLI=.90, NFI=.89, and RMSEA=.08. The results revealed that organizational culture, social support, organizational health, and employee health accounted for 69% of clinical nurses' quality of work life. The major findings of this study indicate that it is essential to create a positive organizational culture and provide adequate organizational support to maintain a balance between the health of clinical nurses and the organization. Further repeated and expanded studies are needed to explore the multidimensional aspects of clinical nurses' quality of work life in Korea, including various factors, such as work environment, work stress, and burnout.

Introduction of structural health and safety monitoring warning systems for Shenzhen-Hong Kong Western Corridor Shenzhen Bay Bridge

NASA Astrophysics Data System (ADS)

Li, N.; Zhang, X. Y.; Zhou, X. T.; Leng, J.; Liang, Z.; Zheng, C.; Sun, X. F.

2008-03-01

Though the brief introduction of the completed structural health and safety monitoring warning systems for Shenzhen-Hongkong western corridor Shenzhen bay highway bridge (SZBHMS), the self-developed system frame, hardware and software scheme of this practical research project are systematically discussed in this paper. The data acquisition and transmission hardware and the basic software based on the NI (National Instruments) Company virtual instruments technology were selected in this system, which adopted GPS time service receiver technology and so on. The objectives are to establish the structural safety monitoring and status evaluation system to monitor the structural responses and working conditions in real time and to analyze the structural working statue using information obtained from the measured data. It will be also provided the scientific decision-making bases for the bridge management and maintenance. Potential technical approaches to the structural safety warning systems, status identification and evaluation method are presented. The result indicated that the performance of the system has achieved the desired objectives, ensure the longterm high reliability, real time concurrence and advanced technology of SZBHMS. The innovate achievement which is the first time to implement in domestic, provide the reference for long-span bridge structural health and safety monitoring warning systems design.

[Road map for health and safety management systems in healthcare facilities, according to the OHSAS 18001:2007 standard].

PubMed

Pugliese, F; Albini, E; Serio, O; Apostoli, P

2011-01-01

The 81/2008 Act has defined a model of a health and safety management system that can contribute to prevent the occupational health and safety risks. We have developed the structure of a health and safety management system model and the necessary tools for its implementation in health care facilities. The realization of a model is structured in various phases: initial review, safety policy, planning, implementation, monitoring, management review and continuous improvement. Such a model, in continuous evolution, is based on the responsibilities of the different corporate characters and on an accurate analysis of risks and involved norms.

De-identification of unstructured paper-based health records for privacy-preserving secondary use.

PubMed

Fenz, Stefan; Heurix, Johannes; Neubauer, Thomas; Rella, Antonio

2014-07-01

Abstract Whenever personal data is processed, privacy is a serious issue. Especially in the document-centric e-health area, the patients' privacy must be preserved in order to prevent any negative repercussions for the patient. Clinical research, for example, demands structured health records to carry out efficient clinical trials, whereas legislation (e.g. HIPAA) regulates that only de-identified health records may be used for research. However, unstructured and often paper-based data dominates information technology, especially in the healthcare sector. Existing approaches are geared towards data in English-language documents only and have not been designed to handle the recognition of erroneous personal data which is the result of the OCR-based digitization of paper-based health records.

Structural Health Monitoring Using Textile Reinforcement Structures with Integrated Optical Fiber Sensors

PubMed Central

Bremer, Kort; Weigand, Frank; Zheng, Yulong; Alwis, Lourdes Shanika; Helbig, Reinhard; Roth, Bernhard

2017-01-01

Optical fiber-based sensors “embedded” in functionalized carbon structures (FCSs) and textile net structures (TNSs) based on alkaline-resistant glass are introduced for the purpose of structural health monitoring (SHM) of concrete-based structures. The design aims to monitor common SHM parameters such as strain and cracks while at the same time acting as a structural strengthening mechanism. The sensor performances of the two systems are characterized in situ using Mach-Zehnder interferometric (MZI) and optical attenuation measurement techniques, respectively. For this purpose, different FCS samples were subjected to varying elongation using a tensile testing machine by carefully incrementing the applied force, and good correlation between the applied force and measured length change was observed. For crack detection, the functionalized TNSs were embedded into a concrete block which was then exposed to varying load using the three-point flexural test until destruction. Promising results were observed, identifying that the location of the crack can be determined using the conventional optical time domain reflectometry (OTDR) technique. The embedded sensors thus evaluated show the value of the dual achievement of the schemes proposed in obtaining strain/crack measurement while being utilized as strengthening agents as well. PMID:28208636

A Review of the Piezoelectric Electromechanical Impedance Based Structural Health Monitoring Technique for Engineering Structures.

PubMed

Na, Wongi S; Baek, Jongdae

2018-04-24

The birth of smart materials such as piezoelectric (PZT) transducers has aided in revolutionizing the field of structural health monitoring (SHM) based on non-destructive testing (NDT) methods. While a relatively new NDT method known as the electromechanical (EMI) technique has been investigated for more than two decades, there are still various problems that must be solved before it is applied to real structures. The technique, which has a significant potential to contribute to the creation of one of the most effective SHM systems, involves the use of a single PZT for exciting and sensing of the host structure. In this paper, studies applied for the past decade related to the EMI technique have been reviewed to understand its trend. In addition, new concepts and ideas proposed by various authors are also surveyed, and the paper concludes with a discussion of the potential directions for future works.

A Review of the Piezoelectric Electromechanical Impedance Based Structural Health Monitoring Technique for Engineering Structures

PubMed Central

Na, Wongi S.; Baek, Jongdae

2018-01-01

The birth of smart materials such as piezoelectric (PZT) transducers has aided in revolutionizing the field of structural health monitoring (SHM) based on non-destructive testing (NDT) methods. While a relatively new NDT method known as the electromechanical (EMI) technique has been investigated for more than two decades, there are still various problems that must be solved before it is applied to real structures. The technique, which has a significant potential to contribute to the creation of one of the most effective SHM systems, involves the use of a single PZT for exciting and sensing of the host structure. In this paper, studies applied for the past decade related to the EMI technique have been reviewed to understand its trend. In addition, new concepts and ideas proposed by various authors are also surveyed, and the paper concludes with a discussion of the potential directions for future works. PMID:29695067

A Qualitative Exploration of Community-Based Organization Programs, Resources, and Training to Promote Adolescent Sexual Health

ERIC Educational Resources Information Center

McCarthy, Molly A.; Fisher, Christopher M.; Zhou, Junmin; Zhu, He; Pelster, Aja Kneip; Schober, Daniel J.; Baldwin, Kathleen; Fortenberry, J. Dennis; Goldsworthy, Richard

2015-01-01

Youth development professionals (YDPs) working at community-based organizations (CBOs) can promote adolescent sexual health through programs. This study explored the programs and resources that youth access at CBOs and training YDPs receive. Twenty-one semi-structured interviews were conducted with YDPs. Qualitative content analyses were conducted…

Vibration-based health monitoring and model refinement of civil engineering structures

DOE Office of Scientific and Technical Information (OSTI.GOV)

Farrar, C.R.; Doebling, S.W.

1997-10-01

Damage or fault detection, as determined by changes in the dynamic properties of structures, is a subject that has received considerable attention in the technical literature beginning approximately 30 years ago. The basic idea is that changes in the structure`s properties, primarily stiffness, will alter the dynamic properties of the structure such as resonant frequencies and mode shapes, and properties derived from these quantities such as modal-based flexibility. Recently, this technology has been investigated for applications to health monitoring of large civil engineering structures. This presentation will discuss such a study undertaken by engineers from New Mexico Sate University, Sandiamore » National Laboratory and Los Alamos National Laboratory. Experimental modal analyses were performed in an undamaged interstate highway bridge and immediately after four successively more severe damage cases were inflicted in the main girder of the structure. Results of these tests provide insight into the abilities of modal-based damage ID methods to identify damage and the current limitations of this technology. Closely related topics that will be discussed are the use of modal properties to validate computer models of the structure, the use of these computer models in the damage detection process, and the general lack of experimental investigation of large civil engineering structures.« less

Development of a cost-effective and flexible vibration DAQ system for long-term continuous structural health monitoring

NASA Astrophysics Data System (ADS)

Nguyen, Theanh; Chan, Tommy H. T.; Thambiratnam, David P.; King, Les

2015-12-01

In the structural health monitoring (SHM) field, long-term continuous vibration-based monitoring is becoming increasingly popular as this could keep track of the health status of structures during their service lives. However, implementing such a system is not always feasible due to on-going conflicts between budget constraints and the need of sophisticated systems to monitor real-world structures under their demanding in-service conditions. To address this problem, this paper presents a comprehensive development of a cost-effective and flexible vibration DAQ system for long-term continuous SHM of a newly constructed institutional complex with a special focus on the main building. First, selections of sensor type and sensor positions are scrutinized to overcome adversities such as low-frequency and low-level vibration measurements. In order to economically tackle the sparse measurement problem, a cost-optimized Ethernet-based peripheral DAQ model is first adopted to form the system skeleton. A combination of a high-resolution timing coordination method based on the TCP/IP command communication medium and a periodic system resynchronization strategy is then proposed to synchronize data from multiple distributed DAQ units. The results of both experimental evaluations and experimental-numerical verifications show that the proposed DAQ system in general and the data synchronization solution in particular work well and they can provide a promising cost-effective and flexible alternative for use in real-world SHM projects. Finally, the paper demonstrates simple but effective ways to make use of the developed monitoring system for long-term continuous structural health evaluation as well as to use the instrumented building herein as a multi-purpose benchmark structure for studying not only practical SHM problems but also synchronization related issues.

Novel Use of Natural Language Processing (NLP) to Predict Suicidal Ideation and Psychiatric Symptoms in a Text-Based Mental Health Intervention in Madrid.

PubMed

Cook, Benjamin L; Progovac, Ana M; Chen, Pei; Mullin, Brian; Hou, Sherry; Baca-Garcia, Enrique

2016-01-01

Natural language processing (NLP) and machine learning were used to predict suicidal ideation and heightened psychiatric symptoms among adults recently discharged from psychiatric inpatient or emergency room settings in Madrid, Spain. Participants responded to structured mental and physical health instruments at multiple follow-up points. Outcome variables of interest were suicidal ideation and psychiatric symptoms (GHQ-12). Predictor variables included structured items (e.g., relating to sleep and well-being) and responses to one unstructured question, "how do you feel today?" We compared NLP-based models using the unstructured question with logistic regression prediction models using structured data. The PPV, sensitivity, and specificity for NLP-based models of suicidal ideation were 0.61, 0.56, and 0.57, respectively, compared to 0.73, 0.76, and 0.62 of structured data-based models. The PPV, sensitivity, and specificity for NLP-based models of heightened psychiatric symptoms (GHQ-12 ≥ 4) were 0.56, 0.59, and 0.60, respectively, compared to 0.79, 0.79, and 0.85 in structured models. NLP-based models were able to generate relatively high predictive values based solely on responses to a simple general mood question. These models have promise for rapidly identifying persons at risk of suicide or psychological distress and could provide a low-cost screening alternative in settings where lengthy structured item surveys are not feasible.

Identifying Impacts Using Adaptive Fiber Bragg Grating Demodulator for Structural Health Monitoring Applications

NASA Astrophysics Data System (ADS)

Kirikera, G. R.; Balogun, O.; Krishnaswamy, S.

2008-02-01

A network of Fiber-Bragg Grating (FBG) sensors is developed as part of a Structural Health Monitoring system to identify impact damage. The sensor signals are adaptively demodulated using two-wave mixing (TWM) technology. The signals from multiple FBG sensors are multiplexed into a single TWM demodulator. The FBG sensor network is mounted on a plate, and the structure is subjected to impacts generated by dropping small ball bearings. Impact locations are identified based on time frequency analysis.

Development and validation of a new population-based simulation model of osteoarthritis in New Zealand.

PubMed

Wilson, R; Abbott, J H

2018-04-01

To describe the construction and preliminary validation of a new population-based microsimulation model developed to analyse the health and economic burden and cost-effectiveness of treatments for knee osteoarthritis (OA) in New Zealand (NZ). We developed the New Zealand Management of Osteoarthritis (NZ-MOA) model, a discrete-time state-transition microsimulation model of the natural history of radiographic knee OA. In this article, we report on the model structure, derivation of input data, validation of baseline model parameters against external data sources, and validation of model outputs by comparison of the predicted population health loss with previous estimates. The NZ-MOA model simulates both the structural progression of radiographic knee OA and the stochastic development of multiple disease symptoms. Input parameters were sourced from NZ population-based data where possible, and from international sources where NZ-specific data were not available. The predicted distributions of structural OA severity and health utility detriments associated with OA were externally validated against other sources of evidence, and uncertainty resulting from key input parameters was quantified. The resulting lifetime and current population health-loss burden was consistent with estimates of previous studies. The new NZ-MOA model provides reliable estimates of the health loss associated with knee OA in the NZ population. The model structure is suitable for analysis of the effects of a range of potential treatments, and will be used in future work to evaluate the cost-effectiveness of recommended interventions within the NZ healthcare system. Copyright © 2018 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Reliability and Validity of Assessing User Satisfaction With Web-Based Health Interventions

PubMed Central

Lehr, Dirk; Reis, Dorota; Vis, Christiaan; Riper, Heleen; Berking, Matthias; Ebert, David Daniel

2016-01-01

Background The perspective of users should be taken into account in the evaluation of Web-based health interventions. Assessing the users’ satisfaction with the intervention they receive could enhance the evidence for the intervention effects. Thus, there is a need for valid and reliable measures to assess satisfaction with Web-based health interventions. Objective The objective of this study was to analyze the reliability, factorial structure, and construct validity of the Client Satisfaction Questionnaire adapted to Internet-based interventions (CSQ-I). Methods The psychometric quality of the CSQ-I was analyzed in user samples from 2 separate randomized controlled trials evaluating Web-based health interventions, one from a depression prevention intervention (sample 1, N=174) and the other from a stress management intervention (sample 2, N=111). At first, the underlying measurement model of the CSQ-I was analyzed to determine the internal consistency. The factorial structure of the scale and the measurement invariance across groups were tested by multigroup confirmatory factor analyses. Additionally, the construct validity of the scale was examined by comparing satisfaction scores with the primary clinical outcome. Results Multigroup confirmatory analyses on the scale yielded a one-factorial structure with a good fit (root-mean-square error of approximation =.09, comparative fit index =.96, standardized root-mean-square residual =.05) that showed partial strong invariance across the 2 samples. The scale showed very good reliability, indicated by McDonald omegas of .95 in sample 1 and .93 in sample 2. Significant correlations with change in depressive symptoms (r=−.35, P<.001) and perceived stress (r=−.48, P<.001) demonstrated the construct validity of the scale. Conclusions The proven internal consistency, factorial structure, and construct validity of the CSQ-I indicate a good overall psychometric quality of the measure to assess the user’s general satisfaction with Web-based interventions for depression and stress management. Multigroup analyses indicate its robustness across different samples. Thus, the CSQ-I seems to be a suitable measure to consider the user’s perspective in the overall evaluation of Web-based health interventions. PMID:27582341

Reliability and Validity of Assessing User Satisfaction With Web-Based Health Interventions.

PubMed

Boß, Leif; Lehr, Dirk; Reis, Dorota; Vis, Christiaan; Riper, Heleen; Berking, Matthias; Ebert, David Daniel

2016-08-31

The perspective of users should be taken into account in the evaluation of Web-based health interventions. Assessing the users' satisfaction with the intervention they receive could enhance the evidence for the intervention effects. Thus, there is a need for valid and reliable measures to assess satisfaction with Web-based health interventions. The objective of this study was to analyze the reliability, factorial structure, and construct validity of the Client Satisfaction Questionnaire adapted to Internet-based interventions (CSQ-I). The psychometric quality of the CSQ-I was analyzed in user samples from 2 separate randomized controlled trials evaluating Web-based health interventions, one from a depression prevention intervention (sample 1, N=174) and the other from a stress management intervention (sample 2, N=111). At first, the underlying measurement model of the CSQ-I was analyzed to determine the internal consistency. The factorial structure of the scale and the measurement invariance across groups were tested by multigroup confirmatory factor analyses. Additionally, the construct validity of the scale was examined by comparing satisfaction scores with the primary clinical outcome. Multigroup confirmatory analyses on the scale yielded a one-factorial structure with a good fit (root-mean-square error of approximation =.09, comparative fit index =.96, standardized root-mean-square residual =.05) that showed partial strong invariance across the 2 samples. The scale showed very good reliability, indicated by McDonald omegas of .95 in sample 1 and .93 in sample 2. Significant correlations with change in depressive symptoms (r=-.35, P<.001) and perceived stress (r=-.48, P<.001) demonstrated the construct validity of the scale. The proven internal consistency, factorial structure, and construct validity of the CSQ-I indicate a good overall psychometric quality of the measure to assess the user's general satisfaction with Web-based interventions for depression and stress management. Multigroup analyses indicate its robustness across different samples. Thus, the CSQ-I seems to be a suitable measure to consider the user's perspective in the overall evaluation of Web-based health interventions.

Measuring emotion socialization in schools.

PubMed

Horner, Christy G; Wallace, Tanner L

2013-10-01

Understanding how school personnel can best support students' development of communication skills around feelings is critical to long-term health outcomes. The measurement of emotion socialization in schools facilitates future research in this area; we review existing measures of emotion socialization to assess their applicability to school-based health studies. A content analysis of four emotion socialization measures was conducted. Inclusion criteria included: high frequency of use in prior research, established documentation of validity and reliability, and sufficient description of measurement procedures. Four dimensions emerged as particularly salient to a measure's future relevance and applicability to school-based health studies: (1) methods of measurement; (2) mode and agent of socialization; (3) type of emotion; and (4) structure versus function of socializing behavior. Future measurement strategies should address (1) the structures of emotion socializing processes; (2) diverse socializing agents such as teachers, peers, and administrators; (3) the intended functions of such processes; (4) student perceptions of and responses to such processes; and (5) the complex interactions of these factors across contexts. Strategies attending to these components will permit future studies of school-based emotion socializing processes to determine how they enhance health and reduce health risks. © 2013, American School Health Association.

Energy efficient wireless sensor network for structural health monitoring using distributed embedded piezoelectric transducers

NASA Astrophysics Data System (ADS)

Li, Peng; Olmi, Claudio; Song, Gangbing

2010-04-01

Piezoceramic based transducers are widely researched and used for structural health monitoring (SHM) systems due to the piezoceramic material's inherent advantage of dual sensing and actuation. Wireless sensor network (WSN) technology benefits from advances made in piezoceramic based structural health monitoring systems, allowing easy and flexible installation, low system cost, and increased robustness over wired system. However, piezoceramic wireless SHM systems still faces some drawbacks, one of these is that the piezoceramic based SHM systems require relatively high computational capabilities to calculate damage information, however, battery powered WSN sensor nodes have strict power consumption limitation and hence limited computational power. On the other hand, commonly used centralized processing networks require wireless sensors to transmit all data back to the network coordinator for analysis. This signal processing procedure can be problematic for piezoceramic based SHM applications as it is neither energy efficient nor robust. In this paper, we aim to solve these problems with a distributed wireless sensor network for piezoceramic base structural health monitoring systems. Three important issues: power system, waking up from sleep impact detection, and local data processing, are addressed to reach optimized energy efficiency. Instead of sweep sine excitation that was used in the early research, several sine frequencies were used in sequence to excite the concrete structure. The wireless sensors record the sine excitations and compute the time domain energy for each sine frequency locally to detect the energy change. By comparing the data of the damaged concrete frame with the healthy data, we are able to find out the damage information of the concrete frame. A relative powerful wireless microcontroller was used to carry out the sampling and distributed data processing in real-time. The distributed wireless network dramatically reduced the data transmission between wireless sensor and the wireless coordinator, which in turn reduced the power consumption of the overall system.

In-situ health monitoring of piezoelectric sensors using electromechanical impedance: A numerical perspective

NASA Astrophysics Data System (ADS)

Bilgunde, Prathamesh N.; Bond, Leonard J.

2018-04-01

Current work presents a numerical investigation to classify the in-situ health of the piezoelectric sensors deployed for structural health monitoring (SHM) of large civil, aircraft and automotive structures. The methodology proposed in this work attempts to model the in-homogeneities in the adhesive with which typically the sensor is bonded to the structure for SHM. It was found that weakening of the bond state causes reduction in the resonance frequency of the structure and eventually approaches the resonance characteristics of a piezoelectric material under traction-free boundary conditions. These changes in the resonance spectrum are further quantified using root mean square deviation-based damage index. Results demonstrate that the electromechanical impedance method can be used to monitor structural integrity of the sensor bonded to the host structure. This cost-effective method can potentially reduce misinterpretation of SHM data for critical infrastructures.

Structural health monitoring using wireless sensor networks

NASA Astrophysics Data System (ADS)

Sreevallabhan, K.; Nikhil Chand, B.; Ramasamy, Sudha

2017-11-01

Monitoring and analysing health of large structures like bridges, dams, buildings and heavy machinery is important for safety, economical, operational, making prior protective measures, and repair and maintenance point of view. In recent years there is growing demand for such larger structures which in turn make people focus more on safety. By using Microelectromechanical Systems (MEMS) Accelerometer we can perform Structural Health Monitoring by studying the dynamic response through measure of ambient vibrations and strong motion of such structures. By using Wireless Sensor Networks (WSN) we can embed these sensors in wireless networks which helps us to transmit data wirelessly thus we can measure the data wirelessly at any remote location. This in turn reduces heavy wiring which is a cost effective as well as time consuming process to lay those wires. In this paper we developed WSN based MEMS-accelerometer for Structural to test the results in the railway bridge near VIT University, Vellore campus.

Learning the moral economy of commodified health care: "community education," failed consumers, and the shaping of ethical clinician-citizens.

PubMed

Rivkin-Fish, Michele

2011-06-01

Leaders of health professional schools often support community-based education as a means of promoting emerging practitioners' awareness of health disparities and commitment to serving the poor. Yet, most programs do not teach about the causes of health disparities, raising questions regarding what social and political lessons students learn from these experiences. This article examines the ways in which community-based clinical education programs help shape the subjectivities of new dentists as ethical clinician-citizens within the US commodified health care system. Drawing on ethnographic research during volunteer and required community-based programs and interviews with participants, I demonstrate three implicit logics that students learned: (1) dialectical ideologies of volunteer entitlement and recipient debt; (2) forms of justification for the often inferior care provided to "failed" consumers (patients with Medicaid or uninsured); and (3) specific forms of obligations characterizing the ethical clinician-citizen. I explore the ways these messages reflected the structured relations of both student encounters and the overarching health care system, and examine the strategies faculty supervisors undertook to challenge these messages and relations. Finally, I argue that promoting commitments to social justice in health care should not rely on cultivating altruism, but should instead be pursued through educating new practitioners about the lives of poor people, the causal relationships between poverty and poor health, and attention to the structure of health care and provider-patient interactions. This approach involves shining a critical light on America's commodified health care system as an arena based in relations of power and inequality.

Computer-Based Readability Testing of Information Booklets for German Cancer Patients.

PubMed

Keinki, Christian; Zowalla, Richard; Pobiruchin, Monika; Huebner, Jutta; Wiesner, Martin

2018-04-12

Understandable health information is essential for treatment adherence and improved health outcomes. For readability testing, several instruments analyze the complexity of sentence structures, e.g., Flesch-Reading Ease (FRE) or Vienna-Formula (WSTF). Moreover, the vocabulary is of high relevance for readers. The aim of this study is to investigate the agreement of sentence structure and vocabulary-based (SVM) instruments. A total of 52 freely available German patient information booklets on cancer were collected from the Internet. The mean understandability level L was computed for 51 booklets. The resulting values of FRE, WSTF, and SVM were assessed pairwise for agreement with Bland-Altman plots and two-sided, paired t tests. For the pairwise comparison, the mean L values are L FRE  = 6.81, L WSTF  = 7.39, L SVM  = 5.09. The sentence structure-based metrics gave significantly different scores (P < 0.001) for all assessed booklets, confirmed by the Bland-Altman analysis. The study findings suggest that vocabulary-based instruments cannot be interchanged with FRE/WSTF. However, both analytical aspects should be considered and checked by authors to linguistically refine texts with respect to the individual target group. Authors of health information can be supported by automated readability analysis. Health professionals can benefit by direct booklet comparisons allowing for time-effective selection of suitable booklets for patients.

TOPICAL REVIEW: Smart aggregates: multi-functional sensors for concrete structures—a tutorial and a review

NASA Astrophysics Data System (ADS)

Song, Gangbing; Gu, Haichang; Mo, Yi-Lung

2008-06-01

This paper summarizes the authors' recent pioneering research work in piezoceramic-based smart aggregates and their innovative applications in concrete civil structures. The basic operating principle of smart aggregates is first introduced. The proposed smart aggregate is formed by embedding a waterproof piezoelectric patch with lead wires into a small concrete block. The proposed smart aggregates are multi-functional and can perform three major tasks: early-age concrete strength monitoring, impact detection and structural health monitoring. The proposed smart aggregates are embedded into the desired location before the casting of the concrete structure. The concrete strength development is monitored by observing the high frequency harmonic wave response of the smart aggregate. Impact on the concrete structure is detected by observing the open-circuit voltage of the piezoceramic patch in the smart aggregate. For structural health monitoring purposes, a smart aggregate-based active sensing system is designed for the concrete structure. Wavelet packet analysis is used as a signal-processing tool to analyze the sensor signal. A damage index based on the wavelet packet analysis is used to determine the structural health status. To better describe the time-history and location information of damage, two types of damage index matrices are proposed: a sensor-history damage index matrix and an actuator-sensor damage index matrix. To demonstrate the multi-functionality of the proposed smart aggregates, different types of concrete structures have been used as test objects, including concrete bridge bent-caps, concrete cylinders and a concrete frame. Experimental results have verified the effectiveness and the multi-functionality of the proposed smart aggregates. The multi-functional smart aggregates have the potential to be applied to the comprehensive monitoring of concrete structures from their earliest stages and throughout their lifetime.

Discrimination, mental health, and suicidal ideation among LGBTQ people of color.

PubMed

Sutter, Megan; Perrin, Paul B

2016-01-01

Discrimination based on race/ethnicity, sexual orientation, and gender identity has been linked to many negative psychological and physical health outcomes in previous research, including increased suicidal ideation. Two hundred lesbian, gay, bisexual, transgender, and queer (LGBTQ) people of color (POC) were surveyed on their experiences of LGBTQ-based discrimination, racism, mental health (depression, anxiety, satisfaction with life), and suicidal ideation in a national online study based in the United States. A structural equation model (SEM) was created and found that LGBTQ-based discrimination exerted an indirect effect on suicidal ideation through mental health. Racism exerted a direct effect on mental health but was not associated with suicidal ideation in the SEM. The effects of LGBTQ-based discrimination on mental health may be a key area for interventions to reduce suicidal ideation in LGBTQ POC. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

A resource-based view of partnership strategies in health care organizations.

PubMed

Yarbrough, Amy K; Powers, Thomas L

2006-01-01

The distribution of management structures in health care has been shifting from independent ownership to interorganizational relationships with other firms. A shortage of resources has been cited as one cause for such collaboration among health care entities. The resource- based view of the firm suggests that organizations differentiate between strategic alliances and acquisition strategies based on a firm's internal resources and the types of resources a potential partner organization possesses. This paper provides a review of the literature using the resource-based theory of the firm to understand what conditions foster different types of health care partnerships. A model of partnership alliances using the resource-based view is presented, strategic linkages are presented, managerial implications are outlined, and directions for future research are given.

Home health nursing care agenda based on health policy in Korea.

PubMed

Ryu, Hosihn; An, Jiyoung; Koabyashi, Mia

2005-06-01

Home health nursing care (HHNC) in Korea has taken on an important role under the mandate of the national health care system since 2000. This program was developed to verify the possibility of early discharge of hospitalized patients and cost containment through a research and development project that was conducted with the government from 1994 to 1999. The process of development of HHNC provided an opportunity to realize the advancement and changes in the system into a consumer-focused structure. This is an important turning point for the Korean health care system that suggests certain possibilities for building a foundation for further changes in the service delivery structure. The structure, which had been limited to a supplier-oriented model, is moving to a consumer-oriented structure. Accordingly, the major function and role of nursing policy makers in Korea is to develop an agenda and alternatives for policy-making in a systematic manner and to present implementation strategies clearly.

A taxonomy of health networks and systems: bringing order out of chaos.

PubMed Central

Bazzoli, G J; Shortell, S M; Dubbs, N; Chan, C; Kralovec, P

1999-01-01

OBJECTIVE: To use existing theory and data for empirical development of a taxonomy that identifies clusters of organizations sharing common strategic/structural features. DATA SOURCES: Data from the 1994 and 1995 American Hospital Association Annual Surveys, which provide extensive data on hospital involvement in hospital-led health networks and systems. STUDY DESIGN: Theories of organization behavior and industrial organization economics were used to identify three strategic/structural dimensions: differentiation, which refers to the number of different products/services along a healthcare continuum; integration, which refers to mechanisms used to achieve unity of effort across organizational components; and centralization, which relates to the extent to which activities take place at centralized versus dispersed locations. These dimensions were applied to three components of the health service/product continuum: hospital services, physician arrangements, and provider-based insurance activities. DATA EXTRACTION METHODS: We identified 295 health systems and 274 health networks across the United States in 1994, and 297 health systems and 306 health networks in 1995 using AHA data. Empirical measures aggregated individual hospital data to the health network and system level. PRINCIPAL FINDINGS: We identified a reliable, internally valid, and stable four-cluster solution for health networks and a five-cluster solution for health systems. We found that differentiation and centralization were particularly important in distinguishing unique clusters of organizations. High differentiation typically occurred with low centralization, which suggests that a broader scope of activity is more difficult to centrally coordinate. Integration was also important, but we found that health networks and systems typically engaged in both ownership-based and contractual-based integration or they were not integrated at all. CONCLUSIONS: Overall, we were able to classify approximately 70 percent of hospital-led health networks and 90 percent of hospital-led health systems into well-defined organizational clusters. Given the widespread perception that organizational change in healthcare has been chaotic, our research suggests that important and meaningful similarities exist across many evolving organizations. The resulting taxonomy provides a new lexicon for researchers, policymakers, and healthcare executives for characterizing key strategic and structural features of evolving organizations. The taxonomy also provides a framework for future inquiry about the relationships between organizational strategy, structure, and performance, and for assessing policy issues, such as Medicare Provider Sponsored Organizations, antitrust, and insurance regulation. Images Figure 2A Figure 2A Figure 2B Figure 2B PMID:10029504

Implementing community participation through legislative reform: a study of the policy framework for community participation in the Western Cape province of South Africa

PubMed Central

2012-01-01

Background Amidst an evolving post-apartheid policy framework for health, policymakers have sought to institutionalize community participation in Primary Health Care, recognizing participation as integral to realizing South Africa’s constitutional commitment to the right to health. With evolving South African legislation supporting community involvement in the health system, early policy developments focused on Community Health Committees (HCs) as the principal institutions of community participation. Formally recognized in the National Health Act of 2003, the National Health Act deferred to provincial governments in establishing the specific roles and functions of HCs. As a result, stakeholders developed a Draft Policy Framework for Community Participation in Health (Draft Policy) to formalize participatory institutions in the Western Cape province. Methods With the Draft Policy as a frame of analysis, the researchers conducted documentary policy analysis and semi-structured interviews on the evolution of South African community participation policy. Moving beyond the specific and unique circumstances of the Western Cape, this study analyzes generalizable themes for rights-based community participation in the health system. Results Framing institutions for the establishment, appointment, and functioning of community participation, the Draft Policy proposed a formal network of communication – from local HCs to the health system. However, this participation structure has struggled to establish itself and function effectively as a result of limitations in community representation, administrative support, capacity building, and policy commitment. Without legislative support for community participation, the enactment of superseding legislation is likely to bring an end to HC structures in the Western Cape. Conclusions Attempts to realize community participation have not adequately addressed the underlying factors crucial to promoting effective participation, with policy reforms necessary: to codify clearly defined roles and functions of community representation; to outline how communities engage with government through effective and accountable channels for participation; and to ensure extensive training and capacity building of community representatives. Given the public health importance of structured and effective policies for community participation, and the normative importance of participation in realizing a rights-based approach to health, this analysis informs researchers on the challenges to institutionalizing participation in health systems policy and provides practitioners with a research base to frame future policy reforms. PMID:22920557

Competency-based training to create the 21st century mental health workforce: strides, stumbles, and solutions.

PubMed

Delaney, Kathleen R; Carlson-Sabelli, Linnea; Shephard, Rebekah; Ridge, Alison

2011-08-01

In response to sustained concerns about the capability of the mental health workforce, federal groups have urged educators to adopt a competency-based system for training students in core mental health skills. A particular emphasis is training students to work in integrated systems, intervene with evidence-based practice, and employ culturally relevant therapies. Creating such a program, particularly one delivered online, requires structures that engage students in their own learning and tools for tracking competencies. We report on our competency-based graduate psychiatric mental health nursing program and the unique methods used to track student skill development and clinical reasoning. Copyright © 2011 Elsevier Inc. All rights reserved.

Multiscale Modeling and Characterization of the Effects of Damage Evolution on the Multifunctional Properties of Polymer Nanocomposites

DTIC Science & Technology

2016-07-27

the mechanical and electrical properties of carbon nanotube -polymer nanocomposites. Focus was placed on understanding and capturing the key... nanotube nanocomposite piezoresistive sensing in performing structural health monitoring in epoxy-based energetic materials. The focus was to...Carbon Nanotube , Nanocomposite, Structural Health Monitoring, Strain Sensing, Damage Sensing 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT UU

A bio-inspired structural health monitoring system based on ambient vibration

NASA Astrophysics Data System (ADS)

Lin, Tzu-Kang; Kiremidjian, Anne; Lei, Chi-Yang

2010-11-01

A structural health monitoring (SHM) system based on naïve Bayesian (NB) damage classification and DNA-like expression data was developed in this research. Adapted from the deoxyribonucleic acid (DNA) array concept in molecular biology, the proposed structural health monitoring system is constructed utilizing a double-tier regression process to extract the expression array from the structural time history recorded during external excitations. The extracted array is symbolized as the various genes of the structure from the viewpoint of molecular biology and reflects the possible damage conditions prevalent in the structure. A scaled down, six-story steel building mounted on the shaking table of the National Center for Research on Earthquake Engineering (NCREE) was used as the benchmark. The structural response at different damage levels and locations under ambient vibration was collected to support the database for the proposed SHM system. To improve the precision of detection in practical applications, the system was enhanced by an optimization process using the likelihood selection method. The obtained array representing the DNA array of the health condition of the structure was first evaluated and ranked. A total of 12 groups of expression arrays were regenerated from a combination of four damage conditions. To keep the length of the array unchanged, the best 16 coefficients from every expression array were selected to form the optimized SHM system. Test results from the ambient vibrations showed that the detection accuracy of the structural damage could be greatly enhanced by the optimized expression array, when compared to the original system. Practical verification also demonstrated that a rapid and reliable result could be given by the final system within 1 min. The proposed system implements the idea of transplanting the DNA array concept from molecular biology into the field of SHM.

Tree Testing of Hierarchical Menu Structures for Health Applications

PubMed Central

Le, Thai; Chaudhuri, Shomir; Chung, Jane; Thompson, Hilaire J; Demiris, George

2014-01-01

To address the need for greater evidence-based evaluation of Health Information Technology (HIT) systems we introduce a method of usability testing termed tree testing. In a tree test, participants are presented with an abstract hierarchical tree of the system taxonomy and asked to navigate through the tree in completing representative tasks. We apply tree testing to a commercially available health application, demonstrating a use case and providing a comparison with more traditional in-person usability testing methods. Online tree tests (N=54) and in-person usability tests (N=15) were conducted from August to September 2013. Tree testing provided a method to quantitatively evaluate the information structure of a system using various navigational metrics including completion time, task accuracy, and path length. The results of the analyses compared favorably to the results seen from the traditional usability test. Tree testing provides a flexible, evidence-based approach for researchers to evaluate the information structure of HITs. In addition, remote tree testing provides a quick, flexible, and high volume method of acquiring feedback in a structured format that allows for quantitative comparisons. With the diverse nature and often large quantities of health information available, addressing issues of terminology and concept classifications during the early development process of a health information system will improve navigation through the system and save future resources. Tree testing is a usability method that can be used to quickly and easily assess information hierarchy of health information systems. PMID:24582924

Structural Health Monitoring of Civil Infrastructure Using Optical Fiber Sensing Technology: A Comprehensive Review

PubMed Central

Ye, X. W.; Su, Y. H.; Han, J. P.

2014-01-01

In the last two decades, a significant number of innovative sensing systems based on optical fiber sensors have been exploited in the engineering community due to their inherent distinctive advantages such as small size, light weight, immunity to electromagnetic interference (EMI) and corrosion, and embedding capability. A lot of optical fiber sensor-based monitoring systems have been developed for continuous measurement and real-time assessment of diversified engineering structures such as bridges, buildings, tunnels, pipelines, wind turbines, railway infrastructure, and geotechnical structures. The purpose of this review article is devoted to presenting a summary of the basic principles of various optical fiber sensors, innovation in sensing and computational methodologies, development of novel optical fiber sensors, and the practical application status of the optical fiber sensing technology in structural health monitoring (SHM) of civil infrastructure. PMID:25133250

Structural health monitoring of civil infrastructure using optical fiber sensing technology: a comprehensive review.

PubMed

Ye, X W; Su, Y H; Han, J P

2014-01-01

In the last two decades, a significant number of innovative sensing systems based on optical fiber sensors have been exploited in the engineering community due to their inherent distinctive advantages such as small size, light weight, immunity to electromagnetic interference (EMI) and corrosion, and embedding capability. A lot of optical fiber sensor-based monitoring systems have been developed for continuous measurement and real-time assessment of diversified engineering structures such as bridges, buildings, tunnels, pipelines, wind turbines, railway infrastructure, and geotechnical structures. The purpose of this review article is devoted to presenting a summary of the basic principles of various optical fiber sensors, innovation in sensing and computational methodologies, development of novel optical fiber sensors, and the practical application status of the optical fiber sensing technology in structural health monitoring (SHM) of civil infrastructure.

Effect of structured teaching programme on VIA test for early detection and diagnosis of cervical cancer.

PubMed

Chacko, Shiny

2014-01-01

The conceptual framework of the study, undertaken in select health centres of New Delhi, was based on General System Model. The research approach was evaluative with one group pre-test and post-test design. The study population comprised of Community Health Workers working in selected centres in Najafgarh, Delhi. Purposive sampling technique was used to select a sample of 30 Community Health Workers. A structured knowledge questionnaire was developed to assess the knowledge of subjects. A Structured Teaching Programme was developed to enhance the knowledge of Community Health Workers. Pre-test was given on day 1 and Structured Teaching Programme administered on same day. Post-test was conducted on day 7. Most of the Community Health Workers were in the age group of 21-30 years with academic qualification up to Higher Secondary level. Maximum Community Health Workers had professional qualification as ANM/MPHW (female). Majority of the Community Health Workers had experience up to 5 years. Initially there was deficit in scores of knowledge of Community Health Workers regarding Visual Inspection with Acetic Acid (VIA) test. Mean post-test knowledge scores of Community Health Workers were found to be signifi- cantly higher than their mean pre-test knowledge score. The Community Health Workers after expo- sure to Structured Teaching Programme gained a significant positive relationship between post-test knowledge scores. The study reveals the efficacy of Structured Teaching Programme in enhancing the knowledge of Community Health Workers regarding VIA test and a need for conducting a regular and well planned health teaching programme on VIA test for improving their knowledge on VIA test for the early detection and diagnosis of cervical cancer.

Measuring the authority of local public health directors in the context of organizational structure: an exploratory, multimodal approach.

PubMed

Miner Gearin, Kimberly J; Thrash, Allison M Rick; Frauendienst, Renee; Myhre, Julie; Gyllstrom, M Elizabeth; Riley, William J; Schroeder, Janelle

2012-11-01

Studies have reported a relationship between the organization of public health services and variability in public health practice at the local and state levels. A national research agenda has prioritized practice-based research to understand pathways that lead to this variation and examine the impact of these differences on outcomes. To measure the extent to which Minnesota local health directors report having key authorities and examine the relationship between organizational structure and authority of local health directors. : Multimodal. Minnesota local health departments. Directors of Minnesota local health departments. Director authorities. Most Minnesota local health directors reported having 6 key authorities related to budget preparation and modification and interaction with local elected officials (n = 51, 71%). Twelve directors (16%) reported that they have 4 or fewer of the 6 authorities. The authority most commonly reported as lacking was the authority to initiate communication with locally elected officials (n = 15, 21%). The percentage of directors who reported having all 6 authorities was higher among those in stand-alone departments (82%) than those in combined organizations (50%). This descriptive study illustrates that emerging practice-based research networks can successfully collaborate on small-scale research projects with immediate application for systems development. Study findings are being used by local public health officials to help articulate their role, aid in succession planning, and inform elected officials, who need to consider the public health implications of potential changes to local public health governance and organization. More studies are needed to refine measurement of authority and structure.

Evolution of an Aggregate-Based Community Health Curriculum.

ERIC Educational Resources Information Center

Segall, Mary; McKay, Rose

1984-01-01

Discusses the graduate program in community health nursing at the University of Colorado that is structured according to the aggregate/family and group model. Describes the development of the program and its evaluation. (JOW)

Leveraging community-based financing for women's nonmaternal health care: experiences of rural Indian women.

PubMed

Gopalan, Saji S; Durairaj, Varatharajan

2015-03-01

Given the increasing need for mainstreaming household financing for women's nonmaternal health care and evidences on community-based financing's contribution to women's health care in general, this study explored their scope for nonmaternal health care in Orissa. A qualitative assessment conducted focus group discussions with rural women who met the eligibility criteria. Community-based financing provided financial access and risk protection for women's nonmaternal health care during the previous 1 year, though not adequately. Schemes covering outpatient care (or mild illnesses) provided relatively more financial access. The major determinants of their restricted financial access were limited sum assured, noncomprehensive coverage of services, exclusion of elderly women, and the lower priority households gave to nonmaternal health care. Community-based financing requires relevant structural changes along with demand-side behavioral modifications to ensure optimal attention to women's nonmaternal health care. © 2012 APJPH.

Fiber optic monitoring methods for composite steel-concrete structures based on determination of neutral axis and deformed shape.

DOT National Transportation Integrated Search

2014-01-01

Structural Health Monitoring has great potential to provide valuable information about the actual structural condition and can help optimize the management activities. However, few effective and robust monitoring methods exist which hinders a nationw...

Primary prevention in public health: an analysis of basic assumptions.

PubMed

Ratcliffe, J; Wallack, L

1985-01-01

The common definition of primary prevention is straightforward; but how it is transformed into a framework to guide action is based on personal and societal feelings and beliefs about the basis for social organization. This article focuses on the two contending primary prevention strategies of health promotion and health protection. The contention between the two strategies stems from a basic disagreement about disease causality in modern society. Health promotion is based on the "lifestyle" theory of disease causality, which sees individual health status linked ultimately to personal decisions about diet, stress, and drug habits. Primary prevention, from this perspective, entails persuading individuals to forgo their risk-taking, self-destructive behavior. Health protection, on the other hand, is based on the "social-structural" theory of disease causality. This theory sees the health status of populations linked ultimately to the unequal distribution of social resources, industrial pollution, occupational stress, and "anti-health promotion" marketing practices. Primary prevention, from this perspective, requires changing existing social and, particularly, economic policies and structures. In order to provide a basis for choosing between these contending strategies, the demonstrated (i.e., past) impact of each strategy on the health of the public is examined. Two conclusions are drawn. First, the health promotion strategy shows little potential for improving the public health, because it systematically ignores the risk-imposing, other-destructive behavior of influential actors (policy-makers and institutions) in society. And second, effective primary prevention efforts entail an "upstream" approach that results in far-reaching sociopolitical and economic change.

A systematic literature review of the key challenges for developing the structure of public health economic models.

PubMed

Squires, Hazel; Chilcott, James; Akehurst, Ronald; Burr, Jennifer; Kelly, Michael P

2016-04-01

To identify the key methodological challenges for public health economic modelling and set an agenda for future research. An iterative literature search identified papers describing methodological challenges for developing the structure of public health economic models. Additional multidisciplinary literature searches helped expand upon important ideas raised within the review. Fifteen articles were identified within the formal literature search, highlighting three key challenges: inclusion of non-healthcare costs and outcomes; inclusion of equity; and modelling complex systems and multi-component interventions. Based upon these and multidisciplinary searches about dynamic complexity, the social determinants of health, and models of human behaviour, six areas for future research were specified. Future research should focus on: the use of systems approaches within health economic modelling; approaches to assist the systematic consideration of the social determinants of health; methods for incorporating models of behaviour and social interactions; consideration of equity; and methodology to help modellers develop valid, credible and transparent public health economic model structures.

The Packaging Technology Study on Smart Composite Structure Based on The Embedded FBG Sensor

NASA Astrophysics Data System (ADS)

Zhang, Youhong; Chang, Xinlong; Zhang, Xiaojun; He, Xiangyong

2018-03-01

It is convenient to carry out the health monitoring of the solid rocket engine composite shell based on the embedded FBG sensor. In this paper, the packaging technology using one-way fiber layer of prepreg fiberglass/epoxy resin was proposed. The proposed packaging process is simple, and the packaged sensor structure size is flexible and convenient to use, at the mean time, the packaged structure has little effect on the pristine composite material structure.

Organizational Barriers to Adopting an Alcohol Screening and Brief Intervention in Community-Based Mental Health Organizations.

PubMed

Patterson, David A; Wolf Adelv Unegv Waya, Silver; Dulmus, Catherine N

2012-06-01

This paper examines two factors related to successfully implementing a brief alcohol screening throughout all community-based mental health organizations. The first issue is related to an organization's internal structures, such as culture and climate that can impede evidenced-based practice implementation. There is literature suggesting that organizational culture and climate affect decisions about whether evidence-based practices are adopted and implemented within health care agencies. Following this literature review on organizational barriers, the history and successes of adopting an alcohol screening and brief intervention are reviewed. Studying, identifying, and understanding the organizational factors associated with the successful dissemination and implementation of best practices throughout community-based mental health organizations would contribute to increasing the likelihood that an alcohol screening and brief intervention are implemented throughout mental health organizations.

Organizational Barriers to Adopting an Alcohol Screening and Brief Intervention in Community-Based Mental Health Organizations

PubMed Central

Patterson, David A.; Wolf (Adelv unegv Waya), Silver; Dulmus, Catherine N.

2012-01-01

This paper examines two factors related to successfully implementing a brief alcohol screening throughout all community-based mental health organizations. The first issue is related to an organization’s internal structures, such as culture and climate that can impede evidenced-based practice implementation. There is literature suggesting that organizational culture and climate affect decisions about whether evidence-based practices are adopted and implemented within health care agencies. Following this literature review on organizational barriers, the history and successes of adopting an alcohol screening and brief intervention are reviewed. Studying, identifying, and understanding the organizational factors associated with the successful dissemination and implementation of best practices throughout community-based mental health organizations would contribute to increasing the likelihood that an alcohol screening and brief intervention are implemented throughout mental health organizations. PMID:24634639

Structural health monitoring for DOT using magnetic shape memory alloy cables in concrete

NASA Astrophysics Data System (ADS)

Davis, Allen; Mirsayar, Mirmilad; Sheahan, Emery; Hartl, Darren

2018-03-01

Embedding shape memory alloy (SMA) wires in concrete components offers the potential to monitor their structural health via external magnetic field sensing. Currently, structural health monitoring (SHM) is dominated by acoustic emission and vibration-based methods. Thus, it is attractive to pursue alternative damage sensing techniques that may lower the cost or increase the accuracy of SHM. In this work, SHM via magnetic field detection applied to embedded magnetic shape memory alloy (MSMA) is demonstrated both experimentally and using computational models. A concrete beam containing iron-based MSMA wire is subjected to a 3-point bend test where structural damage is induced, thereby resulting in a localized phase change of the MSMA wire. Magnetic field lines passing through the embedded MSMA domain are altered by this phase change and can thus be used to detect damage within the structure. A good correlation is observed between the computational and experimental results. Additionally, the implementation of stranded MSMA cables in place of the MSMA wire is assessed through similar computational models. The combination of these computational models and their subsequent experimental validation provide sufficient support for the feasibility of SHM using magnetic field sensing via MSMA embedded components.

An efficient signal processing tool for impedance-based structural health monitoring

NASA Astrophysics Data System (ADS)

O'Brien, Megan K.; Taylor, Stuart G.; Farinholt, Kevin M.; Park, Gyuhae; Farrar, Charles R.

2009-03-01

Various experimental studies have demonstrated that an impedance-based approach to structural health monitoring can be an effective means of damage detection. Using the self-sensing and active-sensing capabilities of piezoelectric materials, the electromechanical impedance response can be monitored to provide a qualitative indication of the overall health of a structure. Although impedance analyzers are commonly used to collect such data, they are bulky and impractical for long-term field implementation, so a smaller and more portable device is desired. However, impedance measurements often contain a sizeable number of data points, and a smaller device may not possess enough memory to store the required information, particularly for real-time analysis. Therefore, the amount of data used to assess the integrity of a structure must be significantly reduced. A new type of cross correlation analysis, for which impedance data is instantaneously correlated between different sensor sets and different frequency ranges, as opposed to be correlated to pre-stored baseline data, is proposed to drastically reduce the amount of data to a single correlation coefficient and provide a quantitative means of detecting damage relative to the sensor positions. The proposed analysis is carried out on a 3-story representative structure and its efficiency is demonstrated.

Application of Ontology Technology in Health Statistic Data Analysis.

PubMed

Guo, Minjiang; Hu, Hongpu; Lei, Xingyun

2017-01-01

Research Purpose: establish health management ontology for analysis of health statistic data. Proposed Methods: this paper established health management ontology based on the analysis of the concepts in China Health Statistics Yearbook, and used protégé to define the syntactic and semantic structure of health statistical data. six classes of top-level ontology concepts and their subclasses had been extracted and the object properties and data properties were defined to establish the construction of these classes. By ontology instantiation, we can integrate multi-source heterogeneous data and enable administrators to have an overall understanding and analysis of the health statistic data. ontology technology provides a comprehensive and unified information integration structure of the health management domain and lays a foundation for the efficient analysis of multi-source and heterogeneous health system management data and enhancement of the management efficiency.

School-Based Clinics: A Guide for Advocates. Developing Policy Statements, Educating Decision Makers, Enlisting Local Support.

ERIC Educational Resources Information Center

Center for Population Options, Washington, DC.

School-based clinics (SBCs) are comprehensive primary health care facilities located within or on the grounds of middle, junior, or senior high schools. Varying in size and organizational structure, SBCs have emerged as an effective model for advancing adolescent health. They have gained attention because of their potential for treating problems…

The role of readability in effective health communication: an experiment using a Japanese health information text on chronic suppurative otitis media.

PubMed

Sakai, Yukiko

2013-09-01

This study identifies the most significant readability factors and examines ways of improving and evaluating Japanese health information text in terms of ease of reading and understanding. Six different Japanese texts were prepared based on an original short text written by a medical doctor for a hospital web site intended for laypersons regarding chronic suppurative otitis media. Four were revised for single readability factor (syntax, vocabulary, or text structure) and two were modified in all three factors. Using a web-based survey, 270 high school students read one of the seven texts, including the original, completed two kinds of comprehension tests, and answered questions on their impressions of the text's readability. Significantly higher comprehension test scores were shown in the true or false test for a mixed text that presented important information first for better text structure. They were also found in the cloze test for a text using common vocabulary and a cohesive mixed text. Vocabulary could be a critical single readability factor when presumably combined with better text structure. Using multiple evaluation methods can help assess comprehensive readability. The findings on improvement and evaluation methods of readability can be applied to support effective health communication. © 2013 The authors. Health Information and Libraries Journal © 2013 Health Libraries Group Health Information and Libraries Journal.

An Overview of Prognosis Health Management Research at Glenn Research Center for Gas Turbine Engine Structures With Special Emphasis on Deformation and Damage Modeling

NASA Technical Reports Server (NTRS)

Arnold, Steven M.; Goldberg, Robert K.; Lerch, Bradley A.; Saleeb, Atef F.

2009-01-01

Herein a general, multimechanism, physics-based viscoelastoplastic model is presented in the context of an integrated diagnosis and prognosis methodology which is proposed for structural health monitoring, with particular applicability to gas turbine engine structures. In this methodology, diagnostics and prognostics will be linked through state awareness variable(s). Key technologies which comprise the proposed integrated approach include (1) diagnostic/detection methodology, (2) prognosis/lifing methodology, (3) diagnostic/prognosis linkage, (4) experimental validation, and (5) material data information management system. A specific prognosis lifing methodology, experimental characterization and validation and data information management are the focal point of current activities being pursued within this integrated approach. The prognostic lifing methodology is based on an advanced multimechanism viscoelastoplastic model which accounts for both stiffness and/or strength reduction damage variables. Methods to characterize both the reversible and irreversible portions of the model are discussed. Once the multiscale model is validated the intent is to link it to appropriate diagnostic methods to provide a full-featured structural health monitoring system.

An Overview of Prognosis Health Management Research at GRC for Gas Turbine Engine Structures With Special Emphasis on Deformation and Damage Modeling

NASA Technical Reports Server (NTRS)

Arnold, Steven M.; Goldberg, Robert K.; Lerch, Bradley A.; Saleeb, Atef F.

2009-01-01

Herein a general, multimechanism, physics-based viscoelastoplastic model is presented in the context of an integrated diagnosis and prognosis methodology which is proposed for structural health monitoring, with particular applicability to gas turbine engine structures. In this methodology, diagnostics and prognostics will be linked through state awareness variable(s). Key technologies which comprise the proposed integrated approach include 1) diagnostic/detection methodology, 2) prognosis/lifing methodology, 3) diagnostic/prognosis linkage, 4) experimental validation and 5) material data information management system. A specific prognosis lifing methodology, experimental characterization and validation and data information management are the focal point of current activities being pursued within this integrated approach. The prognostic lifing methodology is based on an advanced multi-mechanism viscoelastoplastic model which accounts for both stiffness and/or strength reduction damage variables. Methods to characterize both the reversible and irreversible portions of the model are discussed. Once the multiscale model is validated the intent is to link it to appropriate diagnostic methods to provide a full-featured structural health monitoring system.

From home, to market, to headquarters, to home. Relocating health services planning and purchasing in New Zealand.

PubMed

Gauld, Robin

2002-01-01

Health sector restructuring has been in vogue, but no country has engaged in as much health sector restructuring as New Zealand where, in a decade, there have been four different public health sector structures. This article discusses New Zealand's four structures with an emphasis on relocating the critical functions of health care planning and purchasing, and on the development of the present district health board system. The four structures include: an area health board system (1989-1991) with planning and purchasing located at "home" in local areas and closely aligned with service provision; a competitive internal market system (1993-1996) which separated planning and purchasing from service provision; a centralised system with a "headquarters" controlling planning and purchasing (1997-1999) while maintaining the distance from provision; and the district health board system currently under development (1999-) which sees purchasing and planning sent home again to regions and linked closely with service provision. The present system entails the devolution of considerable responsibility to the local level, within a framework of strong central government control. Based on New Zealand's experience, the article notes that all but the market structure appear to have provided an adequate environment for effective health care planning and purchasing.

The Health Promoting Prison (HPP) and its imperative for nursing.

PubMed

Whitehead, Dean

2006-01-01

The World Health Organisation's (WHO) Ottawa Charter for Health Promotion in 1986 provided the catalyst from which the Health Promoting Prison (HPP) movement emerged. Here, an extensive review of the available prison-related health literature provides the basis for critical discussion and recommendations for nursing services and prison-related health care. The findings suggest that current prison-based nursing services are seriously neglected and woefully lacking in structure and resources. This article recommends strategies for reform that includes nurses who practice in all settings, and not just prison-based nurses. If nurses wish to be at the forefront of future HPP strategies, they must first embrace the radical health promotion reforms that are emerging from the current literature. Building sustainable group capacity into prison-based health care, through developing social interaction, cohesion, participation and political action can only benefit the community at large and further emphasise the health promotion role of nursing.

Toward Semantic Interoperability in Home Health Care: Formally Representing OASIS Items for Integration into a Concept-oriented Terminology

PubMed Central

Choi, Jeungok; Jenkins, Melinda L.; Cimino, James J.; White, Thomas M.; Bakken, Suzanne

2005-01-01

Objective: The authors aimed to (1) formally represent OASIS-B1 concepts using the Logical Observation Identifiers, Names, and Codes (LOINC) semantic structure; (2) demonstrate integration of OASIS-B1 concepts into a concept-oriented terminology, the Medical Entities Dictionary (MED); (3) examine potential hierarchical structures within LOINC among OASIS-B1 and other nursing terms; and (4) illustrate a Web-based implementation for OASIS-B1 data entry using Dialogix, a software tool with a set of functions that supports complex data entry. Design and Measurements: Two hundred nine OASIS-B1 items were dissected into the six elements of the LOINC semantic structure and then integrated into the MED hierarchy. Each OASIS-B1 term was matched to LOINC-coded nursing terms, Home Health Care Classification, the Omaha System, and the Sign and Symptom Check-List for Persons with HIV, and the extent of the match was judged based on a scale of 0 (no match) to 4 (exact match). OASIS-B1 terms were implemented as a Web-based survey using Dialogix. Results: Of 209 terms, 204 were successfully dissected into the elements of the LOINC semantics structure and integrated into the MED with minor revisions of MED semantics. One hundred fifty-one OASIS-B1 terms were mapped to one or more of the LOINC-coded nursing terms. Conclusion: The LOINC semantic structure offers a standard way to add home health care data to a comprehensive patient record to facilitate data sharing for monitoring outcomes across sites and to further terminology management, decision support, and accurate information retrieval for evidence-based practice. The cross-mapping results support the possibility of a hierarchical structure of the OASIS-B1 concepts within nursing terminologies in the LOINC database. PMID:15802480

Toward semantic interoperability in home health care: formally representing OASIS items for integration into a concept-oriented terminology.

PubMed

Choi, Jeungok; Jenkins, Melinda L; Cimino, James J; White, Thomas M; Bakken, Suzanne

2005-01-01

The authors aimed to (1) formally represent OASIS-B1 concepts using the Logical Observation Identifiers, Names, and Codes (LOINC) semantic structure; (2) demonstrate integration of OASIS-B1 concepts into a concept-oriented terminology, the Medical Entities Dictionary (MED); (3) examine potential hierarchical structures within LOINC among OASIS-B1 and other nursing terms; and (4) illustrate a Web-based implementation for OASIS-B1 data entry using Dialogix, a software tool with a set of functions that supports complex data entry. Two hundred nine OASIS-B1 items were dissected into the six elements of the LOINC semantic structure and then integrated into the MED hierarchy. Each OASIS-B1 term was matched to LOINC-coded nursing terms, Home Health Care Classification, the Omaha System, and the Sign and Symptom Check-List for Persons with HIV, and the extent of the match was judged based on a scale of 0 (no match) to 4 (exact match). OASIS-B1 terms were implemented as a Web-based survey using Dialogix. Of 209 terms, 204 were successfully dissected into the elements of the LOINC semantics structure and integrated into the MED with minor revisions of MED semantics. One hundred fifty-one OASIS-B1 terms were mapped to one or more of the LOINC-coded nursing terms. The LOINC semantic structure offers a standard way to add home health care data to a comprehensive patient record to facilitate data sharing for monitoring outcomes across sites and to further terminology management, decision support, and accurate information retrieval for evidence-based practice. The cross-mapping results support the possibility of a hierarchical structure of the OASIS-B1 concepts within nursing terminologies in the LOINC database.

[A network to promote health systems based on primary health care in the Region of the Americas].

PubMed

Herrera Vázquez, María Magdalena; Rodríguez Avila, Nuria; Nebot Adell, Carme; Montenegro, Hernán

2007-05-01

To identify the relational components of an international network of organizations that provide technical and financial assistance to promote the development of health systems based on primary health care in the countries of the Region of the Americas; to analyze the linkages that would allow the collaborating partners of the Pan American Health Organization (PAHO) to work together on health issues; and to determine the basic theoretical elements that can help to develop action strategies that support advocacy efforts by a network. This was a qualitative and quantitative cross-sectional study based on identifying key informants and on analyzing social networks. Ethnographic and relational information from 46 international organizations was collected through a self-administered semistructured questionnaire. From 46 international health cooperation organizations, 29 decision makers from 29 organizations participated (63.0% response rate). The structure and the strength of the network was evaluated in terms of density, closeness, clustering, and centralization. The statistical analysis was done using computer programs that included UCINET, Pajek, and Microsoft Access. We found a structurally centralized theoretical network, whose nodes were clustered into four central subgroups linked by a shared vision. The leadership, influence, and political interests reflected the formal and technical-cooperation linkages, the formal support for health systems based on primary health care, and the flow of resources being more often technical ones than financial ones. The interorganizational relational components and the social-action ties that were identified could help in the development and consolidation of a thematic network for advocacy and for the management of technical and financial assistance that supports primary health care in the Americas. The linkages for joint action that were identified could advance international cooperation in developing health systems based on primary health care, once PAHO formulates clear implementation strategies and takes a leadership position in mobilizing financial resources and in creating informal and interpersonal linkages for action.

Quality appraisal of generic self-reported instruments measuring health-related productivity changes: a systematic review

PubMed Central

2014-01-01

Background Health impairments can result in disability and changed work productivity imposing considerable costs for the employee, employer and society as a whole. A large number of instruments exist to measure health-related productivity changes; however their methodological quality remains unclear. This systematic review critically appraised the measurement properties in generic self-reported instruments that measure health-related productivity changes to recommend appropriate instruments for use in occupational and economic health practice. Methods PubMed, PsycINFO, Econlit and Embase were systematically searched for studies whereof: (i) instruments measured health-related productivity changes; (ii) the aim was to evaluate instrument measurement properties; (iii) instruments were generic; (iv) ratings were self-reported; (v) full-texts were available. Next, methodological quality appraisal was based on COSMIN elements: (i) internal consistency; (ii) reliability; (iii) measurement error; (iv) content validity; (v) structural validity; (vi) hypotheses testing; (vii) cross-cultural validity; (viii) criterion validity; and (ix) responsiveness. Recommendations are based on evidence syntheses. Results This review included 25 articles assessing the reliability, validity and responsiveness of 15 different generic self-reported instruments measuring health-related productivity changes. Most studies evaluated criterion validity, none evaluated cross-cultural validity and information on measurement error is lacking. The Work Limitation Questionnaire (WLQ) was most frequently evaluated with moderate respectively strong positive evidence for content and structural validity and negative evidence for reliability, hypothesis testing and responsiveness. Less frequently evaluated, the Stanford Presenteeism Scale (SPS) showed strong positive evidence for internal consistency and structural validity, and moderate positive evidence for hypotheses testing and criterion validity. The Productivity and Disease Questionnaire (PRODISQ) yielded strong positive evidence for content validity, evidence for other properties is lacking. The other instruments resulted in mostly fair-to-poor quality ratings with limited evidence. Conclusions Decisions based on the content of the instrument, usage purpose, target country and population, and available evidence are recommended. Until high-quality studies are in place to accurately assess the measurement properties of the currently available instruments, the WLQ and, in a Dutch context, the PRODISQ are cautiously preferred based on its strong positive evidence for content validity. Based on its strong positive evidence for internal consistency and structural validity, the SPS is cautiously recommended. PMID:24495301

Structural health monitoring of IACC yachts using fiber optic distributed strain sensors: a technical challenge for America's Cup 2000

NASA Astrophysics Data System (ADS)

Murayama, Hideaki; Kageyama, Kazuro; Kimpara, Isao; Akiyoshi, Shimada; Naruse, Hiroshi

2000-06-01

In this study, we developed a health monitoring system using a fiber optic distributed strain sensor for International America's Cup Class (IACC) yachts. Most structural components of an IACC yacht consist of an aluminum honeycomb core sandwiched between carbon fiber reinforced plastic (CFRP) laminates. In such structures, delamination, skin/core debonding and debonding between adhered members will be result in serious fracture of the structure. We equipped two IACC yachts with fiber optic strain sensors designed to measured the distributed strain using a Brillouin optical time domain reflectometer (BOTDR) and to detect any deterioration or damage to the yacht's structures caused by such failures. And based on laboratory test results, we proposed a structural health monitoring technique for IACC yachts that involves analyzing their strain distribution. Some important information about structural conditions of the IACC yachts could be obtained from this system through the periodical strain measurements in the field.

Interactive map communication: pilot study of the visual perceptions and preferences of public health practitioners.

PubMed

Koenig, A; Samarasundera, E; Cheng, T

2011-08-01

To conduct a pilot study into the comprehension and visualisation preferences of geographic information by public health practitioners (PHPs), particularly in the context of interactive, Internet-based atlases. Structured human-computer interaction interviews. Seven academia-based PHPs were interviewed as information service users based on a structured questionnaire to assess their understanding of geographic representations of morbidity data, and identify their visualisation preferences in a geographic information systems environment. Awareness of area-based deprivation indices and the Index of Multiple Deprivation 2007 health and disability domain was near-universal. However, novice users of disease maps had difficulties in interpreting data classifications, in understanding supplementary information in the form of box plots and histograms, and in making use of links between interactive tabular and cartographic information. Choices for colour plans when viewing maps showed little agreement between users, although pre-viewing comments showed preferences for red-blue diverging schema. PHPs new to geographic information would benefit from enhanced interpretive support documentation to meet their needs when using Internet-based, interactive public health atlases, which are rarely provided at such sites. Technical, software-related support alone is insufficient. Increased interaction between PHPs and mapmakers would be beneficial to maximise the potential of the current growth in interactive, electronic atlases, and improve geographic information support for public health decision-making and informing the wider public. Copyright © 2011 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Damage Detection Using Lamb Waves for Structural Health Monitoring

DTIC Science & Technology

2007-03-01

experiments have been reported by Seth Kessler [8]. 2.2 Large Aluminum Plate The second experiment included a 2024-0 aluminum plate with dimensions of...Mechanical Engineering Congress , (IMECE2002- 39017) (17-22 November 2002). 6. Kessler , Seth S. Piezoelectric-Based In-Situ Damage Detection of...Composite Materials for Structural Health Monitoring Systems. Ph.D. thesis, Massachusetts Institute of Technology, January 2002. 7. Kessler , Seth S. “Metis

Inspection Correlation Study of Ultrasonic-Based In Situ Structural Health Monitoring Monthly Report for December 2014-January 2015

DTIC Science & Technology

2015-05-01

fatigue an induced ultrasonic elastic vibration (via piezoelectric transducers [ PZTs ]) propagates through the dogbone specimen. A receiver PZT picks up...inspection of fatigue crack growth in aluminum 7075-T6 dogbone specimens. Acellent Technologies, Inc., is supporting this project through providing...January 2015. 15. SUBJECT TERMS structural health monitoring, probabilistics, fatigue damage, guided waves, Lamb waves 16. SECURITY CLASSIFICATION OF

Print news coverage of school-based human papillomavirus vaccine mandates.

PubMed

Casciotti, Dana M; Smith, Katherine C; Andon, Lindsay; Vernick, Jon; Tsui, Amy; Klassen, Ann C

2014-02-01

In 2007, legislation was proposed in 24 states and the District of Columbia for school-based human papillomavirus (HPV) vaccine mandates, and mandates were enacted in Texas, Virginia, and the District of Columbia. Media coverage of these events was extensive, and media messages both reflected and contributed to controversy surrounding these legislative activities. Messages communicated through the media are an important influence on adolescent and parent understanding of school-based vaccine mandates. We conducted structured text analysis of newspaper coverage, including quantitative analysis of 169 articles published in mandate jurisdictions from 2005 to 2009, and qualitative analysis of 63 articles from 2007. Our structured analysis identified topics, key stakeholders and sources, tone, and the presence of conflict. Qualitative thematic analysis identified key messages and issues. Media coverage was often incomplete, providing little context about cervical cancer or screening. Skepticism and autonomy concerns were common. Messages reflected conflict and distrust of government activities, which could negatively impact this and other youth-focused public health initiatives. If school health professionals are aware of the potential issues raised in media coverage of school-based health mandates, they will be more able to convey appropriate health education messages and promote informed decision-making by parents and students. © 2014, American School Health Association.

A model of roles and responsibilities in oral health promotion based on perspectives of a community-based initiative for pre-school children in the U.K.

PubMed

Henderson, E; Rubin, G

2014-03-01

(i) To explore dental, school and family perspectives of an oral health promotion (OHP) initiative to improve access for pre-school children in deprived communities; (ii) to develop a model of roles and responsibilities for OHP in community settings. Semi-structured focus groups (n = 6) with dental practice staff (n = 24), and semi-structured interviews with school staff (n = 9) and parents and children (n = 4) who were involved in an OHP initiative for pre-school children. Framework analysis was applied to identify themes. Themes were used to develop a model of roles and responsibilities for OHP, based on the WHO Planning and evaluating health promotion model. Respondents subscribed to a community-based approach to improving access to dental services for pre-school children in deprived areas, with an emphasis on shared responsibility and communication. In addition to macro-level actions in directing health policy and services, commissioners were held responsible for investing in micro-level actions, such as funding OHP training and involving parents, and meso-level actions such as reducing barriers to access. The model we have developed builds on WHO recommendations on health promotion to identify the key roles and responsibilities that should be incorporated into further initiatives in OHP.

Fatigue evaluation for Tsing Ma Bridge using structural health monitoring data

NASA Astrophysics Data System (ADS)

Chan, Hung-tin Tommy; Ko, Jan Ming; Li, Zhao-Xia

2001-08-01

Fatigue assessment for the Tsing Ma Bridge (TMB) are presented based on the British standard BS5400 and the real-time structural health monitoring data under railway loading. TMB, as an essential portion of transport network for the Hong Kong airport, is the longest suspension bridge in the world carrying both highway and railway traffic. The bridge design has been mainly based on BS5400. A structural health monitoring system - Wind and Structural Health Monitoring System (WASHMS) for TMB has been operated since the bridge commissioning in May 1997. In order to assess the fatigue behavior of TMB under railway loading, strain gauges were installed on the bridge deck to measure the strain-time histories as soon as the bridge is loaded by a standard railway loading due to the service of an actual train. The strain-time history data at the critical members are then used to determine the stress spectrum, of which the rainflow method recommended for railway bridges by BS5400 is applied to count cycles of stress range. Miner's law is employed to evaluate fatigue damage and remaining service life of the bridge. The evaluated results of fatigue damage and remaining service life would help us to well understand about the fatigue design of the bridge and status in fatigue accumulation.

Evaluation of a Digital Game-Based Learning Program for Enhancing Youth Mental Health: A Structural Equation Modeling of the Program Effectiveness.

PubMed

Huen, Jenny My; Lai, Eliza Sy; Shum, Angie Ky; So, Sam Wk; Chan, Melissa Ky; Wong, Paul Wc; Law, Y W; Yip, Paul Sf

2016-10-07

Digital game-based learning (DGBL) makes use of the entertaining power of digital games for educational purposes. Effectiveness assessment of DGBL programs has been underexplored and no attempt has been made to simultaneously model both important components of DGBL: learning attainment (ie, educational purposes of DGBL) and engagement of users (ie, entertaining power of DGBL) in evaluating program effectiveness. This study aimed to describe and evaluate an Internet-based DGBL program, Professor Gooley and the Flame of Mind, which promotes mental health to adolescents in a positive youth development approach. In particular, we investigated whether user engagement in the DGBL program could enhance their attainment on each of the learning constructs per DGBL module and subsequently enhance their mental health as measured by psychological well-being. Users were assessed on their attainment on each learning construct, psychological well-being, and engagement in each of the modules. One structural equation model was constructed for each DGBL module to model the effect of users' engagement and attainment on the learning construct on their psychological well-being. Of the 498 secondary school students that registered and participated from the first module of the DGBL program, 192 completed all 8 modules of the program. Results from structural equation modeling suggested that a higher extent of engagement in the program activities facilitated users' attainment on the learning constructs on most of the modules and in turn enhanced their psychological well-being after controlling for users' initial psychological well-being and initial attainment on the constructs. This study provided evidence that Internet intervention for mental health, implemented with the technologies and digital innovations of DGBL, could enhance youth mental health. Structural equation modeling is a promising approach in evaluating the effectiveness of DGBL programs.

System Transformation under the California Mental Health Services Act: Implementation of Full Service Partnerships in Los Angeles County

PubMed Central

Starks, Sarah L.; Arns, Paul G.; Padwa, Howard; Friedman, Jack R.; Marrow, Jocelyn; Meldrum, Marcia L.; Bromley, Elizabeth; Kelly, Erin Lee; Brekke, John; Braslow, Joel T.

2018-01-01

Objective The objective is to evaluate the effect of California’s Mental Health Services Act on the structure, volume, location, and patient-centeredness of Los Angeles County public mental health services. Methods This prospective mixed-methods study (2006-2013) is based in 5 Los Angeles County public mental health clinics, all with usual care and 3 with Full Service Partnerships (FSP): new MHSA-funded programs designed to “do whatever it takes” to provide intensive, recovery-oriented, team-based, integrated services for clients with severe mental illness. Study participants include treatment providers (42 FSP, 130 usual care) and clients (174 FSP, 298 usual care). FSPs were compared to usual care on outpatient services received (claims data) and organizational climate, recovery orientation, and provider-client working alliance (surveys; semi-structured interviews), with regression adjustment for client and provider characteristics. Results FSP clients received significantly more (5,238 vs. 1,643 minutes, p<.001), and more-frequently field-based (22% vs. 2%, p<.001), outpatient services than usual care clients in the first year post-admission. FSP clients reported more recovery-oriented services (RSA-R 3.8 vs. 3.5, p<.001) and better provider-client working alliance (WAI-S 3.8 vs. 3.6, p=.01). FSP providers reported more stress (55.0 vs. 51.3, p<.001) and lower morale (48.1 vs. 49.6, p<.001). Conclusions Los Angeles County’s public mental health system was able to transform service delivery in response to well-funded policy mandates. For providers, a structure emphasizing accountability and patient-centeredness was associated with greater stress, despite smaller caseloads. For clients, service structure and volume created opportunities to build stronger provider-client relationships and address client needs and goals. PMID:28142386

Power in health care organizations: contemplations from the first-line management perspective.

PubMed

Isosaari, Ulla

2011-01-01

The aim of this paper is to examine health care organizations' power structures from the first-line management perspective. What liable power structures derive from the theoretical bases of bureaucratic, professional and result based organizations, and what power type do health care organizations represent, according to the empirical data? The paper seeks to perform an analysis using Mintzberg's power configurations of instrument, closed system, meritocracy and political arena. The empirical study was executed at the end of 2005 through a survey in ten Finnish hospital districts in both specialized and primary care. Respondents were all first-line managers in the area and a sample of staff members from internal disease, surgical and psychiatric units, as well as out-patient and primary care units. The number of respondents was 1,197 and the response percentage was 38. The data were analyzed statistically. As a result, it can be seen that a certain kind of organization structure supports the generation of a certain power type. A bureaucratic organization generates an instrument or closed system organization, a professional organization generates meritocracy and also political arena, and a result-based organization has a connection to political arena and meritocracy. First line managers regarded health care organizations as instruments when staff regarded them mainly as meritocracies having features of political arena. Managers felt their position to be limited by rules, whereas staff members regarded their position as having lots of space and influence potential. If the organizations seek innovative and active managers at the unit level, they should change the organizational structure and redistribute the work so that there could be more space for meaningful management. This research adds to the literature and gives helpful suggestions that will be of interest to those in the position of first-line management in health care.

Use of electronic health record structured text and its payoffs. The approach and barriers to using structured text in EHR to document care encounters.

PubMed

Benge, James; Beach, Thomas; Gladding, Connie; Maestas, Gail

2008-01-01

The Military Health System (MHS) deployed its electronic health record (EHR), AHLTA to Military Treatment Facilities (MTFs) around the world. This paper focuses on the approach and barriers to using structured text in AHLTA to document care encounters and illustrates the direct correlation between the use of structured text and achievement of expected benefits. AHLTA uses commercially available products, a health data dictionary and standardized medical terminology, enabling the capture of structured computable data. With structured text stored in the AHLTA Clinical Data Repository (CDR), the MHS has seen a return on its EHR investment with improvements in the accuracy and completeness of coding and the documentation of care provided. Determining the aspects of documentation where structured text is most beneficial, as well as the degree of structured text needed has been a significant challenge. This paper describes how the economic value framework aligns the enterprise strategic objectives with the EHR investment features, performance metrics and expected benefits. The framework analyses focus on return on investment calculations, baseline assessment and post-implementation benefits validation. Cost avoidance, revenue enhancements and operational improvements, such as evidence-based medicine and medical surveillance can be directly attributed to use structured text.

Practitioner Perceptions of the A3 Method for Process Improvement in Health Care

ERIC Educational Resources Information Center

Visich, John K.; Wicks, Angela M.; Zalila, Faiza

2010-01-01

The focus of this article is to present students' perceptions of the recently developed A3 method, a structured problem-solving approach based on lean concepts and tools that have been adapted to the health care environment. The students were all employees of a large health care provider and were enrolled in a customized health care executive MBA…

Structural Vulnerability and Health: Latino Migrant Laborers in the United States

PubMed Central

Quesada, James; Hart, Laurie K.; Bourgois, Philippe

2011-01-01

Latino immigrants in the United States constitute a paradigmatic case of a population group subject to structural violence. Their subordinated location in the global economy and their culturally depreciated status in the United States are exacerbated by legal persecution. Medical Anthropology Volume 30, issues 4 and 5, include a series of ethnographic analyses of the processes that render undocumented Latino immigrants structurally vulnerable to ill-health. We hope to extend the social science concept of ‘structural vulnerability’ to make it a useful tool for health care. Defined as a positionality that imposes physical/emotional suffering on specific population groups and individuals in patterned ways, structural vulnerability is a product of two complementary forces: (1) class-based economic exploitation and cultural, gender/sexual, and racialized discrimination; and (2) processes of symbolic violence and subjectivity formation that have increasingly legitimized punitive neoliberal discourses of individual unworthiness. PMID:21777121

How community physical, structural, and social stressors relate to mental health in the urban slums of Accra, Ghana.

PubMed

Greif, Meredith J; Nii-Amoo Dodoo, F

2015-05-01

Urban health in developing counties is a major public health challenge. It has become increasingly evident that the dialog must expand to include mental health outcomes, and to shift focus to the facets of the urban environment that shape them. Population-based research is necessary, as empirical findings linking the urban environment and mental health have primarily derived from developed countries, and may not be generalizable to developing countries. Thus, the current study assesses the prevalence of mental health problems (i.e., depression, perceived powerlessness), as well as their community-based predictors (i.e., crime, disorder, poverty, poor sanitation, local social capital and cohesion), among a sample of 690 residents in three poor urban communities in Accra, Ghana. It uncovers that residents in poor urban communities in developing countries suffer from mental health problems as a result of local stressors, which include not only physical and structural factors but social ones. Social capital and social cohesion show complex, often unhealthy, relationships with mental health, suggesting considerable drawbacks in making social capital a key focus among policymakers. Copyright © 2015. Published by Elsevier Ltd.

Ethnic minority health in Vietnam: a review exposing horizontal inequity

PubMed Central

Målqvist, Mats; Hoa, Dinh Thi Phuong; Liem, Nguyen Thanh; Thorson, Anna; Thomsen, Sarah

2013-01-01

Background Equity in health is a pressing concern and reaching disadvantaged populations is necessary to close the inequity gap. To date, the discourse has predominately focussed on reaching the poor. At the same time and in addition to wealth, other structural determinants that influence health outcomes exist, one of which is ethnicity. Inequities based on group belongings are recognised as ‘horizontal’, as opposed to the more commonly used notion of ‘vertical’ inequity based on individual characteristics. Objective The aim of the present review is to highlight ethnicity as a source of horizontal inequity in health and to expose mechanisms that cause and maintain this inequity in Vietnam. Design Through a systematic search of available academic and grey literature, 49 publications were selected for review. Information was extracted on: a) quantitative measures of health inequities based on ethnicity and b) qualitative descriptions explaining potential reasons for ethnicity-based health inequities. Results Five main areas were identified: health-care-seeking and utilization, maternal and child health, nutrition, infectious diseases, and oral health and hygiene. Evidence suggests the presence of severe health inequity in health along ethnic lines in all these areas. Research evidence also offers explanations derived from both external and internal group dynamics to this inequity. It is reported that government policies and programs appear to be lacking in culturally adaptation and sensitivity, and examples of bad attitudes and discrimination from health staff toward minority persons were identified. In addition, traditions and patriarchal structures within ethnic minority groups were seen to contribute to the maintenance of harmful health behaviors within these groups. Conclusion Better understandings of the scope and pathways of horizontal inequities are required to address ethnic inequities in health. Awareness of ethnicity as a determinant of health, not only as a covariate of poverty or living area, needs to be improved, and research needs to be designed with this in mind. PMID:23462107

Analysis of the enablers of capacities to produce primary health care-based reforms in Latin America: a multiple case study

PubMed Central

Báscolo, Ernesto Pablo; Yavich, Natalia; Denis, Jean-Louis

2016-01-01

Abstract Background Primary health care (PHC)-based reforms have had different results in Latin America. Little attention has been paid to the enablers of collective action capacities required to produce a comprehensive PHC approach. Objective To analyse the enablers of collective action capacities to transform health systems towards a comprehensive PHC approach in Latin American PHC-based reforms. Methods We conducted a longitudinal, retrospective case study of three municipal PHC-based reforms in Bolivia and Argentina. We used multiple data sources and methodologies: document review; interviews with policymakers, managers and practitioners; and household and services surveys. We used temporal bracketing to analyse how the dynamic of interaction between the institutional reform process and the collective action characteristics enabled or hindered the enablers of collective action capacities required to produce the envisioned changes. Results The institutional structuring dynamics and collective action capacities were different in each case. In Cochabamba, there was an ‘interrupted’ structuring process that achieved the establishment of a primary level with a selective PHC approach. In Vicente López, there was a ‘path-dependency’ structuring process that permitted the consolidation of a ‘primary care’ approach, but with limited influence in hospitals. In Rosario, there was a ‘dialectic’ structuring process that favoured the development of the capacities needed to consolidate a comprehensive PHC approach that permeates the entire system. Conclusion The institutional change processes achieved the development of a primary health care level with different degrees of consolidation and system-wide influence given how the characteristics of each collective action enabled or hindered the ‘structuring’ processes. PMID:27209640

Frequency Response Function Based Damage Identification for Aerospace Structures

NASA Astrophysics Data System (ADS)

Oliver, Joseph Acton

Structural health monitoring technologies continue to be pursued for aerospace structures in the interests of increased safety and, when combined with health prognosis, efficiency in life-cycle management. The current dissertation develops and validates damage identification technology as a critical component for structural health monitoring of aerospace structures and, in particular, composite unmanned aerial vehicles. The primary innovation is a statistical least-squares damage identification algorithm based in concepts of parameter estimation and model update. The algorithm uses frequency response function based residual force vectors derived from distributed vibration measurements to update a structural finite element model through statistically weighted least-squares minimization producing location and quantification of the damage, estimation uncertainty, and an updated model. Advantages compared to other approaches include robust applicability to systems which are heavily damped, large, and noisy, with a relatively low number of distributed measurement points compared to the number of analytical degrees-of-freedom of an associated analytical structural model (e.g., modal finite element model). Motivation, research objectives, and a dissertation summary are discussed in Chapter 1 followed by a literature review in Chapter 2. Chapter 3 gives background theory and the damage identification algorithm derivation followed by a study of fundamental algorithm behavior on a two degree-of-freedom mass-spring system with generalized damping. Chapter 4 investigates the impact of noise then successfully proves the algorithm against competing methods using an analytical eight degree-of-freedom mass-spring system with non-proportional structural damping. Chapter 5 extends use of the algorithm to finite element models, including solutions for numerical issues, approaches for modeling damping approximately in reduced coordinates, and analytical validation using a composite sandwich plate model. Chapter 6 presents the final extension to experimental systems-including methods for initial baseline correlation and data reduction-and validates the algorithm on an experimental composite plate with impact damage. The final chapter deviates from development and validation of the primary algorithm to discuss development of an experimental scaled-wing test bed as part of a collaborative effort for developing structural health monitoring and prognosis technology. The dissertation concludes with an overview of technical conclusions and recommendations for future work.

Universal health coverage in Latin American countries: how to improve solidarity-based schemes.

PubMed

Titelman, Daniel; Cetrángolo, Oscar; Acosta, Olga Lucía

2015-04-04

In this Health Policy we examine the association between the financing structure of health systems and universal health coverage. Latin American health systems encompass a wide range of financial sources, which translate into different solidarity-based schemes that combine contributory (payroll taxes) and non-contributory (general taxes) sources of financing. To move towards universal health coverage, solidarity-based schemes must heavily rely on countries' capacity to increase public expenditure in health. Improvement of solidarity-based schemes will need the expansion of mandatory universal insurance systems and strengthening of the public sector including increased fiscal expenditure. These actions demand a new model to integrate different sources of health-sector financing, including general tax revenue, social security contributions, and private expenditure. The extent of integration achieved among these sources will be the main determinant of solidarity and universal health coverage. The basic challenges for improvement of universal health coverage are not only to spend more on health, but also to reduce the proportion of out-of-pocket spending, which will need increased fiscal resources. Copyright © 2015 Elsevier Ltd. All rights reserved.

Finding the 'sweet spot' in value-based contracts.

PubMed

Eggbeer, Bill; Sears, Kevin; Homer, Ken

2015-08-01

Health systems pursing value-based contracts should address six important considerations: The definition of value. Contracting goals. Cost of implementation. Risk exposure. Contract structure and design. Essential contractual protections.

Distributed Prognostics based on Structural Model Decomposition

NASA Technical Reports Server (NTRS)

Daigle, Matthew J.; Bregon, Anibal; Roychoudhury, I.

2014-01-01

Within systems health management, prognostics focuses on predicting the remaining useful life of a system. In the model-based prognostics paradigm, physics-based models are constructed that describe the operation of a system and how it fails. Such approaches consist of an estimation phase, in which the health state of the system is first identified, and a prediction phase, in which the health state is projected forward in time to determine the end of life. Centralized solutions to these problems are often computationally expensive, do not scale well as the size of the system grows, and introduce a single point of failure. In this paper, we propose a novel distributed model-based prognostics scheme that formally describes how to decompose both the estimation and prediction problems into independent local subproblems whose solutions may be easily composed into a global solution. The decomposition of the prognostics problem is achieved through structural decomposition of the underlying models. The decomposition algorithm creates from the global system model a set of local submodels suitable for prognostics. Independent local estimation and prediction problems are formed based on these local submodels, resulting in a scalable distributed prognostics approach that allows the local subproblems to be solved in parallel, thus offering increases in computational efficiency. Using a centrifugal pump as a case study, we perform a number of simulation-based experiments to demonstrate the distributed approach, compare the performance with a centralized approach, and establish its scalability. Index Terms-model-based prognostics, distributed prognostics, structural model decomposition ABBREVIATIONS

Experimental Modal Analysis and Dynaic Strain Fiber Bragg Gratings for Structural Health Monitoring of Composite Aerospace Structures

NASA Astrophysics Data System (ADS)

Panopoulou, A.; Fransen, S.; Gomez Molinero, V.; Kostopoulos, V.

2012-07-01

The objective of this work is to develop a new structural health monitoring system for composite aerospace structures based on dynamic response strain measurements and experimental modal analysis techniques. Fibre Bragg Grating (FBG) optical sensors were used for monitoring the dynamic response of the composite structure. The structural dynamic behaviour has been numerically simulated and experimentally verified by means of vibration testing. The hypothesis of all vibration tests was that actual damage in composites reduces their stiffness and produces the same result as mass increase produces. Thus, damage was simulated by slightly varying locally the mass of the structure at different zones. Experimental modal analysis based on the strain responses was conducted and the extracted strain mode shapes were the input for the damage detection expert system. A feed-forward back propagation neural network was the core of the damage detection system. The features-input to the neural network consisted of the strain mode shapes, extracted from the experimental modal analysis. Dedicated training and validation activities were carried out based on the experimental results. The system showed high reliability, confirmed by the ability of the neural network to recognize the size and the position of damage on the structure. The experiments were performed on a real structure i.e. a lightweight antenna sub- reflector, manufactured and tested at EADS CASA ESPACIO. An integrated FBG sensor network, based on the advantage of multiplexing, was mounted on the structure with optimum topology. Numerical simulation of both structures was used as a support tool at all the steps of the work. Potential applications for the proposed system are during ground qualification extensive tests of space structures and during the mission as modal analysis tool on board, being able via the FBG responses to identify a potential failure.

Structural Determinants of Health among Im/Migrants in the Indoor Sex Industry: Experiences of Workers and Managers/Owners in Metropolitan Vancouver

PubMed Central

Krüsi, Andrea; Zhang, Emma; Chettiar, Jill; Shannon, Kate

2017-01-01

Background Globally, im/migrant women are overrepresented in the sex industry and experience disproportionate health inequities. Despite evidence that the health impacts of migration may vary according to the timing and stage of migration (e.g., early arrival vs. long-term migration), limited evidence exists regarding social and structural determinants of health across different stages of migration, especially among im/migrants engaged in sex work. Our aim was to describe and analyze the evolving social and structural determinants of health and safety across the arrival and settlement process for im/migrants in the indoor sex industry. Methods We analyzed qualitative interviews conducted with 44 im/migrant sex workers and managers/owners working in indoor sex establishments (e.g., massage parlours, micro-brothels) in Metropolitan Vancouver, Canada in 2011; quantitative data from AESHA, a larger community-based cohort, were used to describe socio-demographic and social and structural characteristics of im/migrant sex workers. Results Based on quantitative data among 198 im/migrant workers in AESHA, 78.3% were Chinese-born, the median duration in Canada was 6 years, and most (86.4%) serviced clients in formal indoor establishments. Qualitative narratives revealed diverse pathways into sex work upon arrival to Canada, including language barriers to conventional labour markets and the higher pay and relative flexibility of sex work. Once engaged in sex work, fear associated with police raids (e.g., immigration concerns, sex work disclosure) and language barriers to sexual negotiation and health, social and legal supports posed pervasive challenges to health, safety and human rights during long-term settlement in Canada. Conclusions Findings highlight the critical influences of criminalization, language barriers, and stigma and discrimination related to sex work and im/migrant status in shaping occupational health and safety for im/migrants engaged in sex work. Interventions and policy reforms that emphasize human rights and occupational health are needed to promote health and wellbeing across the arrival and settlement process. PMID:28141835

Adding value to figures: a web-based European public health information system.

PubMed

van der Wilk, Eveline A; Verschuuren, Marieke

2010-01-01

In 2008 a prototype, web-based system was launched which provided information for different user groups interested in European public health topics. The EUPHIX system contained scientifically sound data, with presentations as well as textual information. The information was structured according to the European Community Health Indicators (ECHI) shortlist. The information included different types of data presentations (tables, interactive graphs and maps), explanatory texts and overviews of the data sources and the literature used. The content was produced by a network of European experts according to a structured, peer-reviewed editorial process. Thus EUPHIX provided an easily accessible, comprehensive, state-of-the-art information source. To ensure that it will continue, financial support will be needed. Co-ownership by the European Commission and the Member States seems an appropriate solution.

Group discussions with structured reminiscence and a problem-based method as an intervention to prevent depressive symptoms in older people.

PubMed

Djukanović, Ingrid; Carlsson, Jörg; Peterson, Ulla

2016-04-01

To evaluate the effect of group discussions, in which structured reminiscence and a problem-based method were used, on depressive symptoms, quality of life and self-rated health among older people. Depressive symptoms in older people have a considerable impact on self-rated health and quality of life, with a high rate of co-morbidity and mortality. As the ageing population is growing, late-life depression is becoming an important public health problem and there is a need to find preventive interventions to avert unnecessary suffering. The study was quasi-experimental, with a one-group pretest-post-test design and follow-up after one year. Initially, a questionnaire was sent to the total population of 55-80-year-old retirees in a community in the northeast of Sweden, (n = 679). The questionnaire concerned demographics and covered areas such as health, depression and quality of life. The intervention consisted of group discussions where structured reminiscence and a problem-based method were used. The participants (n = 18) met 10 times under the guidance of a group-leader, a registered nurse educated in the method. Each session had different themes with a focus on positive memories but also on the present situation and the future. Parametric, nonparametric tests and content analysis were used. Participants evaluated the intervention positively, showed a decrease in depressive symptoms, an increase in self-rated health and experienced an increased autonomy. No long- lasting effect was seen. Group discussions where structured reminiscence and a problem-based method are used might be an option to prevent depressive symptoms in older people. This method might provide an opportunity for older people with depressive symptoms to improve their quality of life, however, to maintain the positive outcome the intervention should probably be continuous. © 2016 John Wiley & Sons Ltd.

Print News Coverage of School-Based HPV Vaccine Mandate

PubMed Central

Casciotti, Dana; Smith, Katherine C.; Andon, Lindsay; Vernick, Jon; Tsui, Amy; Klassen, Ann C.

2015-01-01

BACKGROUND In 2007, legislation was proposed in 24 states and the District of Columbia for school-based HPV vaccine mandates, and mandates were enacted in Texas, Virginia, and the District of Columbia. Media coverage of these events was extensive, and media messages both reflected and contributed to controversy surrounding these legislative activities. Messages communicated through the media are an important influence on adolescent and parent understanding of school-based vaccine mandates. METHODS We conducted structured text analysis of newspaper coverage, including quantitative analysis of 169 articles published in mandate jurisdictions from 2005-2009, and qualitative analysis of 63 articles from 2007. Our structured analysis identified topics, key stakeholders and sources, tone, and the presence of conflict. Qualitative thematic analysis identified key messages and issues. RESULTS Media coverage was often incomplete, providing little context about cervical cancer or screening. Skepticism and autonomy concerns were common. Messages reflected conflict and distrust of government activities, which could negatively impact this and other youth-focused public health initiatives. CONCLUSIONS If school health professionals are aware of the potential issues raised in media coverage of school-based health mandates, they will be more able to convey appropriate health education messages, and promote informed decision-making by parents and students. PMID:25099421

Bearing diagnostics: A method based on differential geometry

NASA Astrophysics Data System (ADS)

Tian, Ye; Wang, Zili; Lu, Chen; Wang, Zhipeng

2016-12-01

The structures around bearings are complex, and the working environment is variable. These conditions cause the collected vibration signals to become nonlinear, non-stationary, and chaotic characteristics that make noise reduction, feature extraction, fault diagnosis, and health assessment significantly challenging. Thus, a set of differential geometry-based methods with superiorities in nonlinear analysis is presented in this study. For noise reduction, the Local Projection method is modified by both selecting the neighborhood radius based on empirical mode decomposition and determining noise subspace constrained by neighborhood distribution information. For feature extraction, Hessian locally linear embedding is introduced to acquire manifold features from the manifold topological structures, and singular values of eigenmatrices as well as several specific frequency amplitudes in spectrograms are extracted subsequently to reduce the complexity of the manifold features. For fault diagnosis, information geometry-based support vector machine is applied to classify the fault states. For health assessment, the manifold distance is employed to represent the health information; the Gaussian mixture model is utilized to calculate the confidence values, which directly reflect the health status. Case studies on Lorenz signals and vibration datasets of bearings demonstrate the effectiveness of the proposed methods.

Simulation tools for guided wave based structural health monitoring

NASA Astrophysics Data System (ADS)

Mesnil, Olivier; Imperiale, Alexandre; Demaldent, Edouard; Baronian, Vahan; Chapuis, Bastien

2018-04-01

Structural Health Monitoring (SHM) is a thematic derived from Non Destructive Evaluation (NDE) based on the integration of sensors onto or into a structure in order to monitor its health without disturbing its regular operating cycle. Guided wave based SHM relies on the propagation of guided waves in plate-like or extruded structures. Using piezoelectric transducers to generate and receive guided waves is one of the most widely accepted paradigms due to the low cost and low weight of those sensors. A wide range of techniques for flaw detection based on the aforementioned setup is available in the literature but very few of these techniques have found industrial applications yet. A major difficulty comes from the sensitivity of guided waves to a substantial number of parameters such as the temperature or geometrical singularities, making guided wave measurement difficult to analyze. In order to apply guided wave based SHM techniques to a wider spectrum of applications and to transfer those techniques to the industry, the CEA LIST develops novel numerical methods. These methods facilitate the evaluation of the robustness of SHM techniques for multiple applicative cases and ease the analysis of the influence of various parameters, such as sensors positioning or environmental conditions. The first numerical tool is the guided wave module integrated to the commercial software CIVA, relying on a hybrid modal-finite element formulation to compute the guided wave response of perturbations (cavities, flaws…) in extruded structures of arbitrary cross section such as rails or pipes. The second numerical tool is based on the spectral element method [2] and simulates guided waves in both isotropic (metals) and orthotropic (composites) plate like-structures. This tool is designed to match the widely accepted sparse piezoelectric transducer array SHM configuration in which each embedded sensor acts as both emitter and receiver of guided waves. This tool is under development and will be adapted to simulate complex real-life structures such as curved composite panels with stiffeners. This communication will present these numerical tools and their main functionalities.

Applying activity-based costing in long-term care.

PubMed

Wodchis, W P

1998-01-01

As greater numbers of the elderly use health services, and as health care costs climb, effective financial tracking is essential. Cost management in health care can benefit if costs are linked to the care activities where they are incurred. Activity-based costing (ABC) provides a useful approach. The framework aligns costs (inputs), through activities (process), to outputs and outcomes. It allocates costs based on client care needs rather than management structure. The ABC framework was tested in a residential care facility and in supportive housing apartments. The results demonstrate the feasibility and advantages of ABC for long term care agencies, including community-based care.

Operationalising and piloting the IUHPE European accreditation system for health promotion.

PubMed

Battel-Kirk, Barbara; Barry, Margaret M; van der Zanden, Gerard; Contu, Paolo; Gallardo, Carmen; Martinez, Ana; Speller, Viv; Debenedetti, Sara

2015-09-01

The International Union for Health Promotion and Education (IUHPE) European Accreditation System for Health Promotion aims to promote quality assurance in health promotion practice, education and training. The System is designed to be flexible and sensitive to the different contexts for health promotion practice, education and training in Europe, while maintaining robust criteria. These competency-based criteria were developed in the CompHP Project (2009-2012) that developed core competencies, professional standards and an accreditation framework for health promotion practice, education and training in the context of workforce capacity development in Europe.This paper describes how consultations undertaken with the health promotion community informed the structure and processes of the IUHPE Accreditation System. An overview of its development, key functions and the piloting of its implementation, which was co-funded by the European Union in the context of the EU Health Programme, is presented.Feedback from consultations with key health promotion stakeholders in Europe indicated overall support for the development of an accreditation system for health promotion. However, a number of potential barriers to its implementation were noted including: absence of dedicated practitioners and professional bodies in some countries; lack of clarity about professional boundaries; lack of financial resources required to facilitate capacity building; and concerns about the costs, objectivity and transparency of the system. Feedback from the consultations shaped and informed the process of designing an operational accreditation system to ensure that it would be responsive to potential users' needs and concerns.Based on the agreed structures and processes, a web-based application system was developed and managed at IUHPE headquarters. A governance structure was established together with agreed policies and procedures for the System. During the pilot period, applications from 20 health promotion practitioners, two health promotion education programmes and one national accreditation organisation were processed. Feedback from the piloting stage will inform further refinement of the system.While recognising the challenges, the overall positive feedback and the commitment demonstrated by the health promotion community form a constructive platform for the implementation of the IUHPE Accreditation System in Europe and internationally. © The Author(s) 2014.

Implementation of the nursing process in a health area: models and assessment structures used

PubMed Central

Huitzi-Egilegor, Joseba Xabier; Elorza-Puyadena, Maria Isabel; Urkia-Etxabe, Jose Maria; Asurabarrena-Iraola, Carmen

2014-01-01

OBJECTIVE: to analyze what nursing models and nursing assessment structures have been used in the implementation of the nursing process at the public and private centers in the health area Gipuzkoa (Basque Country). METHOD: a retrospective study was undertaken, based on the analysis of the nursing records used at the 158 centers studied. RESULTS: the Henderson model, Carpenito's bifocal structure, Gordon's assessment structure and the Resident Assessment Instrument Nursing Home 2.0 have been used as nursing models and assessment structures to implement the nursing process. At some centers, the selected model or assessment structure has varied over time. CONCLUSION: Henderson's model has been the most used to implement the nursing process. Furthermore, the trend is observed to complement or replace Henderson's model by nursing assessment structures. PMID:25493672

The Evolution of an Innovative Community-Engaged Health Navigator Program to Address Social Determinants of Health.

PubMed

Page-Reeves, Janet; Moffett, Maurice L; Steimel, Leah; Smith, Daryl T

Health navigators and other types of community health workers (CHWs) have become recognized as essential components of quality care, and key for addressing health disparities owing to the complex health care services landscape presents almost insurmountable challenges for vulnerable individuals. Bernalillo County, New Mexico, has high rates of uninsurance, poverty, and food insecurity. The design of the Pathways to a Healthy Bernalillo County Program (BP) has evolved innovations that are unique in terms of program stability and security, expansive reach, and community capacity across six domains: sustainable public mechanism for program funding, involvement of community organizations in designing the program, expanded focus to address the broader social determinants of health with targeted outreach, an integrated, community-based implementation structure, an outcomes-based payment structure, and using an adaptive program design that actively incorporates navigators in the process. In 2008, the Pathways to a Healthy Bernalillo County Program (BP), located in the Albuquerque metropolitan area in central New Mexico, was established to provide navigation and support for the most vulnerable county residents. BP is funded through a 1% carve out of county mill levy funds. The pathways model is an outcome-based approach for health and social services coordination that uses culturally competent CHW as "navigators" trained to connect at-risk individuals to needed health and social services. One of the important innovations of the pathways approach is a shift in focus from merely providing discrete services to confirming healthy outcomes for the individual patient.

Evaluating the online platform of a blended-learning pharmacist continuing education degree program.

PubMed

Wilbur, Kerry

2016-01-01

Background Distance-based continuing education opportunities are increasingly embraced by health professionals worldwide. Methods To evaluate the online component of a blended-learning degree program for pharmacists, we conducted a structured self-assessment and peer review using an instrument systematically devised according to Moore's principles of transactional distance. The web-based platform for 14 courses was reviewed by both local and external faculty, followed by shared reflection of individual and aggregate results. Results Findings indicated a number of course elements for modification to enhance the structure, dialog, and autonomy of the student learning experience. Conclusion Our process was an important exercise in quality assurance and is worthwhile for other health disciplines developing and delivering distance-based content to pursue.

Evaluating the online platform of a blended-learning pharmacist continuing education degree program

PubMed Central

Wilbur, Kerry

2016-01-01

Background Distance-based continuing education opportunities are increasingly embraced by health professionals worldwide. Methods To evaluate the online component of a blended-learning degree program for pharmacists, we conducted a structured self-assessment and peer review using an instrument systematically devised according to Moore's principles of transactional distance. The web-based platform for 14 courses was reviewed by both local and external faculty, followed by shared reflection of individual and aggregate results. Results Findings indicated a number of course elements for modification to enhance the structure, dialog, and autonomy of the student learning experience. Conclusion Our process was an important exercise in quality assurance and is worthwhile for other health disciplines developing and delivering distance-based content to pursue. PMID:27282277

Evaluating the online platform of a blended-learning pharmacist continuing education degree program.

PubMed

Wilbur, Kerry

2016-01-01

Distance-based continuing education opportunities are increasingly embraced by health professionals worldwide. To evaluate the online component of a blended-learning degree program for pharmacists, we conducted a structured self-assessment and peer review using an instrument systematically devised according to Moore's principles of transactional distance. The web-based platform for 14 courses was reviewed by both local and external faculty, followed by shared reflection of individual and aggregate results. Findings indicated a number of course elements for modification to enhance the structure, dialog, and autonomy of the student learning experience. Our process was an important exercise in quality assurance and is worthwhile for other health disciplines developing and delivering distance-based content to pursue.

Uniform circular array for structural health monitoring of composite structures

NASA Astrophysics Data System (ADS)

Stepinski, Tadeusz; Engholm, Marcus

2008-03-01

Phased array with all-azimuth angle coverage would be extremely useful in structural health monitoring (SHM) of planar structures. One method to achieve the 360° coverage is to use uniform circular arrays (UCAs). In this paper we present the concept of UCA adapted for SHM applications. We start from a brief presentation of UCA beamformers based on the principle of phase mode excitation. UCA performance is illustrated by the results of beamformer simulations performed for the narrowband and wideband ultrasonic signals. Preliminary experimental results obtained with UCA used for the reception of ultrasonic signals propagating in an aluminum plate are also presented.

Activity limitations in the lower extremities in patients with osteoarthritis: the modifying effects of illness perceptions and mental health.

PubMed

Botha-Scheepers, S; Riyazi, N; Kroon, H M; Scharloo, M; Houwing-Duistermaat, J J; Slagboom, E; Rosendaal, F R; Breedveld, F C; Kloppenburg, M

2006-11-01

Using the International Classification of Functioning, Disability and Health as framework, we evaluated modifying effects of illness perceptions and mental health on the association between impairments in body structures and functions due to osteoarthritis (OA) and limitation in activities in the lower extremities. Self-reported limitation in activities was assessed by the Western Ontario and McMaster Universities OA index (WOMAC) function subscale in 316 patients with knee or hip pain or evidence of OA on knee or hip radiographs. Body structures and functions were evaluated during clinical and radiological assessments. Illness perceptions and mental health were assessed with the revised Illness Perception Questionnaire (IPQ-R) and the mental component summary score of the RAND 36-item Health Survey, respectively. For each patient an expected WOMAC function score was calculated, using an equation based on a multivariate model of the association of body structures and functions with limitation in activities. The median (interquartile) self-reported WOMAC function score was 22.2 (9.6-43.5). Ninety-one patients reported more and 120 patients reported less limitation in activities than expected. Patients with lumbar spine degeneration, physical or exercise therapy and high IPQ-R identity, consequences and chronic timeline scores had an increased risk to report more limitation in activities than the expected range. Low IPQ-R identity, consequences and emotional representation scores and better mental health were associated with reporting less limitation in activities than the expected range. Illness perceptions and mental health modify the association between self-reported limitation in activities and calculated limitation in activities based on impairments in body structures and functions due to OA.

Trends in Asset Structure between Not-for-Profit and Investor Owned Hospitals

PubMed Central

Song, Paula H.; Reiter, Kristin L.

2010-01-01

The delivery of health care is a capital intensive industry and thus hospital investment strategy continues to be an important area of interest for both health policy and research. Much attention has been given to hospitals’ capital investment policies with relatively little attention to investments in financial assets, which serve an important role in NFP hospitals. This study describes and analyzes trends in aggregate asset structure between NFP and IO hospitals during the post-capital based PPS implementation period, providing the first documentation of long-term trends in hospital investment. We find hospitals’ aggregate asset structure differs significantly based on ownership, size, and profitability. For both NFP and IO hospitals, financial securities have remained consistent over time, while fixed asset representation has declined in IO hospitals. PMID:20519429

On the modal characteristics of damaging structures subjected to earthquakes

NASA Astrophysics Data System (ADS)

Carlo Ponzo, Felice; Ditommaso, Rocco; Auletta, Gianluca; Iacovino, Chiara; Mossucca, Antonello; Nigro, Antonella; Nigro, Domenico

2015-04-01

Structural Health Monitoring, especially for structures located in seismic prone areas, has assumed a meaning of great importance in last years, for the possibility to make a more objective and more rapid estimation of the damage occurred on buildings after a seismic event. In the last years many researchers are working to set-up new methodologies for Non-destructive Damage Evaluation based on the variation of the dynamic behaviour of structures under seismic loads. The NDE methods for damage detection and evaluation can be classified into four levels, according to the specific criteria provided by the Rytter. Each level of identification is correlated with specific information related to monitored structure. In fact, by increasing the level it is possible to obtain more information about the state of the health of the structures, to know if damage occurred on the structures, to quantify and localize the damage and to evaluate its impact on the monitored structure. Several authors discussed on the possibility to use the mode shape curvature to localize damage on structural elements, for example, by applying the curvature-based method to frequency response function instead of mode shape, and demonstrated the potential of this approach by considering real data. Damage detection approach based on dynamic monitoring of structural properties over time has received a considerable attention in recent scientific literature. In earthquake engineering field, the recourse to experimental research is necessary to understand the mechanical behaviour of the various structural and non-structural components. In this paper a new methodology to detect and localize a possible damage occurred on a framed structure after an earthquake is presented and discussed. The main outcomes retrieved from many numerical non linear dynamic models of reinforced concrete framed structures characterized by 3, 5 and 8 floors with different geometric configurations and designed for gravity loads only are here presented. In addition, the main results of experimental shaking table tests carried out on a steel framed model are also showed to confirm the effectiveness of the proposed procedure. Acknowledgements This study was partially funded by the Italian Civil Protection Department within the project DPC-RELUIS 2014 - RS4 ''Seismic observatory of structures and health monitoring''.

Scenario-based design: A method for connecting information system design with public health operations and emergency management

PubMed Central

Reeder, Blaine; Turner, Anne M

2011-01-01

Responding to public health emergencies requires rapid and accurate assessment of workforce availability under adverse and changing circumstances. However, public health information systems to support resource management during both routine and emergency operations are currently lacking. We applied scenario-based design as an approach to engage public health practitioners in the creation and validation of an information design to support routine and emergency public health activities. Methods: Using semi-structured interviews we identified the information needs and activities of senior public health managers of a large municipal health department during routine and emergency operations. Results: Interview analysis identified twenty-five information needs for public health operations management. The identified information needs were used in conjunction with scenario-based design to create twenty-five scenarios of use and a public health manager persona. Scenarios of use and persona were validated and modified based on follow-up surveys with study participants. Scenarios were used to test and gain feedback on a pilot information system. Conclusion: The method of scenario-based design was applied to represent the resource management needs of senior-level public health managers under routine and disaster settings. Scenario-based design can be a useful tool for engaging public health practitioners in the design process and to validate an information system design. PMID:21807120

Design of external sensors board based on Bluetooth interface of smart phones for structural health monitoring system

NASA Astrophysics Data System (ADS)

Yu, Yan; Zhou, Yaping; Zhao, Xuefeng; Li, Dongsheng; Ou, Jinping

2016-04-01

As an important part of new information technology, the Internet of Things(IoT) is based on intelligent perception, recognition technology, ubiquitous computing, ubiquitous network integration, and it is known as the third wave of the development of information industry in the world after the computer and the Internet. And Smart Phones are the general term for a class of mobile phones with a separate operating system and operational memory, in which the third-party service programs including software, games, navigation, et.al, can be installed. Smart Phones, with not only sensors but also actuators, are widely used in the IoT world. As the current hot issues in the engineering area, Structural health monitoring (SHM) is also facing new problems about design ideas in the IoT environment. The development of IoT, wireless sensor network and mobile communication technology, provides a good technical platform for SHM. Based on these facts, this paper introduces a kind of new idea for Structural Health Monitoring using Smart Phones Technique. The system is described in detail, and the external sensor board based on Bluetooth interface is designed, the test based on Smart Phones is finished to validate the implementation and feasibility. The research is preliminary and more tests need to be carried out before it can be of practical use.

Strain sensors optimal placement for vibration-based structural health monitoring. The effect of damage on the initially optimal configuration

NASA Astrophysics Data System (ADS)

Loutas, T. H.; Bourikas, A.

2017-12-01

We revisit the optimal sensor placement of engineering structures problem with an emphasis on in-plane dynamic strain measurements and to the direction of modal identification as well as vibration-based damage detection for structural health monitoring purposes. The approach utilized is based on the maximization of a norm of the Fisher Information Matrix built with numerically obtained mode shapes of the structure and at the same time prohibit the sensorization of neighbor degrees of freedom as well as those carrying similar information, in order to obtain a satisfactory coverage. A new convergence criterion of the Fisher Information Matrix (FIM) norm is proposed in order to deal with the issue of choosing an appropriate sensor redundancy threshold, a concept recently introduced but not further investigated concerning its choice. The sensor configurations obtained via a forward sequential placement algorithm are sub-optimal in terms of FIM norm values but the selected sensors are not allowed to be placed in neighbor degrees of freedom providing thus a better coverage of the structure and a subsequent better identification of the experimental mode shapes. The issue of how service induced damage affects the initially nominated as optimal sensor configuration is also investigated and reported. The numerical model of a composite sandwich panel serves as a representative aerospace structure upon which our investigations are based.

The Nursing & Allied Health (CINAHL) data base: a guide to effective searching.

PubMed

Fishel, C C

1985-01-01

The Cumulative Index to Nursing & Allied Health Literature is now available online through both BRS and DIALOG. Known as the NURSING & ALLIED HEALTH (CINAHL) file, it is the data base of choice for professionals in these fields. Unlike the National Library of Medicine's Medical Subject Headings (MeSH), CINAHL has a strong nursing orientation and a specific, current nursing vocabulary. Search techniques are similar to those used on MEDLINE since CINAHL has adopted the powerful MeSH tree structure format. The arrival of this data base is a significant advance for the nursing profession.

Active damage interrogation system for structural health monitoring

NASA Astrophysics Data System (ADS)

Lichtenwalner, Peter F.; Dunne, James P.; Becker, Ronald S.; Baumann, Erwin W.

1997-05-01

An integrated and automated smart structures approach for in situ damage assessment has been implemented and evaluated in a laboratory environment for health monitoring of a realistic aerospace structural component. This approach, called Active Damage Interrogation (ADI), utilizes an array of piezoelectric transducers attached to or embedded within the structure for both actuation and sensing. The ADI system, which is model independent, actively interrogates the structure through broadband excitation of multiple actuators across the desired frequency range. Statistical analysis of the changes in transfer functions between actuator/sensor pairs is used to detect, localize, and assess the severity of damage in the structure. This paper presents the overall concept of the ADI system and provides experimental results of damage assessment studies conducted for a composite structural component of the MD-900 Explorer helicopter rotor system. The potential advantages of this approach include simplicity (no need for a model), sensitivity, and low cost implementation. The results obtained thus far indicate considerably promise for integrated structural health monitoring of aerospace vehicles, leading to the practice of condition-based maintenance and consequent reduction in life cycle costs.

Structural health monitoring of inflatable structures for MMOD impacts

NASA Astrophysics Data System (ADS)

Anees, Muhammad; Gbaguidi, Audrey; Kim, Daewon; Namilae, Sirish

2017-04-01

Inflatable structures for space habitat are highly prone to damage caused by micrometeoroid and orbital debris impacts. Although the structures are effectively shielded against these impacts through multiple layers of impact resistant materials, there is a necessity for a health monitoring system to monitor the structural integrity and damage state within the structures. Assessment of damage is critical for the safety of personnel in the space habitat, as well as predicting the repair needs and the remaining useful life of the habitat. In this paper, we propose a unique impact detection and health monitoring system based on hybrid nanocomposite sensors. The sensors are composed of two fillers, carbon nanotubes and coarse graphene platelets with an epoxy matrix material. The electrical conductivity of these flexible nanocomposite sensors is highly sensitive to strains as well as presence of any holes and damage in the structure. The sensitivity of the sensors to the presence of 3mm holes due to an event of impact is evaluated using four point probe electrical resistivity measurements. An array of these sensors when sandwiched between soft good layers in a space habitat can act as a damage detection layer for inflatable structures. An algorithm is developed to determine the event of impact, its severity and location on the sensing layer for active health monitoring.

OOMM--Object-Oriented Matrix Modelling: an instrument for the integration of the Brasilia Regional Health Information System.

PubMed

Cammarota, M; Huppes, V; Gaia, S; Degoulet, P

1998-01-01

The development of Health Information Systems is widely determined by the establishment of the underlying information models. An Object-Oriented Matrix Model (OOMM) is described which target is to facilitate the integration of the overall health system. The model is based on information modules named micro-databases that are structured in a three-dimensional network: planning, health structures and information systems. The modelling tool has been developed as a layer on top of a relational database system. A visual browser facilitates the development and maintenance of the information model. The modelling approach has been applied to the Brasilia University Hospital since 1991. The extension of the modelling approach to the Brasilia regional health system is considered.

Getting Real Performance Out of Pay-for-Performance

PubMed Central

Nicholson, Sean; Pauly, Mark V; Wu, Anita Ya Jung; Murray, James F; Teutsch, Steven M; Berger, Marc L

2008-01-01

Context Most private and public health insurers are implementing pay-for-performance (P4P) programs in an effort to improve the quality of medical care. This article offers a paradigm for evaluating how P4P programs should be structured and how effective they are likely to be. Methods This article assesses the current comprehensiveness of evidence-based medicine by estimating the percentage of outpatient medical spending for eighteen medical processes recommended by the Institute of Medicine. Findings Three conditions must be in place for outcomes-based P4P programs to improve the quality of care: (1) health insurers must not fully understand what medical processes improve health (i.e., the health production function); (2) providers must know more about the health production function than insurers do; and (3) health insurers must be able to measure a patient's risk-adjusted health. Only two of these conditions currently exist. Payers appear to have incomplete knowledge of the health production function, and providers appear to know more about the health production function than payers do, but accurate methods of adjusting the risk of a patient's health status are still being developed. Conclusions This article concludes that in three general situations, P4P will have a different impact on quality and costs and so should be structured differently. When information about patients’ health and the health production function is incomplete, as is currently the case, P4P payments should be kept small, should be based on outcomes rather than processes, and should target physicians’ practices and health systems. As information improves, P4P incentive payments could be increased, and P4P may become more powerful. Ironically, once information becomes complete, P4P can be replaced entirely by “optimal fee-for-service.” PMID:18798885

Health policy making under information constraints: an evaluation of the policy responses to the economic crisis in Greece.

PubMed

Goranitis, Ilias; Siskou, Olga; Liaropoulos, Lycourgos

2014-09-01

Cost consolidation in the highly fragmented and inefficient Greek health care system was necessary. However, policies introduced were partly formed in a context of insufficient information. Expenditure data from a consumption point of view were lacking and the depth of the political and structural problems was of unknown magnitude to the supervisory authorities. Drawing upon relevant literature and evidence from the newly implemented OECD System of Health Accounts, the paper evaluates the health policy responses to the economic crisis in Greece. The discussion and recommendations are also of interest to other countries where data sources are not reliable or decisions are based on preliminary data and projections. Between 2009 and 2012, across-the-board cuts have resulted in a decline in public health expenditure for inpatient care by 8.6%, for pharmaceuticals by 42.3% and for outpatient care by 34.6%. Further cuts are expected from the ongoing reforms but more structural changes are needed. Cost-containment was not well targeted and expenditure cuts were not always addressed to the real reasons of the pre-crisis cost explosion. Policy responses were restricted to quick and easy fiscal adjustment, ignoring the need for substantial structural reforms or individuals' right to access health care irrespective of their financial capacity. Developing appropriate information infrastructure, restructuring and consolidating the hospital sector and moving toward a tax-based national health insurance could offer valuable benefits to the system. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Vibration-based monitoring to detect mass changes in satellites

NASA Astrophysics Data System (ADS)

Maji, Arup; Vernon, Breck

2012-04-01

Vibration-based structural health monitoring could be a useful form of determining the health and safety of space structures. A particular concern is the possibility of a foreign object that attaches itself to a satellite in orbit for adverse reasons. A frequency response analysis was used to determine the changes in mass and moment of inertia of the space structure based on a change in the natural frequencies of the structure or components of the structure. Feasibility studies were first conducted on a 7 in x 19 in aluminum plate with various boundary conditions. Effect of environmental conditions on the frequency response was determined. The baseline frequency response for the plate was then used as the basis for detection of the addition, and possibly the location, of added masses on the plate. The test results were compared to both analytical solutions and finite element models created in SAP2000. The testing was subsequently expanded to aluminum alloy satellite panels and a mock satellite with dummy payloads. Statistical analysis was conducted on variations of frequency due to added mass and thermal changes to determine the threshold of added mass that can be detected.

A structural model of health behavior modification among patients with cardiovascular disease.

PubMed

Goong, Hwasoo; Ryu, Seungmi; Xu, Lijuan

2016-02-01

The purpose of the study was to test a structural equation model in which social support, health beliefs, and stage of change predict the health behaviors of patients with cardiovascular disease. A cross-sectional correlational design was used. Using convenience sampling, a survey about social support, health belief, stage of change, and health behavior was completed by 314 adults with cardiovascular disease from outpatient clinics in 2 university hospitals in Korea. Data were analyzed using a structural equation model with the Analysis of Moment program. The participants were aged 53.44±13.19 years (mean±SD), and about 64% of them were male. The proposed model fit the data from the study well, explaining 19% and 60% of the variances in the stage of change and health behavior, respectively. The findings indicate that the performance of health behavior modification among the patients with cardiovascular disease can be explained by social support, health belief, and stage of change based on a health-belief and stage-of-change model. Further studies are warranted to confirm the efficacy of health-promoting strategies in initiating and maintaining the performance of health behaviors by providing social support from family and medical staff and enhancing health belief. Copyright © 2015 Elsevier Inc. All rights reserved.

The impact of structural uncertainty on cost-effectiveness models for adjuvant endocrine breast cancer treatments: the need for disease-specific model standardization and improved guidance.

PubMed

Frederix, Gerardus W J; van Hasselt, Johan G C; Schellens, Jan H M; Hövels, Anke M; Raaijmakers, Jan A M; Huitema, Alwin D R; Severens, Johan L

2014-01-01

Structural uncertainty relates to differences in model structure and parameterization. For many published health economic analyses in oncology, substantial differences in model structure exist, leading to differences in analysis outcomes and potentially impacting decision-making processes. The objectives of this analysis were (1) to identify differences in model structure and parameterization for cost-effectiveness analyses (CEAs) comparing tamoxifen and anastrazole for adjuvant breast cancer (ABC) treatment; and (2) to quantify the impact of these differences on analysis outcome metrics. The analysis consisted of four steps: (1) review of the literature for identification of eligible CEAs; (2) definition and implementation of a base model structure, which included the core structural components for all identified CEAs; (3) definition and implementation of changes or additions in the base model structure or parameterization; and (4) quantification of the impact of changes in model structure or parameterizations on the analysis outcome metrics life-years gained (LYG), incremental costs (IC) and the incremental cost-effectiveness ratio (ICER). Eleven CEA analyses comparing anastrazole and tamoxifen as ABC treatment were identified. The base model consisted of the following health states: (1) on treatment; (2) off treatment; (3) local recurrence; (4) metastatic disease; (5) death due to breast cancer; and (6) death due to other causes. The base model estimates of anastrazole versus tamoxifen for the LYG, IC and ICER were 0.263 years, €3,647 and €13,868/LYG, respectively. In the published models that were evaluated, differences in model structure included the addition of different recurrence health states, and associated transition rates were identified. Differences in parameterization were related to the incidences of recurrence, local recurrence to metastatic disease, and metastatic disease to death. The separate impact of these model components on the LYG ranged from 0.207 to 0.356 years, while incremental costs ranged from €3,490 to €3,714 and ICERs ranged from €9,804/LYG to €17,966/LYG. When we re-analyzed the published CEAs in our framework by including their respective model properties, the LYG ranged from 0.207 to 0.383 years, IC ranged from €3,556 to €3,731 and ICERs ranged from €9,683/LYG to €17,570/LYG. Differences in model structure and parameterization lead to substantial differences in analysis outcome metrics. This analysis supports the need for more guidance regarding structural uncertainty and the use of standardized disease-specific models for health economic analyses of adjuvant endocrine breast cancer therapies. The developed approach in the current analysis could potentially serve as a template for further evaluations of structural uncertainty and development of disease-specific models.

Health care funding in New South Wales: from health care needs to hospital outputs.

PubMed

Hindle, Don

2002-01-01

This paper summarises the structure of the State's health care system, and then focuses on the main processes of resource allocation: needs-based funding of 17 Area Health Services, and output-based funding of specific service providers. The general model is widely accepted by informed observers to be fundamentally sound. In particular, the resource distribution formula whereby needs-based allocations are made is a largely valid model that has been progressively refined over fifteen years and is probably as good as any in the world. I conclude that the recent decision to require Area Health Services to use a common framework for out-put-based funding was long overdue, and that many of its features represent best practice. However, I argue that more should be done to refine some of the details and that NSW Health might need to give more consideration to ideas that have been tested and evaluated in other health care systems.

Principles of health infrastructure planning in less developed countries.

PubMed

Unger, J P; Criel, B

1995-01-01

This article proposes a number of key principles for health infrastructure planning, based on a literature review on the one hand, and on a process of internal deduction on the other. The principles discussed are the following: an integrated health system; a thrifty planning of tiers within that health system; a specificity of tiers; a homogeneity of the tiers' structures; a minimum package of activities; a territorial responsibility and/or an explicit and discrete responsibility for a well-defined population; a necessary and sufficient population basis; a partial separation of administrative and public health planning bases; and, finally, rules for a geographical division and integration of non-governmental organizations. The definition of two strategies, primary health care and district health systems, is also revisited.

[Prerequisites for electronic systems evaluating safe and effective drug therapy. A contribution to the Action Plan of the Federal Health Ministry].

PubMed

Aly, A-F; Menges, K; Haas, C H; Zimmermann, L; Kaltschmidt, J; Criegee-Rieck, M

2011-11-01

Evaluation of effective and safe drug therapy assisted by electronic systems is based on certain prerequisites, including structured data of drugs and from patients. These prerequisites were identified in a workshop within the scope of the National Action Plan and have been reported in a 7+1-point plan: medicinal product data must be correct and up-to-date based on the summary of product characteristics approved by the responsible authorities. Product data must be available in an agreed textual structure and must use defined semantic elements within this structure. Identifiers must be allocated to all drugs and substances in order to enable unique identification and exchange across systems. Semantic structures of the product data, on the one hand, and of patient data, on the other, must be defined across system boundaries and for the whole German national health care system, and be available to every stakeholder, up-to-date, and preferably freely accessible. This consensus regarding content and structural conventions is a prerequisite for other scenarios in the health care system, such as transmitting individual case safety reports without system and media discontinuity, and is currently of great importance with respect to the European legislation on pharmacovigilance, which will be implemented nationally.

Structural Health Monitoring of Nuclear Spent Fuel Storage Facilities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yu, Lingyu

Interim storage of spent nuclear fuel from reactor sites has gained additional importance and urgency for resolving waste-management-related technical issues. To ensure that nuclear power remains clean energy, monitoring has been identified by DOE as a high priority cross-cutting need, necessary to determine and predict the degradation state of the systems, structures, and components (SSCs) important to safety (ITS). Therefore, nondestructive structural condition monitoring becomes a need to be installed on existing or to be integrated into future storage system to quantify the state of health or to guarantee the safe operation of nuclear power plants (NPPs) during their extendedmore » life span. In this project, the lead university and the collaborating national laboratory teamed to develop a nuclear structural health monitoring (n-SHM) system based on in-situ piezoelectric sensing technologies that can monitor structural degradation and aging for nuclear spent fuel DCSS and similar structures. We also aimed to identify and quantify possible influences of nuclear spent fuel environment (temperature and radiation) to the piezoelectric sensor system and come up with adequate solutions and guidelines therefore. We have therefore developed analytical model for piezoelectric based n-SHM methods, with considerations of temperature and irradiation influence on the model of sensing and algorithms in acoustic emission (AE), guided ultrasonic waves (GUW), and electromechanical impedance spectroscopy (EMIS). On the other side, experimentally the temperature and irradiation influence on the piezoelectric sensors and sensing capabilities were investigated. Both short-term and long-term irradiation investigation with our collaborating national laboratory were performed. Moreover, we developed multi-modal sensing, validated in laboratory setup, and conducted the testing on the We performed multi-modal sensing development, verification and validation tests on very complex structures including a medium-scale vacuum drying chamber and a small-scale mockup canister available for the desired testing. Our work developed the potential candidate for long term structural health monitoring of spent fuel canister through piezoelectric wafer sensors and provided the sensing methodologies based on AE and GUW methodologies. It overall provides an innovative system and methodology for enhancing the safe operation of nuclear power plant. All major accomplishments planned in the original proposal were successfully achieved.« less

Rethinking schools of public health: a strategic alliance model.

PubMed

Moloughney, Brent W; Skinner, Harvey A

2006-01-01

Canada is in the midst of rejuvenation of public health organizations, mandates and infrastructure. Major planning exercises are underway regarding public health human resources, where academic institutions have a key role to play. To what extent could schools of public health be part of the solution? Many universities across Canada are considering or in the process of implementing MPH programs (some 17 programs planned and/or underway) and possible schools of public health. However, concerns are raised about critical mass, quality and standards. We encourage innovation and debate about ways to enhance collaborative and structural arrangements for education programs. A school of public health model might emerge from this, but so too might other models. Also, novel types of organizational structure need consideration. One example is a "strategic alliance" model that is broad-based, integrative and adaptive--building on the interdisciplinary focus needed for addressing public health concerns in the 21st century. From our perspective, the central question is: what (new) types of organizational structures and, equally important, collaborative networks will enable Canada to strengthen its public health workforce so that it may better address local and global challenges to public health?

Comparative Logic Modeling for Policy Analysis: The Case of HIV Testing Policy Change at the Department of Veterans Affairs

PubMed Central

Langer, Erika M; Gifford, Allen L; Chan, Kee

2011-01-01

Objective Logic models have been used to evaluate policy programs, plan projects, and allocate resources. Logic Modeling for policy analysis has been used rarely in health services research but can be helpful in evaluating the content and rationale of health policies. Comparative Logic Modeling is used here on human immunodeficiency virus (HIV) policy statements from the Department of Veterans Affairs (VA) and Centers for Disease Control and Prevention (CDC). We created visual representations of proposed HIV screening policy components in order to evaluate their structural logic and research-based justifications. Data Sources and Study Design We performed content analysis of VA and CDC HIV testing policy documents in a retrospective case study. Data Collection Using comparative Logic Modeling, we examined the content and primary sources of policy statements by the VA and CDC. We then quantified evidence-based causal inferences within each statement. Principal Findings VA HIV testing policy structure largely replicated that of the CDC guidelines. Despite similar design choices, chosen research citations did not overlap. The agencies used evidence to emphasize different components of the policies. Conclusion Comparative Logic Modeling can be used by health services researchers and policy analysts more generally to evaluate structural differences in health policies and to analyze research-based rationales used by policy makers. PMID:21689094

Vibration based structural health monitoring of an arch bridge: From automated OMA to damage detection

NASA Astrophysics Data System (ADS)

Magalhães, F.; Cunha, A.; Caetano, E.

2012-04-01

In order to evaluate the usefulness of approaches based on modal parameters tracking for structural health monitoring of bridges, in September of 2007, a dynamic monitoring system was installed in a concrete arch bridge at the city of Porto, in Portugal. The implementation of algorithms to perform the continuous on-line identification of modal parameters based on structural responses to ambient excitation (automated Operational Modal Analysis) has permitted to create a very complete database with the time evolution of the bridge modal characteristics during more than 2 years. This paper describes the strategy that was followed to minimize the effects of environmental and operational factors on the bridge natural frequencies, enabling, in a subsequent stage, the identification of structural anomalies. Alternative static and dynamic regression models are tested and complemented by a Principal Components Analysis. Afterwards, the identification of damages is tried with control charts. At the end, it is demonstrated that the adopted processing methodology permits the detection of realistic damage scenarios, associated with frequency shifts around 0.2%, which were simulated with a numerical model.

Shame as a barrier to health seeking among indigenous Huichol migrant labourers: an interpretive approach of the "violence continuum" and "authoritative knowledge".

PubMed

Gamlin, Jennie B

2013-11-01

This article discusses the manner in which social and historical factors impact upon indigenous conceptions of health and health-seeking behaviour, reinforcing their authoritative knowledge about birth and wellbeing. It explores how Mexican indigenous Huichol migrant labourers experience structural, everyday and symbolic violence while away working, and in their home communities. The study was based on semi-structured interviews and observations with 33 Huichol migrant labourers and 12 key informants from the community (traditional healthcare providers), health sector (medical doctors based in the highlands) and tobacco industry (farmers, tobacco union leader and pesticide sellers) during 2010-11. Findings show how the continuum of violence is experienced by these migrants as shame, timidity and humiliation, expressions of symbolic violence that have helped define their tradition of birthing alone and their feeling of entitlement to the conditional welfare payments which sustain their marginalised subsistence lifestyle. This paper proposes that there is a cyclical relationship between structural violence and authoritative knowledge as the former reinforces their adherence to a set of cultural beliefs and practices which are the basis of racial discrimination against them. Copyright © 2013 Elsevier Ltd. All rights reserved.

Damage tolerance modeling and validation of a wireless sensory composite panel for a structural health monitoring system

NASA Astrophysics Data System (ADS)

Talagani, Mohamad R.; Abdi, Frank; Saravanos, Dimitris; Chrysohoidis, Nikos; Nikbin, Kamran; Ragalini, Rose; Rodov, Irena

2013-05-01

The paper proposes the diagnostic and prognostic modeling and test validation of a Wireless Integrated Strain Monitoring and Simulation System (WISMOS). The effort verifies a hardware and web based software tool that is able to evaluate and optimize sensorized aerospace composite structures for the purpose of Structural Health Monitoring (SHM). The tool is an extension of an existing suite of an SHM system, based on a diagnostic-prognostic system (DPS) methodology. The goal of the extended SHM-DPS is to apply multi-scale nonlinear physics-based Progressive Failure analyses to the "as-is" structural configuration to determine residual strength, remaining service life, and future inspection intervals and maintenance procedures. The DPS solution meets the JTI Green Regional Aircraft (GRA) goals towards low weight, durable and reliable commercial aircraft. It will take advantage of the currently developed methodologies within the European Clean sky JTI project WISMOS, with the capability to transmit, store and process strain data from a network of wireless sensors (e.g. strain gages, FBGA) and utilize a DPS-based methodology, based on multi scale progressive failure analysis (MS-PFA), to determine structural health and to advice with respect to condition based inspection and maintenance. As part of the validation of the Diagnostic and prognostic system, Carbon/Epoxy ASTM coupons were fabricated and tested to extract the mechanical properties. Subsequently two composite stiffened panels were manufactured, instrumented and tested under compressive loading: 1) an undamaged stiffened buckling panel; and 2) a damaged stiffened buckling panel including an initial diamond cut. Next numerical Finite element models of the two panels were developed and analyzed under test conditions using Multi-Scale Progressive Failure Analysis (an extension of FEM) to evaluate the damage/fracture evolution process, as well as the identification of contributing failure modes. The comparisons between predictions and test results were within 10% accuracy.

Civionics specifications for fiber optic sensors for structural health monitoring

NASA Astrophysics Data System (ADS)

Rivera, Evangeline; Mufti, Aftab A.; Thomson, Douglas J.

2004-07-01

As the design and construction of civil structures continue to evolve, it is becoming imperative that these structures be monitored for their health. In order to meet this need, the discipline of Civionics has emerged. It involves the applications to civil structures and aims to assist engineers in realizing the full benefits of structural health monitoring (SHM). Therefore, the goal of the specification outlined in this work is to ensure that correct installation and operating of fiber optic sensors, such as bridges, will be discussed that motivated the writing of these specifications. The main reason for the failure of FOS based monitoring systems can be traced directly to the installation of the fiber sensor itself. Therefore, by creating a standard procedure for SHM, several ambiguities are eliminated such as fiber sensor specifications and the types of cables required. As a result, these specifications will help ensure that the sensors will survive the installation process and eventually prove their value over years of monitoring the health of the structure. The Civionics FOS specifications include the requirements for fiber sensors, specifically Bragg grating sensors, and their corresponding readout unit. It also includes specifications on the cables, conduits, junction boxes, cable termination and the environmental.

Enhancing Evidence-Informed Decision Making: Strategies for Engagement between Public Health Faculty and Policymakers in Kenya

ERIC Educational Resources Information Center

Jessani, Nasreen; Kennedy, Caitlin; Bennett, Sara

2017-01-01

This article examines the complex interactions and strategies for engagement--both existing as well as desired--between academic Knowledge Brokers (KBs) and national health policymakers in Kenya. Based on semi-structured interviews with academic KBs and university leaders from six Schools of Public Health (SPHs) as well as national policymakers,…

Urban forest health monitoring: large-scale assessments in the United States

Treesearch

Anne Buckelew Cumming; Daniel B. Twardus; David J. Nowak

2008-01-01

The U.S. Department of Agriculture, Forest Service (USFS), together with state partners, developed methods to monitor urban forest structure, function, and health at a large statewide scale. Pilot studies have been established in five states using protocols based on USFS Forest Inventory and Analysis and Forest Health Monitoring program data collection standards....

Understanding health literacy for strategic health marketing: eHealth literacy, health disparities, and the digital divide.

PubMed

Bodie, Graham D; Dutta, Mohan Jyoti

2008-01-01

Even despite policy efforts aimed at reducing health-related disparities, evidence mounts that population-level gaps in literacy and healthcare quality are increasing. This widening of disparities in American culture is likely to worsen over the coming years due, in part, to our increasing reliance on Internet-based technologies to disseminate health information and services. The purpose of the current article is to incorporate health literacy into an Integrative Model of eHealth Use. We argue for this theoretical understanding of eHealth literacy and propose that macro-level disparities in social structures are connected to health disparities through the micro-level conduits of eHealth literacy, motivation, and ability. In other words, structural inequities reinforce themselves and continue to contribute to healthcare disparities through the differential distribution of technologies that simultaneously enhance and impede literacy, motivation, and ability of different groups (and individuals) in the population. We conclude the article by suggesting pragmatic implications of our analysis.

Race, biology, and health care: reassessing a relationship.

PubMed

Byrd, W M

1990-01-01

Recent reports reaffirm huge disparities in the health of blacks compared to other Americans. These disparities persist in part because of the current attempt by health policy makers to frame racially based health differences in non-racial terms. Yet an historical analysis shows that since ancient times, blacks have been the victims of racism in the biomedical sciences; health-system discrimination and deprivation; and later, medical and scientific exploitation. Race- and class-based structuring of the health delivery system has combined with other factors, including physicians' attitudes conditioned by their participation in slavery, and the scientific myth of black biological and intellectual inferiority, to establish a "slave health deficit" that has never been corrected. Until the persistent institutional racism and racial discrimination in health policy, health delivery, and medical educational systems are eradicated, African-Americans will continue to experience poor health outcome.

Using appreciative inquiry to transform health care.

PubMed

Trajkovski, Suza; Schmied, Virginia; Vickers, Margaret; Jackson, Debra

2013-08-01

Amid tremendous changes in contemporary health care stimulated by shifts in social, economic and political environments, health care managers are challenged to provide new structures and processes to continually improve health service delivery. The general public and the media are becoming less tolerant of poor levels of health care, and health care professionals need to be involved and supported to bring about positive change in health care. Appreciative inquiry (AI) is a philosophy and method for promoting transformational change, shifting from a traditional problem-based orientation to a more strength-based approach to change, that focuses on affirmation, appreciation and positive dialog. This paper discusses how an innovative participatory approach such as AI may be used to promote workforce engagement and organizational learning, and facilitate positive organizational change in a health care context.

Structure-based drug discovery for botulinum neurotoxins.

PubMed

Swaminathan, Subramanyam

2013-01-01

Clostridium botulinum neurotoxin is the most poisonous substance known to humans. It is a potential biowarfare threat and a public health hazard. The only therapeutics available is antibody treatment which will not be effective for post-exposure therapy. There are no drugs available for post-intoxication treatment. Accordingly, it is imperative to develop effective drugs to counter botulism. Available structural information on botulinum neurotoxins both alone and in complex with their substrates offers an efficient method for designing structure-based drugs to treat botulism.

Are community-based pharmacists underused in the care of persons living with HIV? A need for structural and policy changes.

PubMed

Kibicho, Jennifer; Pinkerton, Steven D; Owczarzak, Jill; Mkandawire-Valhmu, Lucy; Kako, Peninnah M

2015-01-01

To describe community pharmacists' perceptions on their current role in direct patient care services, an expanded role for pharmacists in providing patient care services, and changes needed to optimally use pharmacists' expertise to provide high-quality direct patient care services to people living with human immunodeficiency virus (HIV) infections. Cross-sectional study. Four Midwestern cities in the United States in August through October 2009. 28 community-based pharmacists practicing in 17 pharmacies. Interviews. Opinions of participants about roles of specialty and nonspecialty pharmacists in caring for patients living with HIV infections. Pharmacists noted that although challenges in our health care system characterized by inaccessible health professionals presented opportunities for a greater pharmacist role, there were missed opportunities for greater level of patient care services in many community-based nonspecialty settings. Many pharmacists in semispecialty and nonspecialty pharmacies expressed a desire for an expanded role in patient care congruent with their pharmacy education and training. Structural-level policy changes needed to transform community-based pharmacy settings to patient-centered medical homes include recognizing pharmacists as important players in the multidisciplinary health care team, extending the health information exchange highway to include pharmacist-generated electronic therapeutic records, and realigning financial incentives. Comprehensive policy initiatives are needed to optimize the use of highly trained pharmacists in enhancing the quality of health care to an ever-growing number of Americans with chronic conditions who access care in community-based pharmacy settings.

A Systems Engineering Process for an Integrated Structural Health Monitoring System

DTIC Science & Technology

2007-03-01

York NY, 1999. 2nd ed. 3. Chambers, Jeffrey T., Brian L. Wardle, and Seth S. Kessler . “Durability Assessment of Lamb Wave-Based Structural Health...Institute of Technology, 1960. 222 Bibliography 10. Kessler , Seth S., S. Mark Spearing, Mauro J. Atalla, Carlos E. S. Cesnik, and Constantinos...Materials, March 4-8 2001, Newport Beach, CA. Available at http://web.mit.edu/sskess/www/papers/SPIE01.pdf. 11. Kessler , Seth S., S. Mark Spearing

Integrating relationship- and research-based approaches in Australian health promotion practice.

PubMed

Klinner, Christiane; Carter, Stacy M; Rychetnik, Lucie; Li, Vincy; Daley, Michelle; Zask, Avigdor; Lloyd, Beverly

2015-12-01

We examine the perspectives of health promotion practitioners on their approaches to determining health promotion practice, in particular on the role of research and relationships in this process. Using Grounded Theory methods, we analysed 58 semi-structured interviews with 54 health promotion practitioners in New South Wales, Australia. Practitioners differentiated between relationship-based and research-based approaches as two sources of knowledge to guide health promotion practice. We identify several tensions in seeking to combine these approaches in practice and describe the strategies that participants adopted to manage these tensions. The strategies included working in an evidence-informed rather than evidence-based way, creating new evidence about relationship-based processes and outcomes, adopting 'relationship-based' research and evaluation methods, making research and evaluation useful for communities, building research and evaluation skills and improving collaboration between research and evaluation and programme implementation staff. We conclude by highlighting three systemic factors which could further support the integration of research-based and relationship-based health promotion practices: (i) expanding conceptions of health promotion evidence, (ii) developing 'relationship-based' research methods that enable practitioners to measure complex social processes and outcomes and to facilitate community participation and benefit, and (iii) developing organizational capacity. © The Author (2014). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

SHARD - a SeisComP3 module for Structural Health Monitoring

NASA Astrophysics Data System (ADS)

Weber, B.; Becker, J.; Ellguth, E.; Henneberger, R.; Herrnkind, S.; Roessler, D.

2016-12-01

Monitoring building and structure response to strong earthquake ground shaking or human-induced vibrations in real-time forms the backbone of modern structural health monitoring (SHM). The continuous data transmission, processing and analysis reduces drastically the time decision makers need to plan for appropriate response to possible damages of high-priority buildings and structures. SHARD is a web browser based module using the SeisComp3 framework to monitor the structural health of buildings and other structures by calculating standard engineering seismology parameters and checking their exceedance in real-time. Thresholds can be defined, e.g. compliant with national building codes (IBC2000, DIN4149 or EC8), for PGA/PGV/PGD, response spectra and drift ratios. In case thresholds are exceeded automatic or operator driven reports are generated and send to the decision makers. SHARD also determines waveform quality in terms of data delay and variance to report sensor status. SHARD is the perfect tool for civil protection to monitor simultaneously multiple city-wide critical infrastructure as hospitals, schools, governmental buildings and structures as bridges, dams and power substations.

Social determinants of disability-based disadvantage in Solomon islands.

PubMed

Gartrell, Alexandra; Jennaway, Megan; Manderson, Lenore; Fangalasuu, Judy; Dolaiano, Simon

2018-04-01

Development discourse widely recognises that disability is the result of economic and social processes and structures that fail to accommodate persons with disabilities. Empirical work on the relationship between disability and poverty however, conceptualize poverty through an economic resource lens in high-income countries. To address this conceptual gap this article uses a social determinants of health perspective to examine how socio-cultural, economic and political contexts shape disability-based disadvantage. This article draws upon ethnographic research and supplementary data collected using rapid assessment techniques in Solomon Islands. Findings suggest that the disability-poverty nexus and inequalities in health, wellbeing and quality of life must be understood within broader patterns of social vulnerability that are institutionalised in landownership and patterns of descent, gendered power relations and disability specific stigmas that preclude social and productive engagement . This article demonstrates how a social determinant of health perspective that closely examines lived experiences of disability provides critical analytical insights into the structural mechanisms that constitute disability-based disadvantage. This article provides foundation knowledge on which policies and further research to promote disability-inclusion and equity can be based.

Demedicalisation of “Medical prescription of sport”: The Strasbourg programme as Viewed by Sports Educators

PubMed

Marsault, Christelle

2016-06-08

Promoting health by sport has now gone one step further. Integrated into the 2015 Health Act, medical prescription of sport activities is organized locally, as illustrated by the Strasbourg “sport-health prescription” programme, which promotes physical activity for patients with stable chronic diseases within local sports structures. Observation of the real functioning of this programme, based on the practices and descriptions of six sports educators in various structures, reveals demedicalisation in favour of sportification, as sports educators translate the prescription according to their specific institution and policies. Although there is a general consensus about the need for physical education to fight against inactivity and isolation of patients, the expected effects of physical activity are redefined according to a political economy of local structures. Implementation of the sport-health programme is subject to the social and political conditions of the local sports movement.

Value-based choice: An integrative, neuroscience-informed model of health goals.

PubMed

Berkman, Elliot T

2018-01-01

Traditional models of health behaviour focus on the roles of cognitive, personality and social-cognitive constructs (e.g. executive function, grit, self-efficacy), and give less attention to the process by which these constructs interact in the moment that a health-relevant choice is made. Health psychology needs a process-focused account of how various factors are integrated to produce the decisions that determine health behaviour. I present an integrative value-based choice model of health behaviour, which characterises the mechanism by which a variety of factors come together to determine behaviour. This model imports knowledge from research on behavioural economics and neuroscience about how choices are made to the study of health behaviour, and uses that knowledge to generate novel predictions about how to change health behaviour. I describe anomalies in value-based choice that can be exploited for health promotion, and review neuroimaging evidence about the involvement of midline dopamine structures in tracking and integrating value-related information during choice. I highlight how this knowledge can bring insights to health psychology using illustrative case of healthy eating. Value-based choice is a viable model for health behaviour and opens new avenues for mechanism-focused intervention.

Trends in asset structure between not-for-profit and investor-owned hospitals.

PubMed

Song, Paula H; Reiter, Kristin L

2010-12-01

The delivery of health care is a capital-intensive industry, and thus, hospital investment strategy continues to be an important area of interest for both health policy and research. Much attention has been given to hospitals' capital investment policies with relatively little attention to investments in financial assets, which serve an important role in not-for-profit (NFP) hospitals. This study describes and analyzes trends in aggregate asset structure between NFP and investor-owned (IO) hospitals during the post-capital-based prospective payment system implementation period, providing the first documentation of long-term trends in hospital investment. The authors find hospitals' aggregate asset structure differs significantly based on ownership, size, and profitability. For both NFP and IO hospitals, financial securities have remained consistent over time, while fixed asset representation has declined in IO hospitals.

Reliability-based optimization of an active vibration controller using evolutionary algorithms

NASA Astrophysics Data System (ADS)

Saraygord Afshari, Sajad; Pourtakdoust, Seid H.

2017-04-01

Many modern industrialized systems such as aircrafts, rotating turbines, satellite booms, etc. cannot perform their desired tasks accurately if their uninhibited structural vibrations are not controlled properly. Structural health monitoring and online reliability calculations are emerging new means to handle system imposed uncertainties. As stochastic forcing are unavoidable, in most engineering systems, it is often needed to take them into the account for the control design process. In this research, smart material technology is utilized for structural health monitoring and control in order to keep the system in a reliable performance range. In this regard, a reliability-based cost function is assigned for both controller gain optimization as well as sensor placement. The proposed scheme is implemented and verified for a wing section. Comparison of results for the frequency responses is considered to show potential applicability of the presented technique.

Mapping the role of structural and interpersonal violence in the lives of women: implications for public health interventions and policy.

PubMed

Montesanti, Stephanie Rose; Thurston, Wilfreda E

2015-11-11

Research on interpersonal violence towards women has commonly focused on individual or proximate-level determinants associated with violent acts ignores the roles of larger structural systems that shape interpersonal violence. Though this research has contributed to an understanding of the prevalence and consequences of violence towards women, it ignores how patterns of violence are connected to social systems and social institutions. In this paper, we discuss the findings from a scoping review that examined: 1) how structural and symbolic violence contributes to interpersonal violence against women; and 2) the relationships between the social determinants of health and interpersonal violence against women. We used concept mapping to identify what was reported on the relationships among individual-level characteristics and population-level influence on gender-based violence against women and the consequences for women's health. Institutional ethics review was not required for this scoping review since there was no involvement or contact with human subjects. The different forms of violence-symbolic, structural and interpersonal-are not mutually exclusive, rather they relate to one another as they manifest in the lives of women. Structural violence is marked by deeply unequal access to the determinants of health (e.g., housing, good quality health care, and unemployment), which then create conditions where interpersonal violence can happen and which shape gendered forms of violence for women in vulnerable social positions. Our web of causation illustrates how structural factors can have negative impacts on the social determinants of health and increases the risk for interpersonal violence among women. Public health policy responses to violence against women should move beyond individual-level approaches to violence, to consider how structural and interpersonal level violence and power relations shape the 'lived experiences' of violence for women.

The Social Structuring of Mental Health over the Adult Life Course: Advancing Theory in the Sociology of Aging

PubMed Central

Clarke, Philippa; Marshall, Victor; House, James; Lantz, Paula

2011-01-01

The sociology of aging draws on a broad array of theoretical perspectives from several disciplines, but rarely has it developed its own. We build on past work to advance and empirically test a model of mental health framed in terms of structural theorizing and situated within the life course perspective. Whereas most prior research has been based on cross-sectional data, we utilize four waves of data from a nationally representative sample of American adults (Americans' Changing Lives Study) collected prospectively over a 15-year period and find that education, employment and marital status, as well as their consequences for income and health, effectively explain the increase in depressive symptoms after age 65. We also found significant cohort differences in age trajectories of mental health that were partly explained by historical increases in education. We demonstrate that a purely structural theory can take us far in explaining later life mental health. PMID:22081728

Smart-aggregate-based damage detection of fiber-reinforced-polymer-strengthened columns under reversed cyclic loading

NASA Astrophysics Data System (ADS)

Howser, Rachel; Moslehy, Yashar; Gu, Haichang; Dhonde, Hemant; Mo, Y. L.; Ayoub, Ashraf; Song, Gangbing

2011-07-01

Structural health monitoring is an important aspect of the maintenance of large civil infrastructures, especially for bridge columns in areas of high seismic activity. In this project, recently developed innovative piezoceramic-based sensors were utilized to perform the health monitoring of a shear-critical reinforced concrete (RC) bridge column subjected to reversed cyclic loading. After the column failed, it was wrapped with fiber reinforced polymer (FRP) sheets, commonly used to retrofit seismically damaged structures. The FRP-strengthened column was retested under the same reversed cyclic loading pattern. Innovative piezoceramic-based sensors, called 'smart aggregates', were utilized as transducers for health monitoring purposes. On the basis of the smart aggregates developed, an active-sensing approach and an impact-hammer-based approach were used to evaluate the health status of the RC column during the loading procedure. Wave transmission energy is attenuated by the existence of cracks during the loading procedure, and this attenuation phenomenon alters the curve of the transfer function between the actuator and sensor. To detect the damage occurrence and evaluate the damage severity, transfer function curves were compared with those obtained during the period of healthy status. A transfer-function-based damage index matrix was developed to demonstrate the damage severity at different locations. Experimental results verified the effectiveness of the smart aggregates in health monitoring of the FRP-strengthened column as well as the unstrengthened column. The experimental results show that the proposed smart-aggregate-based approach can successfully detect damage occurrence and evaluate its severity.

Governance in community based health programmes in I.R of Iran.

PubMed

Falahat, Katayoun; Eftekhari, Monir Baradaran; Malekafzali, Hossein; Forouzan, Ameneh Setareh; Dejman, Masoumeh

2013-02-01

To assess the nature of community-based health programme experience in Iran, and use the results in order to advocate more friendly policies in community, academy and funding organisations. The qualitative study was done in 2010-11 at various locations in Iran using semi structural in-depth interviews with the principals and managers of programmes, and focus group discussions with volunteers and service users of 13 Community Based Health Programmes which were active for at least five years. A total of 21 in-depth interviews and 20 focus group discussions were conducted. Data analysis was based on deductive-inductive content analysis approach considering the pre-determined structure in accordance with the study questions. The participants' views were analysed within the main category of governance, including the three sub-categories of leadership, monitoring and evaluation, and resource mobilisation. According to the participants, governmental programmes have centralised decision-making and management processes and local volunteers have no role in selecting managers at different levels of a programme. Such programmes are funded by the governmental core resources. In non-government organisations, resources available for such purposes mainly come through charitable individuals, service delivery fees and profitable economical activities, financial participation of volunteers and by using other organisations' facilities. In most programmes, there were no systematic process for monitoring and evaluation. Community-based Health programmes in Iran need to be revised in line with the positive input.There is a need to have community-based units within the Ministry of Health and Medical Education and other relevant organisations.

Associations of mental health with cardiovascular risk phenotypes and adiposity in adolescence: A cross-sectional community-based study.

PubMed

Lycett, Kate; McNamara, Clare; Mensah, Fiona K; Burgner, David; Kerr, Jessica A; Muller, Josh; Wake, Melissa

2018-06-01

Cardiovascular disease and mental illness commonly co-occur in later life, but it is unknown how early these associations arise. We aimed to determine the extent to which: (i) childhood mental health is associated with functional and structural cardiovascular risk phenotypes and adiposity in late childhood/adolescence, and (ii) associations between mental health and cardiovascular phenotypes may be explained by differential body mass index. This cross-sectional study drew on three longitudinal community-based cohort studies (two enriched for overweight/obesity) in metropolitan Melbourne, Australia, with harmonized follow-up in 2014. Mental health exposures included emotional and behavioural problems (Strength and Difficulties Questionnaire) and psychosocial health and general well-being (Pediatric Quality of Life Inventory (PedsQL)), which were assessed by self- and parent-proxy report. Cardiovascular risk phenotypes and adiposity measures included mean arterial pressure, pulse wave velocity, carotid artery intima-media thickness, retinal arterioleto-venule ratio, waist circumference, % body fat, and BMI z-score. We used multivariable linear regression models, adjusting for age, sex and neighbourhood disadvantage, to examine associations. Of the 364 participants (mean age 14.7, standard deviation 2.0, years), 30% were overweight and 16% obese. All adiposity indicators were positively associated with higher behavioural/emotional problems and poorer psychosocial health and negatively associated with better ratings of positive general well-being, as reported by parents and children (all P ≤ 0.03). However, there was little evidence that cardiovascular functional or structural phenotypes varied by mental health. By late childhood/adolescence, mental health is strongly associated with adiposity but not with cardiovascular structure or function. This suggests that the known relationship between these constructs may not develop until early or mid-adulthood. © 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

A Sensor Data Fusion System Based on k-Nearest Neighbor Pattern Classification for Structural Health Monitoring Applications

PubMed Central

Vitola, Jaime; Pozo, Francesc; Tibaduiza, Diego A.; Anaya, Maribel

2017-01-01

Civil and military structures are susceptible and vulnerable to damage due to the environmental and operational conditions. Therefore, the implementation of technology to provide robust solutions in damage identification (by using signals acquired directly from the structure) is a requirement to reduce operational and maintenance costs. In this sense, the use of sensors permanently attached to the structures has demonstrated a great versatility and benefit since the inspection system can be automated. This automation is carried out with signal processing tasks with the aim of a pattern recognition analysis. This work presents the detailed description of a structural health monitoring (SHM) system based on the use of a piezoelectric (PZT) active system. The SHM system includes: (i) the use of a piezoelectric sensor network to excite the structure and collect the measured dynamic response, in several actuation phases; (ii) data organization; (iii) advanced signal processing techniques to define the feature vectors; and finally; (iv) the nearest neighbor algorithm as a machine learning approach to classify different kinds of damage. A description of the experimental setup, the experimental validation and a discussion of the results from two different structures are included and analyzed. PMID:28230796

A Sensor Data Fusion System Based on k-Nearest Neighbor Pattern Classification for Structural Health Monitoring Applications.

PubMed

Vitola, Jaime; Pozo, Francesc; Tibaduiza, Diego A; Anaya, Maribel

2017-02-21

Civil and military structures are susceptible and vulnerable to damage due to the environmental and operational conditions. Therefore, the implementation of technology to provide robust solutions in damage identification (by using signals acquired directly from the structure) is a requirement to reduce operational and maintenance costs. In this sense, the use of sensors permanently attached to the structures has demonstrated a great versatility and benefit since the inspection system can be automated. This automation is carried out with signal processing tasks with the aim of a pattern recognition analysis. This work presents the detailed description of a structural health monitoring (SHM) system based on the use of a piezoelectric (PZT) active system. The SHM system includes: (i) the use of a piezoelectric sensor network to excite the structure and collect the measured dynamic response, in several actuation phases; (ii) data organization; (iii) advanced signal processing techniques to define the feature vectors; and finally; (iv) the nearest neighbor algorithm as a machine learning approach to classify different kinds of damage. A description of the experimental setup, the experimental validation and a discussion of the results from two different structures are included and analyzed.

Aquatic toxicity of acrylates and methacrylates: quantitative structure-activity relationships based on Kow and LC50

DOE Office of Scientific and Technical Information (OSTI.GOV)

Reinert, K.H.

1987-12-01

Recent EPA scrutiny of acrylate and methacrylate monomers has resulted in restrictive consent orders and Significant New Use Rules under the Toxic Substances Control Act, based on structure-activity relationships using mouse skin painting studies. The concern is centered on human health issues regarding worker and consumer exposure. Environmental issues, such as aquatic toxicity, are still of concern. Understanding the relationships and environmental risks to aquatic organisms may improve the understanding of the potential risks to human health. This study evaluates the quantitative structure-activity relationships from measured log Kow's and log LC50's for Pimephales promelas (fathead minnow) and Carassius auratus (goldfish).more » Scientific support of the current regulations is also addressed. Two monomer classes were designated: acrylates and methacrylates. Spearman rank correlation and linear regression were run. Based on this study, an ecotoxicological difference exists between acrylates and methacrylates. Regulatory activities and scientific study should reflect this difference.« less

Structural Racism in the Workplace: Does Perception Matter for Health Inequalities?

PubMed Central

McCluney, Courtney L.; Schmitz, Lauren L.; Hicken, Margaret T.; Sonnega, Amanda

2017-01-01

Structural racism has been linked to racial health inequalities and may operate through an unequal labor market that results in inequalities in psychosocial workplace environments (PWE). Experiences of the PWE may be a critical but understudied source of racial health disparities as most adults spend a large portion of their lives in the workplace, and work-related stress affects health outcomes. Further, it is not clear if the objective characteristics of the workplace are important for health inequalities or if these inequalities are driven by the perception of the workplace. Using data from the 2008 to 2012 waves of the Health and Retirement Study (HRS), a probability-based sample of US adults 50 years of age and older and the Department of Labor’s Occupational Information Network (O*NET), we examine the role of both standardized, objective (O*NET) and survey-based, subjective (as in HRS) measures of PWEs on health and Black-White health inequalities. We find that Blacks experience more stressful PWEs and have poorer health as measured by self-rated health, episodic memory function, and mean arterial pressure. Mediation analyses suggest that these objective O*NET ratings, but not the subjective perceptions, partially explain the relationship between race and health. We discuss these results within the extant literature on workplace and health and health inequalities. Furthermore, we discuss the use of standardized objective measures of the PWE to capture racial inequalities in workplace environment. PMID:28552294

Structural racism in the workplace: Does perception matter for health inequalities?

PubMed

McCluney, Courtney L; Schmitz, Lauren L; Hicken, Margaret T; Sonnega, Amanda

2018-02-01

Structural racism has been linked to racial health inequalities and may operate through an unequal labor market that results in inequalities in psychosocial workplace environments (PWE). Experiences of the PWE may be a critical but understudied source of racial health disparities as most adults spend a large portion of their lives in the workplace, and work-related stress affects health outcomes. Further, it is not clear if the objective characteristics of the workplace are important for health inequalities or if these inequalities are driven by the perception of the workplace. Using data from the 2008 to 2012 waves of the Health and Retirement Study (HRS), a probability-based sample of US adults 50 years of age and older and the Department of Labor's Occupational Information Network (O*NET), we examine the role of both standardized, objective (O*NET) and survey-based, subjective (as in HRS) measures of PWEs on health and Black-White health inequalities. We find that Blacks experience more stressful PWEs and have poorer health as measured by self-rated health, episodic memory function, and mean arterial pressure. Mediation analyses suggest that these objective O*NET ratings, but not the subjective perceptions, partially explain the relationship between race and health. We discuss these results within the extant literature on workplace and health and health inequalities. Furthermore, we discuss the use of standardized objective measures of the PWE to capture racial inequalities in workplace environment. Copyright © 2017 Elsevier Ltd. All rights reserved.

Scenario-based design: a method for connecting information system design with public health operations and emergency management.

PubMed

Reeder, Blaine; Turner, Anne M

2011-12-01

Responding to public health emergencies requires rapid and accurate assessment of workforce availability under adverse and changing circumstances. However, public health information systems to support resource management during both routine and emergency operations are currently lacking. We applied scenario-based design as an approach to engage public health practitioners in the creation and validation of an information design to support routine and emergency public health activities. Using semi-structured interviews we identified the information needs and activities of senior public health managers of a large municipal health department during routine and emergency operations. Interview analysis identified 25 information needs for public health operations management. The identified information needs were used in conjunction with scenario-based design to create 25 scenarios of use and a public health manager persona. Scenarios of use and persona were validated and modified based on follow-up surveys with study participants. Scenarios were used to test and gain feedback on a pilot information system. The method of scenario-based design was applied to represent the resource management needs of senior-level public health managers under routine and disaster settings. Scenario-based design can be a useful tool for engaging public health practitioners in the design process and to validate an information system design. Copyright © 2011 Elsevier Inc. All rights reserved.

Does the organizational structure of health care systems influence care-seeking decisions? A qualitative analysis of Danish cancer patients' reflections on care-seeking.

PubMed

Andersen, Rikke Sand; Vedsted, Peter; Olesen, Frede; Bro, Flemming; Søndergaard, Jens

2011-09-01

The absence of a more significant improvement in cancer survival in countries such as the UK and Denmark may be partly rooted in delayed care-seeking among cancer patients. Past research on patient delay has mainly focused on patient characteristics (e.g. sociodemographic and psychological factors and symptom recognition) as causes of delayed care-seeking, while few studies have examined how the organizational structure of health care systems may influence patients' reflections on seeking care. The aim of this study was to explore this relationship. The analysis presented is based on semi-structured interviews with 30 cancer patients and their families. The article raises two hypotheses on the relationship between structural elements of a health care system and people's reflections on seeking health care: (1) Gatekeeping introduces an asymmetrical relationship between the patient and the GP which potentially results in self-restricting care-seeking, (2) Continuity in the doctor-patient relationship may negatively influence patient reflections on access to health care, as the focus shifts from the medical issues of the consultation to reflections on how to properly interact with the GP and the system in which she/he is situated. It is concluded that these hypotheses form a sound basis for further primary care research on how the organizational structure of health care systems influences patient reflections on access to medical care.

Non-governmental organizational health operations in humanitarian crises: the case for technical support units.

PubMed

Greenough, P Gregg; Nazerali, Rahim; Fink, Sheri; VanRooyen, Michael J

2007-01-01

As the humanitarian health response industry grows, there is a need for technical health expertise that can build an evidence base around outcome measures and raise the quality and accountability of the health relief response. We propose the formation of technical support units (TSUs), entities of health expertise institutionalized within humanitarian non-governmental organizations (NGOs), which will bridge the gap between the demand for evidence-based, humanitarian programming and the field capacity to accomplish it. With the input of major humanitarian NGOs and donors, this paper discusses the attributes and capacities ofTSUs; and the mechanisms for creating and enhancing TSUs within the NGO management structure.

The role of state mental health authorities in managing change for the implementation of evidence-based practices.

PubMed

Isett, Kimberley Roussin; Burnam, M Audrey; Coleman-Beattie, Brenda; Hyde, Pamela S; Morrissey, Joseph P; Magnabosco, Jennifer L; Rapp, Charles; Ganju, Vijay; Goldman, Howard H

2008-06-01

The evidence-based practice demonstration for services to adults with serious mental illness has ended its pilot stage. This paper presents the approaches states employed to combine traditional policy levers with more strategic/institutional efforts (e.g., leadership) to facilitate implementation of these practices. Two rounds of site visits were completed and extensive interview data collected. The data were analyzed to find trends that were consistent across states and across practices. Two themes emerged for understanding implementation of evidence-based practices: the support and influence of the state mental health authority matters and so does the structure of the mental health systems.

Vertical integration models to prepare health systems for capitation.

PubMed

Cave, D G

1995-01-01

Health systems will profit most under capitation if their vertical integration strategy provides operational stability, a strong primary care physician base, efficient delivery of medical services, and geographic access to physicians. Staff- and equity-based systems best meet these characteristics for success because they have one governance structure and a defined mission statement. Moreover, physician bonds are strong because these systems maximize physicians' income potential and control the revenue stream.

Promoting quality: the health-care organization from a management perspective.

PubMed

Glickman, Seth W; Baggett, Kelvin A; Krubert, Christopher G; Peterson, Eric D; Schulman, Kevin A

2007-12-01

Although agreement about the need for quality improvement in health care is almost universal, the means of achieving effective improvement in overall care is not well understood. Avedis Donabedian developed the structure-process-outcome framework in which to think about quality-improvement efforts. There is now a robust evidence-base in the quality-improvement literature on process and outcomes, but structure has received considerably less attention. The health-care field would benefit from expanding the current interpretation of structure to include broader perspectives on organizational attributes as primary determinants of process change and quality improvement. We highlight and discuss the following key elements of organizational attributes from a management perspective: (i) executive management, including senior leadership and board responsibilities (ii) culture, (iii) organizational design, (iv) incentive structures and (v) information management and technology. We discuss the relevant contributions from the business and medical literature for each element, and provide this framework as a roadmap for future research in an effort to develop the optimal definition of 'structure' for transforming quality-improvement initiatives.

Perceived challenges and opportunities arising from integration of mental health into primary care: a cross-sectional survey of primary health care workers in south-west Ethiopia

PubMed Central

2014-01-01

Background The WHO’s mental health Gap Action Programme seeks to narrow the treatment gap for mental disorders by advocating integration of mental health into primary health care (PHC). This study aimed to assess the challenges and opportunities of this approach from the perspective of PHC workers in a sub-Saharan African country. Methods A facility-based cross-sectional survey of 151 PHC workers was conducted from 1st to 30th November 2011 in Jimma zone, south-west Ethiopia. A structured questionnaire was used to ask about past training and mental health experience, knowledge and attitudes towards mental disorders and provision of mental health care in PHC. Semi-structured interviews were carried out with 12 heads of health facilities for more in-depth understanding. Results Almost all PHC workers (96.0%) reported that mental health care was important in Ethiopia and the majority (66.9%) expressed interest in actually delivering mental health care. Higher levels of general health training (degree vs. diploma) and pre-service clinical exposure to mental health care were associated with more favourable attitudes. Knowledge about mental disorder diagnoses, symptoms and treatments was low. Almost half (45.0%) of PHC workers reported that supernatural factors were important causes of mental disorders. Health system and structural issues, such as poor medication supply, lack of rooms, time constraints, absence of specialist supervision and lack of treatment guidelines, were identified as challenges. Almost all PHC workers (96.7%) reported a need for more training, including a clinical attachment, in order to be able to deliver mental health care competently. Conclusions Despite acceptability to PHC workers, the feasibility of integrating mental health into PHC in this sub-Saharan African setting is limited by important gaps in PHC worker knowledge and expectations regarding mental health care, coupled with health system constraints. In addition to clinically-based refresher mental health training, expansion of the specialist mental health workforce may be needed to support integration in practice. PMID:24602215

Perceived challenges and opportunities arising from integration of mental health into primary care: a cross-sectional survey of primary health care workers in south-west Ethiopia.

PubMed

Abera, Mubarek; Tesfaye, Markos; Belachew, Tefera; Hanlon, Charlotte

2014-03-06

The WHO's mental health Gap Action Programme seeks to narrow the treatment gap for mental disorders by advocating integration of mental health into primary health care (PHC). This study aimed to assess the challenges and opportunities of this approach from the perspective of PHC workers in a sub-Saharan African country. A facility-based cross-sectional survey of 151 PHC workers was conducted from 1st to 30th November 2011 in Jimma zone, south-west Ethiopia. A structured questionnaire was used to ask about past training and mental health experience, knowledge and attitudes towards mental disorders and provision of mental health care in PHC. Semi-structured interviews were carried out with 12 heads of health facilities for more in-depth understanding. Almost all PHC workers (96.0%) reported that mental health care was important in Ethiopia and the majority (66.9%) expressed interest in actually delivering mental health care. Higher levels of general health training (degree vs. diploma) and pre-service clinical exposure to mental health care were associated with more favourable attitudes. Knowledge about mental disorder diagnoses, symptoms and treatments was low. Almost half (45.0%) of PHC workers reported that supernatural factors were important causes of mental disorders. Health system and structural issues, such as poor medication supply, lack of rooms, time constraints, absence of specialist supervision and lack of treatment guidelines, were identified as challenges. Almost all PHC workers (96.7%) reported a need for more training, including a clinical attachment, in order to be able to deliver mental health care competently. Despite acceptability to PHC workers, the feasibility of integrating mental health into PHC in this sub-Saharan African setting is limited by important gaps in PHC worker knowledge and expectations regarding mental health care, coupled with health system constraints. In addition to clinically-based refresher mental health training, expansion of the specialist mental health workforce may be needed to support integration in practice.

Implementation of a High-Speed FPGA and DSP Based FFT Processor for Improving Strain Demodulation Performance in a Fiber-Optic-Based Sensing System

NASA Technical Reports Server (NTRS)

Farley, Douglas L.

2005-01-01

NASA's Aviation Safety and Security Program is pursuing research in on-board Structural Health Management (SHM) technologies for purposes of reducing or eliminating aircraft accidents due to system and component failures. Under this program, NASA Langley Research Center (LaRC) is developing a strain-based structural health-monitoring concept that incorporates a fiber optic-based measuring system for acquiring strain values. This fiber optic-based measuring system provides for the distribution of thousands of strain sensors embedded in a network of fiber optic cables. The resolution of strain value at each discrete sensor point requires a computationally demanding data reduction software process that, when hosted on a conventional processor, is not suitable for near real-time measurement. This report describes the development and integration of an alternative computing environment using dedicated computing hardware for performing the data reduction. Performance comparison between the existing and the hardware-based system is presented.

Effects of Teachers' Epistemological, Health View and Pedagogical Beliefs on the Didactic Strategy to Teach Adolescent Reproductive Health: A Cameroonian Perspective

ERIC Educational Resources Information Center

Nchia, Lawrence Ntam; Joseph, Tamesse L.; Fonkeng, George Epah; Ngeh, George Nditafon

2017-01-01

Despite the recommended didactic strategy to teach Adolescent Reproductive Health in Cameroon using Competency Based Approach with entry through problem situations, a lot of resistance is till observed within biology teachers in this multicultural and linguistic country. This cross sectional study uses Structural Equation Modelling (SEM)…

Shifting visions: "delegation" policies and the building of a "rights-based" approach to maternal mortality.

PubMed

Freedman, Lynn P

2002-01-01

"Rights-based" approaches fold human rights principles into the ongoing work of health policy making and programming. The example of delegation of anesthesia provision for emergency obstetric care is used to demonstrate how a rights-based approach, applied to this problem in the context of high-mortality countries, requires decision makers to shift from an individual, ethics-based, clinical perspective to a structural, rights-based, public health perspective. This fluid and context-sensitive approach to human rights also applies at the international level, where the direction of overall maternal mortality reduction strategy is set. By contrasting family planning programs and maternal mortality programs, this commentary argues for choosing the human rights approach that speaks most effectively to the power dynamics underlying the particular health problem being addressed. In the case of maternal death in high-mortality countries, this means a strategic focus on the health care system itself.

Health care professional workstation: software system construction using DSSA scenario-based engineering process.

PubMed

Hufnagel, S; Harbison, K; Silva, J; Mettala, E

1994-01-01

This paper describes a new method for the evolutionary determination of user requirements and system specifications called scenario-based engineering process (SEP). Health care professional workstations are critical components of large scale health care system architectures. We suggest that domain-specific software architectures (DSSAs) be used to specify standard interfaces and protocols for reusable software components throughout those architectures, including workstations. We encourage the use of engineering principles and abstraction mechanisms. Engineering principles are flexible guidelines, adaptable to particular situations. Abstraction mechanisms are simplifications for management of complexity. We recommend object-oriented design principles, graphical structural specifications, and formal components' behavioral specifications. We give an ambulatory care scenario and associated models to demonstrate SEP. The scenario uses health care terminology and gives patients' and health care providers' system views. Our goal is to have a threefold benefit. (i) Scenario view abstractions provide consistent interdisciplinary communications. (ii) Hierarchical object-oriented structures provide useful abstractions for reuse, understandability, and long term evolution. (iii) SEP and health care DSSA integration into computer aided software engineering (CASE) environments. These environments should support rapid construction and certification of individualized systems, from reuse libraries.

Structure-based thresholds of toxicological concern-guidance for application to substances present at low levels in the diet

DOE Office of Scientific and Technical Information (OSTI.GOV)

Renwick, A.G.

Health-based guidance values, such as the ADI, use chemical-specific data to determine the highest intake that would be without significant adverse health effects. A threshold of toxicological concern (TTC) is a level of intake predicted to be without adverse effects based on the toxicity of structurally related compounds. The main advantage of the use of TTCs is that the risk of low exposures can be evaluated without the need for chemical-specific animal toxicity data. TTCs have been used for many years for screening the safety of packaging migrants by the FDA in the USA, and of flavoring substances, by themore » JECFA. A recent reassessment of the use of TTCs, organized by ILSI Europe, has developed a decision tree which allows a systematic approach to the evaluation of low levels of diverse chemicals in food. The decision tree incorporates a series of increasing TTC values into a step-wise approach. Potentially genotoxic carcinogens are considered first, based on the presence of known structural alerts. Aflatoxin-like, azoxy- and nitroso-compounds are removed from consideration because they are the most potent, and a practical TTC could not be established. Other compounds with structural alerts for genotoxicity are allocated a TTC of 0.15 {mu}g/person per day. Compounds without structural alerts for genotoxicity are evaluated based on chemical structure and intake using a series of TTC values derived by the application of a 100-fold uncertainty factor to the 5th percentile of the distribution of NOAELs from chronic studies on compounds sharing similar structural characteristics.« less

Bridge Structure Deformation Prediction Based on GNSS Data Using Kalman-ARIMA-GARCH Model

PubMed Central

Li, Xiaoqing; Wang, Yu

2018-01-01

Bridges are an essential part of the ground transportation system. Health monitoring is fundamentally important for the safety and service life of bridges. A large amount of structural information is obtained from various sensors using sensing technology, and the data processing has become a challenging issue. To improve the prediction accuracy of bridge structure deformation based on data mining and to accurately evaluate the time-varying characteristics of bridge structure performance evolution, this paper proposes a new method for bridge structure deformation prediction, which integrates the Kalman filter, autoregressive integrated moving average model (ARIMA), and generalized autoregressive conditional heteroskedasticity (GARCH). Firstly, the raw deformation data is directly pre-processed using the Kalman filter to reduce the noise. After that, the linear recursive ARIMA model is established to analyze and predict the structure deformation. Finally, the nonlinear recursive GARCH model is introduced to further improve the accuracy of the prediction. Simulation results based on measured sensor data from the Global Navigation Satellite System (GNSS) deformation monitoring system demonstrated that: (1) the Kalman filter is capable of denoising the bridge deformation monitoring data; (2) the prediction accuracy of the proposed Kalman-ARIMA-GARCH model is satisfactory, where the mean absolute error increases only from 3.402 mm to 5.847 mm with the increment of the prediction step; and (3) in comparision to the Kalman-ARIMA model, the Kalman-ARIMA-GARCH model results in superior prediction accuracy as it includes partial nonlinear characteristics (heteroscedasticity); the mean absolute error of five-step prediction using the proposed model is improved by 10.12%. This paper provides a new way for structural behavior prediction based on data processing, which can lay a foundation for the early warning of bridge health monitoring system based on sensor data using sensing technology. PMID:29351254

Bridge Structure Deformation Prediction Based on GNSS Data Using Kalman-ARIMA-GARCH Model.

PubMed

Xin, Jingzhou; Zhou, Jianting; Yang, Simon X; Li, Xiaoqing; Wang, Yu

2018-01-19

Bridges are an essential part of the ground transportation system. Health monitoring is fundamentally important for the safety and service life of bridges. A large amount of structural information is obtained from various sensors using sensing technology, and the data processing has become a challenging issue. To improve the prediction accuracy of bridge structure deformation based on data mining and to accurately evaluate the time-varying characteristics of bridge structure performance evolution, this paper proposes a new method for bridge structure deformation prediction, which integrates the Kalman filter, autoregressive integrated moving average model (ARIMA), and generalized autoregressive conditional heteroskedasticity (GARCH). Firstly, the raw deformation data is directly pre-processed using the Kalman filter to reduce the noise. After that, the linear recursive ARIMA model is established to analyze and predict the structure deformation. Finally, the nonlinear recursive GARCH model is introduced to further improve the accuracy of the prediction. Simulation results based on measured sensor data from the Global Navigation Satellite System (GNSS) deformation monitoring system demonstrated that: (1) the Kalman filter is capable of denoising the bridge deformation monitoring data; (2) the prediction accuracy of the proposed Kalman-ARIMA-GARCH model is satisfactory, where the mean absolute error increases only from 3.402 mm to 5.847 mm with the increment of the prediction step; and (3) in comparision to the Kalman-ARIMA model, the Kalman-ARIMA-GARCH model results in superior prediction accuracy as it includes partial nonlinear characteristics (heteroscedasticity); the mean absolute error of five-step prediction using the proposed model is improved by 10.12%. This paper provides a new way for structural behavior prediction based on data processing, which can lay a foundation for the early warning of bridge health monitoring system based on sensor data using sensing technology.

On the use of attractor dimension as a feature in structural health monitoring

USGS Publications Warehouse

Nichols, J.M.; Virgin, L.N.; Todd, M.D.; Nichols, J.D.

2003-01-01

Recent works in the vibration-based structural health monitoring community have emphasised the use of correlation dimension as a discriminating statistic in seperating a damaged from undamaged response. This paper explores the utility of attractor dimension as a 'feature' and offers some comparisons between different metrics reflecting dimension. This focus is on evaluating the performance of two different measures of dimension as damage indicators in a structural health monitoring context. Results indicate that the correlation dimension is probably a poor choice of statistic for the purpose of signal discrimination. Other measures of dimension may be used for the same purposes with a higher degree of statistical reliability. The question of competing methodologies is placed in a hypothesis testing framework and answered with experimental data taken from a cantilivered beam.

Public health research systems in the European union

PubMed Central

2011-01-01

Background Strengthening health research is an important objective for international health organisations, but there has been less attention to support for health research in Europe. We describe the public-health (population and organisational level) research systems in the 27 European Union countries. Methods We developed a typology for describing health research structures based on funding streams and strategies. We drew data from internet sources and asked country informants to review these for consistency and completeness. The structures were described as organograms and narratives in country profiles for each of the 27 EU member states. National public-health research structures included public and independent funding organisations, 'mixed' institutions (which receive funds, and both use and allocate them) and provider institutions. Results Most health research is funded through ministries of science or science councils (and sometimes foundations), while parliaments and regions may also contribute. National institutes of public health are usually funded by ministries of health. Many national research organisations both determine research programmes and undertake health research, but there is a move towards public-health sciences within the universities, and a transition from internal grants to competitive funding. Of 27 national research strategies, 17 referred to health and 11 to public health themes. Although all countries had strategies for public health itself, we found little coherence in public-health research programmes. The European Commission has country contact points for both EU research and health programmes, but they do not coordinate with national health-research programmes. Conclusions Public-health research is broadly distributed across programmes in EU countries. Better understanding of research structures, programmes and results would improve recognition for public health in Europe, and contribute to practice. EU ministries of health should give greater attention to national public-health research strategies and programmes, and the European Union and the World Health Organisation can provide coordination and support. PMID:21970897

Designing Place-Based Interventions for Sustainability and Replicability: The Case of GO! Austin/VAMOS! Austin

PubMed Central

Hussaini, Aliya; Pulido, Carmen Llanes; Basu, Semonti; Ranjit, Nalini

2018-01-01

Place-based health efforts account for the role of the community environment in shaping decisions and circumstances that affect population well-being. Such efforts, rooted as they are in the theory that health is socially determined, mobilize resources for health promotion that are not typically used, and offer a more informed and robust way of promoting health outcomes within a community. Common criticisms of place-based work include the difficulty of replication, since engagement is so specific to a place, and limited sustainability of the work, in the absence of continued institutional structures, both within the community and supporting structures outside the community, to keep these initiatives resilient. This paper describes a place-based initiative, GO! Austin/VAMOS! Austin (GAVA), which was designed to harness the strengths of place-based work—namely, its specificity to place and community. From the start, the project was designed to balance this specificity with a focus on developing and utilizing a standardized set of evidence-informed implementation and evaluation approaches and tools that were flexible enough to be modified for specific settings. This was accompanied by an emphasis on leadership and capacity building within resident leaders, which provided for informed intervention and demand building capacity, but also for longevity as partners, philanthropic, and otherwise, moved in and out of the work. PMID:29623272

Designing Place-Based Interventions for Sustainability and Replicability: The Case of GO! Austin/VAMOS! Austin.

PubMed

Hussaini, Aliya; Pulido, Carmen Llanes; Basu, Semonti; Ranjit, Nalini

2018-01-01

Place-based health efforts account for the role of the community environment in shaping decisions and circumstances that affect population well-being. Such efforts, rooted as they are in the theory that health is socially determined, mobilize resources for health promotion that are not typically used, and offer a more informed and robust way of promoting health outcomes within a community. Common criticisms of place-based work include the difficulty of replication , since engagement is so specific to a place, and limited sustainability of the work, in the absence of continued institutional structures, both within the community and supporting structures outside the community, to keep these initiatives resilient. This paper describes a place-based initiative, GO! Austin/VAMOS! Austin (GAVA), which was designed to harness the strengths of place-based work-namely, its specificity to place and community. From the start, the project was designed to balance this specificity with a focus on developing and utilizing a standardized set of evidence-informed implementation and evaluation approaches and tools that were flexible enough to be modified for specific settings. This was accompanied by an emphasis on leadership and capacity building within resident leaders, which provided for informed intervention and demand building capacity, but also for longevity as partners, philanthropic, and otherwise, moved in and out of the work.

A Demonstration of Concrete Structural Health Monitoring Framework for Degradation due to Alkali-Silica Reaction

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mahadevan, Sankaran; Agarwal, Vivek; Neal, Kyle

Assessment and management of aging concrete structures in nuclear power plants require a more systematic approach than simple reliance on existing code margins of safety. Structural health monitoring of concrete structures aims to understand the current health condition of a structure based on heterogeneous measurements to produce high-confidence actionable information regarding structural integrity that supports operational and maintenance decisions. This ongoing research project is seeking to develop a probabilistic framework for health diagnosis and prognosis of aging concrete structures in a nuclear power plant that is subjected to physical, chemical, environment, and mechanical degradation. The proposed framework consists of fourmore » elements: monitoring, data analytics, uncertainty quantification and prognosis. This report focuses on degradation caused by ASR (alkali-silica reaction). Controlled specimens were prepared to develop accelerated ASR degradation. Different monitoring techniques – thermography, digital image correlation (DIC), mechanical deformation measurements, nonlinear impact resonance acoustic spectroscopy (NIRAS), and vibro-acoustic modulation (VAM) -- were used to detect the damage caused by ASR. Heterogeneous data from the multiple techniques was used for damage diagnosis and prognosis, and quantification of the associated uncertainty using a Bayesian network approach. Additionally, MapReduce technique has been demonstrated with synthetic data. This technique can be used in future to handle large amounts of observation data obtained from the online monitoring of realistic structures.« less

Nanotechnology and MEMS-based systems for civil infrastructure safety and security: Opportunities and challenges

NASA Astrophysics Data System (ADS)

Robinson, Nidia; Saafi, Mohamed

2006-03-01

Critical civil infrastructure systems such as bridges, high rises, dams, nuclear power plants and pipelines present a major investment and the health of the United States' economy and the lifestyle of its citizens both depend on their safety and security. The challenge for engineers is to maintain the safety and security of these large structures in the face of terrorism threats, natural disasters and long-term deterioration, as well as to meet the demands of emergency response times. With the significant negative impact that these threats can have on the structural environment, health monitoring of civil infrastructure holds promise as a way to provide information for near real-time condition assessment of the structure's safety and security. This information can be used to assess the integrity of the structure for post-earthquake and terrorist attacks rescue and recovery, and to safely and rapidly remove the debris and to temporary shore specific structural elements. This information can also be used for identification of incipient damage in structures experiencing long-term deterioration. However, one of the major obstacles preventing sensor-based monitoring is the lack of reliable, easy-to-install, cost-effective and harsh environment resistant sensors that can be densely embedded into large-scale civil infrastructure systems. Nanotechnology and MEMS-based systems which have matured in recent years represent an innovative solution to current damage detection systems, leading to wireless, inexpensive, durable, compact, and high-density information collection. In this paper, ongoing research activities at Alabama A&M University (AAMU) Center for Transportation Infrastructure Safety and Security on the application of nanotechnology and MEMS to Civil Infrastructure for health monitoring will presented. To date, research showed that nanotechnology and MEMS-based systems can be used to wirelessly detect and monitor different damage mechanisms in concrete structures as well as monitor critical structures' stability during floods and barge impact. However, some technical issues that needs to be addressed before full implementation of these new systems and will also be discussed in this paper.

NASA Applications of Structural Health Monitoring Technology

NASA Technical Reports Server (NTRS)

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

2013-01-01

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

NASA Applications of Structural Health Monitoring Technology

NASA Technical Reports Server (NTRS)

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

2013-01-01

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

Health care providers' perceived barriers to and need for the implementation of a national integrated health care standard on childhood obesity in the Netherlands - a mixed methods approach.

PubMed

Schalkwijk, Annemarie A H; Nijpels, Giel; Bot, Sandra D M; Elders, Petra J M

2016-03-08

In 2010, a national integrated health care standard for (childhood) obesity was published and disseminated in the Netherlands. The aim of this study is to gain insight into the needs of health care providers and the barriers they face in terms of implementing this integrated health care standard. A mixed-methods approach was applied using focus groups, semi-structured, face-to-face interviews and an e-mail-based internet survey. The study's participants included: general practitioners (GPs) (focus groups); health care providers in different professions (face-to-face interviews) and health care providers, including GPs; youth health care workers; pediatricians; dieticians; psychologists and physiotherapists (survey). First, the transcripts from the focus groups were analyzed thematically. The themes identified in this process were then used to analyze the interviews. The results of the analysis of the qualitative data were used to construct the statements used in the e-mail-based internet survey. Responses to items were measured on a 5-point Likert scale and were categorized into three outcomes: 'agree' or 'important' (response categories 1 and 2), 'disagree' or 'not important'. Twenty-seven of the GPs that were invited (51 %) participated in four focus groups. Seven of the nine health care professionals that were invited (78 %) participated in the interviews and 222 questionnaires (17 %) were returned and included in the analysis. The following key barriers were identified with regard to the implementation of the integrated health care standard: reluctance to raise the subject; perceived lack of motivation and knowledge on the part of the parents; previous negative experiences with lifestyle programs; financial constraints and the lack of a structured multidisciplinary approach. The main needs identified were: increased knowledge and awareness on the part of both health care providers and parents/children; a social map of effective intervention; structural funding; task rearrangements; a central care coordinator and structural information feedback from the health care providers involved. The integrated health care standard stipulate that the care of overweight or obese children be provided using an integrated approach. The barriers and needs identified in this study can be used to define strategies to improve the implementation of the integrated health care standard pertaining to overweight and obese children in the Netherlands.

QUANTITATIVE STRUCTURE ACTIVITY RELATIONSHIP (QSAR) MODELS TO PREDICT CHEMICAL TOXICITY FOR VARIOUS HEALTH ENDPOINTS

EPA Science Inventory

Although ranking schemes based on exposure and toxicity have been developed to aid in the prioritization of research funds for identifying chemicals of regulatory concern, there are significant gaps in the availability of experimental toxicity data for most health endpoints. Pred...

A Structured Public Health Approach to Increasing Rates and Duration of Breastfeeding in Romania

PubMed Central

Brînzaniuc, Alexandra; Oprescu, Florin; Cherecheş, Răzvan M.; Mureşan, Marta; Dungy, Claibourne I.

2011-01-01

Abstract Background Studies indicate that since 1990, rates of breastfeeding initiation and duration in Eastern Europe, including Romania, have decreased. Most breastfeeding promotion efforts in Romania have focused on in-hospital care, with an emphasis on training clinicians. Prior studies report that about 88% of Romanian mothers initiate breastfeeding in the hospital; however, these same studies report limited breastfeeding duration. We posit that an important problem is lack of support and education in the weeks and months following the birth. The nature of this problem suggests the need for an integrated and structured public health solution. Methods Based on our independent research, the results of an international maternal and child health (MCH) conference, and consultation with Romanian and American experts, we propose use of the public health problem-solving paradigm to support breastfeeding in Romania. Results This article presents a conceptual model showing the integration of input, output, and process components and a logic model explicating possible interventions (or needs) and barriers to breastfeeding. We propose a public health solution that begins with a new MCH within the public health training structure at a major Romanian university and a summer course bringing together Romanian and American students to study MCH, including breastfeeding. Conclusions We believe that these two courses will promote enthusiasm and generate ideas to develop community-based interventions as well as policy recommendations to increase breastfeeding duration in Romania. We suggest that this public health problem-solving approach provides an integrated way of maintaining and increasing breastfeeding; furthermore, this approach could be broadly used in Eastern Europe. PMID:21675866

Reducing Sweeping Frequencies in Microwave NDT Employing Machine Learning Feature Selection

PubMed Central

Moomen, Abdelniser; Ali, Abdulbaset; Ramahi, Omar M.

2016-01-01

Nondestructive Testing (NDT) assessment of materials’ health condition is useful for classifying healthy from unhealthy structures or detecting flaws in metallic or dielectric structures. Performing structural health testing for coated/uncoated metallic or dielectric materials with the same testing equipment requires a testing method that can work on metallics and dielectrics such as microwave testing. Reducing complexity and expenses associated with current diagnostic practices of microwave NDT of structural health requires an effective and intelligent approach based on feature selection and classification techniques of machine learning. Current microwave NDT methods in general based on measuring variation in the S-matrix over the entire operating frequency ranges of the sensors. For instance, assessing the health of metallic structures using a microwave sensor depends on the reflection or/and transmission coefficient measurements as a function of the sweeping frequencies of the operating band. The aim of this work is reducing sweeping frequencies using machine learning feature selection techniques. By treating sweeping frequencies as features, the number of top important features can be identified, then only the most influential features (frequencies) are considered when building the microwave NDT equipment. The proposed method of reducing sweeping frequencies was validated experimentally using a waveguide sensor and a metallic plate with different cracks. Among the investigated feature selection techniques are information gain, gain ratio, relief, chi-squared. The effectiveness of the selected features were validated through performance evaluations of various classification models; namely, Nearest Neighbor, Neural Networks, Random Forest, and Support Vector Machine. Results showed good crack classification accuracy rates after employing feature selection algorithms. PMID:27104533

Is Internet search better than structured instruction for web-based health education?

PubMed

Finkelstein, Joseph; Bedra, McKenzie

2013-01-01

Internet provides access to vast amounts of comprehensive information regarding any health-related subject. Patients increasingly use this information for health education using a search engine to identify education materials. An alternative approach of health education via Internet is based on utilizing a verified web site which provides structured interactive education guided by adult learning theories. Comparison of these two approaches in older patients was not performed systematically. The aim of this study was to compare the efficacy of a web-based computer-assisted education (CO-ED) system versus searching the Internet for learning about hypertension. Sixty hypertensive older adults (age 45+) were randomized into control or intervention groups. The control patients spent 30 to 40 minutes searching the Internet using a search engine for information about hypertension. The intervention patients spent 30 to 40 minutes using the CO-ED system, which provided computer-assisted instruction about major hypertension topics. Analysis of pre- and post- knowledge scores indicated a significant improvement among CO-ED users (14.6%) as opposed to Internet users (2%). Additionally, patients using the CO-ED program rated their learning experience more positively than those using the Internet.

Linking Primary Care Information Systems and Public Health Vertical Programs in the Philippines: An Open-source Experience

PubMed Central

Tolentino, Herman; Marcelo, Alvin; Marcelo, Portia; Maramba, Inocencio

2005-01-01

Community-based primary care information systems are one of the building blocks for national health information systems. In the Philippines, after the devolution of health care to local governments, we observed “health information system islands” connected to national vertical programs being implemented in devolved health units. These structures lead to a huge amount of “information work” in the transformation of health information at the community level. This paper describes work done to develop and implement the open-source Community Based Health Information Tracking System (CHITS) Project, which was implemented to address this information management problem and its outcomes. Several lessons learned from the field as well as software development strategies are highlighted in building community level information systems that link to national level health information systems. PMID:16779052

Promoting a structural view of biology for varied audiences: an overview of RCSB PDB resources and experiences.

PubMed

Dutta, Shuchismita; Zardecki, Christine; Goodsell, David S; Berman, Helen M

2010-10-01

The Research Collaboratory for Structural Bioinformatics Protein Data Bank (RCSB PDB) supports scientific research and education worldwide by providing an essential resource of information on biomolecular structures. In addition to serving as a deposition, data-processing and distribution center for PDB data, the RCSB PDB offers resources and online materials that different audiences can use to customize their structural biology instruction. These include resources for general audiences that present macromolecular structure in the context of a biological theme, method-based materials for researchers who take a more traditional approach to the presentation of structural science, and materials that mix theme-based and method-based approaches for educators and students. Through these efforts the RCSB PDB aims to enable optimal use of structural data by researchers, educators and students designing and understanding experiments in biology, chemistry and medicine, and by general users making informed decisions about their life and health.

Community-based health and schools of nursing: supporting health promotion and research.

PubMed

Shannon, Crystal

2014-01-01

This article examines the role of community-based schools of nursing in the promotion of public health and research in poverty-stricken areas. This was a three-phase study (questionnaire and key-informants' interviews) that surveyed representatives of prelicensure associate and baccalaureate nursing schools (n=17), nursing-school key informants (n=6) and community leaders (n=10). A 13-question web-based survey and semi-structured interview of key informants elicited data on demographics, nursing program design, exposure of faculty and students to various research and health promotion methods, and beliefs about student involvement. Nursing schools participated minimally in community-based health promotion (CBHP) and community-based participatory research saw reduced need for student involvement in such activities, cited multiple barriers to active community collaboration, and reported restricted community partnerships. CBHP was recognized to be a valuable element of health care and student education, but is obstructed by many barriers. This study suggests that nursing schools are not taking full advantage of relationships with community leaders. Recommendations for action are given. © 2013 Wiley Periodicals, Inc.

Art engagement and mental health: experiences of service users of a community-based arts programme at Tate Modern, London.

PubMed

McKeown, Eamonn; Weir, Hannele; Berridge, Emma-Jane; Ellis, Liz; Kyratsis, Yiannis

2016-01-01

To examine the experiences of mental health service users who took part in an arts-based programme at Tate Modern, a major London art gallery. Exploratory qualitative design. Data were collected using in-depth semi-structured interviews with 10 mental health service users who had taken part in a community-based programme at Tate Modern. Additionally, six art educators from Tate Modern were interviewed. Concepts that emerged from the text were identified using thematic analysis. All participants valued the gallery-based programme. The three overarching thematic areas were: the symbolic and physical context in which the programme workshops were located; the relational and social context of the programme workshops; and reflections on the relationship between the arts-based programme and subsequent mental health. Art galleries are increasingly seen to function as vehicles for popular education with mental health service users. This study adds to the growing body of evidence related to how mental health service users experience and reflect on arts-related programmes targeted at them. This study indicates that emphasis on how users experience gallery-based programmes may contribute to a more nuanced understanding of the relationship between art and mental health. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

[The standardization of medical care and the training of medical personnel].

PubMed

Korbut, V B; Tyts, V V; Boĭshenko, V A

1997-09-01

The medical specialist training at all levels (medical orderly, doctor's assistant, general practitioner, doctors) should be based on the medical care standards. Preliminary studies in the field of military medicine standards have demonstrated that the medical service of the Armed Forces of Russia needs medical resources' standards, structure and organization standards, technology standards. Military medical service resources' standards should reflect the requisitions for: all medical specialists' qualification, equipment and material for medical set-ups, field medical systems, drugs, etc. Standards for structures and organization should include requisitions for: command and control systems in military formations' and task forces' medical services and their information support; health-care and evacuation functions, sanitary control and anti-epidemic measures and personnel health protection. Technology standards development could improve and regulate the health care procedures in the process of evacuation. Standards' development will help to solve the problem of the data-base for the military medicine education system and medical research.

Disadvantaged persons' participation in health promotion projects: some structural dimensions.

PubMed

Boyce, W F

2001-05-01

A structural perspective was used in studying community participation of disadvantaged groups (poor women, street youth, and disabled persons) in health promotion projects. Five community projects in the Canadian Health Promotion Contribution Program were examined in a comparative case study utilizing in-depth interviews, documents, and secondary sources. Analysis revealed relatively low numbers and restricted range of participants, difficulties in recruiting and maintaining participants, declining rates of active participation over time, and limited target group influence and power. This paper reports on the relationship between various dimensions of structure (social-cultural, organizational, political-legal-economic) and the community participation process. Participation was influenced by structural factors such as bureaucratic rules and regulators, perceived minority group rights and relations, agency reputations and responsibilities, available resources, and organizational roles. Control of projects by target group members, rather than by service agencies, was an important overall organizational structural factor which allowed community members to achieve influence in projects. The study concludes that a conceptual model based on structural factors is useful in explaining how key factors from federal and local levels can restrict or facilitate the community participation process.

Upending the social ecological model to guide health promotion efforts toward policy and environmental change.

PubMed

Golden, Shelley D; McLeroy, Kenneth R; Green, Lawrence W; Earp, Jo Anne L; Lieberman, Lisa D

2015-04-01

Efforts to change policies and the environments in which people live, work, and play have gained increasing attention over the past several decades. Yet health promotion frameworks that illustrate the complex processes that produce health-enhancing structural changes are limited. Building on the experiences of health educators, community activists, and community-based researchers described in this supplement and elsewhere, as well as several political, social, and behavioral science theories, we propose a new framework to organize our thinking about producing policy, environmental, and other structural changes. We build on the social ecological model, a framework widely employed in public health research and practice, by turning it inside out, placing health-related and other social policies and environments at the center, and conceptualizing the ways in which individuals, their social networks, and organized groups produce a community context that fosters healthy policy and environmental development. We conclude by describing how health promotion practitioners and researchers can foster structural change by (1) conveying the health and social relevance of policy and environmental change initiatives, (2) building partnerships to support them, and (3) promoting more equitable distributions of the resources necessary for people to meet their daily needs, control their lives, and freely participate in the public sphere. © 2015 Society for Public Health Education.

National Institutes of Health Toolbox Emotion Battery for English- and Spanish-speaking adults: normative data and factor-based summary scores.

PubMed

Babakhanyan, Ida; McKenna, Benjamin S; Casaletto, Kaitlin B; Nowinski, Cindy J; Heaton, Robert K

2018-01-01

The National Institutes of Health Toolbox Emotion Battery (NIHTB-EB) is a "common currency", computerized assessment developed to measure the full spectrum of emotional health. Though comprehensive, the NIHTB-EB's 17 scales may be unwieldy for users aiming to capture more global indices of emotional functioning. NIHTB-EB was administered to 1,036 English-speaking and 408 Spanish-speaking adults as a part of the NIH Toolbox norming project. We examined the factor structure of the NIHTB-EB in English- and Spanish-speaking adults and developed factor analysis-based summary scores. Census-weighted norms were presented for English speakers, and sample-weighted norms were presented for Spanish speakers. Exploratory factor analysis for both English- and Spanish-speaking cohorts resulted in the same 3-factor solution: 1) negative affect, 2) social satisfaction, and 3) psychological well-being. Confirmatory factor analysis supported similar factor structures for English- and Spanish-speaking cohorts. Model fit indices fell within the acceptable/good range, and our final solution was optimal compared to other solutions. Summary scores based upon the normative samples appear to be psychometrically supported and should be applied to clinical samples to further validate the factor structures and investigate rates of problematic emotions in medical and psychiatric populations.

A symmetry measure for damage detection with mode shapes

NASA Astrophysics Data System (ADS)

Chen, Justin G.; Büyüköztürk, Oral

2017-11-01

This paper introduces a feature for detecting damage or changes in structures, the continuous symmetry measure, which can quantify the amount of a particular rotational, mirror, or translational symmetry in a mode shape of a structure. Many structures in the built environment have geometries that are either symmetric or almost symmetric, however damage typically occurs in a local manner causing asymmetric changes in the structure's geometry or material properties, and alters its mode shapes. The continuous symmetry measure can quantify these changes in symmetry as a novel indicator of damage for data-based structural health monitoring approaches. This paper describes the concept as a basis for detecting changes in mode shapes and detecting structural damage. Application of the method is demonstrated in various structures with different symmetrical properties: a pipe cross-section with a finite element model and experimental study, the NASA 8-bay truss model, and the simulated IASC-ASCE structural health monitoring benchmark structure. The applicability and limitations of the feature in applying it to structures of varying geometries is discussed.

Conceptualizing a Human Right to Prevention in Global HIV/AIDS Policy

PubMed Central

Meier, Benjamin Mason; Brugh, Kristen Nichole; Halima, Yasmin

2012-01-01

Given current constraints on universal treatment campaigns, recent advances in public health prevention initiatives have revitalized efforts to stem the tide of HIV transmission. Yet, despite a growing imperative for prevention—supported by the promise of behavioral, structural and biomedical approaches to lower the incidence of HIV—human rights frameworks remain limited in addressing collective prevention policy through global health governance. Assessing the evolution of rights-based approaches to global HIV/AIDS policy, this review finds that human rights have shifted from collective public health to individual treatment access. While the advent of the HIV/AIDS pandemic gave meaning to rights in framing global health policy, the application of rights in treatment access litigation came at the expense of public health prevention efforts. Where the human rights framework remains limited to individual rights enforced against a state duty bearer, such rights have faced constrained application in framing population-level policy to realize the public good of HIV prevention. Concluding that human rights frameworks must be developed to reflect the complementarity of individual treatment and collective prevention, this article conceptualizes collective rights to public health, structuring collective combination prevention to alleviate limitations on individual rights frameworks and frame rights-based global HIV/AIDS policy to assure research expansion, prevention access and health system integration. PMID:23226723

Carbon Nanotube-Based Structural Health Monitoring Sensors

NASA Technical Reports Server (NTRS)

Wincheski, Russell; Jordan, Jeffrey; Oglesby, Donald; Watkins, Anthony; Patry, JoAnne; Smits, Jan; Williams, Phillip

2011-01-01

Carbon nanotube (CNT)-based sensors for structural health monitoring (SHM) can be embedded in structures of all geometries to monitor conditions both inside and at the surface of the structure to continuously sense changes. These CNTs can be manipulated into specific orientations to create small, powerful, and flexible sensors. One of the sensors is a highly flexible sensor for crack growth detection and strain field mapping that features a very dense and highly ordered array of single-walled CNTs. CNT structural health sensors can be mass-produced, are inexpensive, can be packaged in small sizes (0.5 micron(sup 2)), require less power than electronic or piezoelectric transducers, and produce less waste heat per square centimeter than electronic or piezoelectric transducers. Chemically functionalized lithographic patterns are used to deposit and align the CNTs onto metallic electrodes. This method consistently produces aligned CNTs in the defined locations. Using photo- and electron-beam lithography, simple Cr/Au thin-film circuits are patterned onto oxidized silicon substrates. The samples are then re-patterned with a CNT-attracting, self-assembled monolayer of 3-aminopropyltriethoxysilane (APTES) to delineate the desired CNT locations between electrodes. During the deposition of the solution-suspended single- wall CNTs, the application of an electric field to the metallic contacts causes alignment of the CNTs along the field direction. This innovation is a prime candidate for smart skin technologies with applications ranging from military, to aerospace, to private industry.

Evaluation of a Digital Game-Based Learning Program for Enhancing Youth Mental Health: A Structural Equation Modeling of the Program Effectiveness

PubMed Central

Huen, Jenny MY; Lai, Eliza SY; Shum, Angie KY; So, Sam WK; Chan, Melissa KY; Wong, Paul WC; Law, YW

2016-01-01

Background Digital game-based learning (DGBL) makes use of the entertaining power of digital games for educational purposes. Effectiveness assessment of DGBL programs has been underexplored and no attempt has been made to simultaneously model both important components of DGBL: learning attainment (ie, educational purposes of DGBL) and engagement of users (ie, entertaining power of DGBL) in evaluating program effectiveness. Objective This study aimed to describe and evaluate an Internet-based DGBL program, Professor Gooley and the Flame of Mind, which promotes mental health to adolescents in a positive youth development approach. In particular, we investigated whether user engagement in the DGBL program could enhance their attainment on each of the learning constructs per DGBL module and subsequently enhance their mental health as measured by psychological well-being. Methods Users were assessed on their attainment on each learning construct, psychological well-being, and engagement in each of the modules. One structural equation model was constructed for each DGBL module to model the effect of users' engagement and attainment on the learning construct on their psychological well-being. Results Of the 498 secondary school students that registered and participated from the first module of the DGBL program, 192 completed all 8 modules of the program. Results from structural equation modeling suggested that a higher extent of engagement in the program activities facilitated users’ attainment on the learning constructs on most of the modules and in turn enhanced their psychological well-being after controlling for users’ initial psychological well-being and initial attainment on the constructs. Conclusions This study provided evidence that Internet intervention for mental health, implemented with the technologies and digital innovations of DGBL, could enhance youth mental health. Structural equation modeling is a promising approach in evaluating the effectiveness of DGBL programs. PMID:27717921

Indoor Residual Spraying Delivery Models to Prevent Malaria: Comparison of Community- and District-Based Approaches in Ethiopia

PubMed Central

Johns, Benjamin; Yihdego, Yemane Yeebiyo; Kolyada, Lena; Dengela, Dereje; Chibsa, Sheleme; Dissanayake, Gunawardena; George, Kristen; Taffese, Hiwot Solomon; Lucas, Bradford

2016-01-01

ABSTRACT Background: Indoor residual spraying (IRS) for malaria prevention has traditionally been implemented in Ethiopia by the district health office with technical and operational inputs from regional, zonal, and central health offices. The United States President's Malaria Initiative (PMI) in collaboration with the Government of Ethiopia tested the effectiveness and efficiency of integrating IRS into the government-funded community-based rural health services program. Methods: Between 2012 and 2014, PMI conducted a mixed-methods study in 11 districts of Oromia region to compare district-based IRS (DB IRS) and community-based IRS (CB IRS) models. In the DB IRS model, each district included 2 centrally located operational sites where spray teams camped during the IRS campaign and from which they traveled to the villages to conduct spraying. In the CB IRS model, spray team members were hired from the communities in which they operated, thus eliminating the need for transport and camping facilities. The study team evaluated spray coverage, the quality of spraying, compliance with environmental and safety standards, and cost and performance efficiency. Results: The average number of eligible structures found and sprayed in the CB IRS districts increased by 19.6% and 20.3%, respectively, between 2012 (before CB IRS) and 2013 (during CB IRS). Between 2013 and 2014, the numbers increased by about 14%. In contrast, in the DB IRS districts the number of eligible structures found increased by only 8.1% between 2012 and 2013 and by 0.4% between 2013 and 2014. The quality of CB IRS operations was good and comparable to that in the DB IRS model, according to wall bioassay tests. Some compliance issues in the first year of CB IRS implementation were corrected in the second year, bringing compliance up to the level of the DB IRS model. The CB IRS model had, on average, higher amortized costs per district than the DB IRS model but lower unit costs per structure sprayed and per person protected because the community-based model found and sprayed more structures. Conclusion: Established community-based service delivery systems can be adapted to include a seasonal IRS campaign alongside the community-based health workers' routine activities to improve performance efficiency. Further modifications of the community-based IRS model may reduce the total cost of the intervention and increase its financial sustainability. PMID:27965266

An automatic damage detection algorithm based on the Short Time Impulse Response Function

NASA Astrophysics Data System (ADS)

Auletta, Gianluca; Carlo Ponzo, Felice; Ditommaso, Rocco; Iacovino, Chiara

2016-04-01

Structural Health Monitoring together with all the dynamic identification techniques and damage detection techniques are increasing in popularity in both scientific and civil community in last years. The basic idea arises from the observation that spectral properties, described in terms of the so-called modal parameters (eigenfrequencies, mode shapes, and modal damping), are functions of the physical properties of the structure (mass, energy dissipation mechanisms and stiffness). Damage detection techniques traditionally consist in visual inspection and/or non-destructive testing. A different approach consists in vibration based methods detecting changes of feature related to damage. Structural damage exhibits its main effects in terms of stiffness and damping variation. Damage detection approach based on dynamic monitoring of structural properties over time has received a considerable attention in recent scientific literature. We focused the attention on the structural damage localization and detection after an earthquake, from the evaluation of the mode curvature difference. The methodology is based on the acquisition of the structural dynamic response through a three-directional accelerometer installed on the top floor of the structure. It is able to assess the presence of any damage on the structure providing also information about the related position and severity of the damage. The procedure is based on a Band-Variable Filter, (Ditommaso et al., 2012), used to extract the dynamic characteristics of systems that evolve over time by acting simultaneously in both time and frequency domain. In this paper using a combined approach based on the Fourier Transform and on the seismic interferometric analysis, an useful tool for the automatic fundamental frequency evaluation of nonlinear structures has been proposed. Moreover, using this kind of approach it is possible to improve some of the existing methods for the automatic damage detection providing stable results also during the strong motion phase. This approach helps to overcome the limitation derived from the use of techniques based on simple Fourier Transform that provide good results when the response of the monitored system is stationary, but fails when the system exhibits a non-stationary behaviour. The main advantage derived from the use of the proposed approach for Structural Health Monitoring is based on the simplicity of the interpretation of the nonlinear variations of the fundamental frequency. The proposed methodology has been tested on numerical models of reinforced concrete structures designed for only gravity loads without and with the presence of infill panels. In order to verify the effectiveness of the proposed approach for the automatic evaluation of the fundamental frequency over time, the results of an experimental campaign of shaking table tests conducted at the seismic laboratory of University of Basilicata (SISLAB) have been used. Acknowledgements This study was partially funded by the Italian Civil Protection Department within the project DPC-RELUIS 2015 - RS4 ''Seismic observatory of structures and health monitoring''. References Ditommaso, R., Mucciarelli, M., Ponzo, F.C. (2012) Analysis of non-stationary structural systems by using a band-variable filter. Bulletin of Earthquake Engineering. DOI: 10.1007/s10518-012-9338-y.

New sensors and techniques for the structural health monitoring of propulsion systems.

PubMed

Woike, Mark; Abdul-Aziz, Ali; Oza, Nikunj; Matthews, Bryan

2013-01-01

The ability to monitor the structural health of the rotating components, especially in the hot sections of turbine engines, is of major interest to aero community in improving engine safety and reliability. The use of instrumentation for these applications remains very challenging. It requires sensors and techniques that are highly accurate, are able to operate in a high temperature environment, and can detect minute changes and hidden flaws before catastrophic events occur. The National Aeronautics and Space Administration (NASA), through the Aviation Safety Program (AVSP), has taken a lead role in the development of new sensor technologies and techniques for the in situ structural health monitoring of gas turbine engines. This paper presents a summary of key results and findings obtained from three different structural health monitoring approaches that have been investigated. This includes evaluating the performance of a novel microwave blade tip clearance sensor; a vibration based crack detection technique using an externally mounted capacitive blade tip clearance sensor; and lastly the results of using data driven anomaly detection algorithms for detecting cracks in a rotating disk.

New Sensors and Techniques for the Structural Health Monitoring of Propulsion Systems

PubMed Central

2013-01-01

The ability to monitor the structural health of the rotating components, especially in the hot sections of turbine engines, is of major interest to aero community in improving engine safety and reliability. The use of instrumentation for these applications remains very challenging. It requires sensors and techniques that are highly accurate, are able to operate in a high temperature environment, and can detect minute changes and hidden flaws before catastrophic events occur. The National Aeronautics and Space Administration (NASA), through the Aviation Safety Program (AVSP), has taken a lead role in the development of new sensor technologies and techniques for the in situ structural health monitoring of gas turbine engines. This paper presents a summary of key results and findings obtained from three different structural health monitoring approaches that have been investigated. This includes evaluating the performance of a novel microwave blade tip clearance sensor; a vibration based crack detection technique using an externally mounted capacitive blade tip clearance sensor; and lastly the results of using data driven anomaly detection algorithms for detecting cracks in a rotating disk. PMID:23935425

Organization of the Saudi health system.

PubMed

Al-Yousuf, M; Akerele, T M; Al-Mazrou, Y Y

2002-01-01

Using existing data, we reviewed the organizational structure of the Saudi Arabian health system: its demography and history, principal health indicators, organization and management, type and distribution of facilities, financial base, and the impact on it of the Haj. We noted duplication of services, inadequate coordination between some health industry sectors, and the need for a more extensive and rational health centre network with improved information systems and data collection. We also noted scope for a greater role for the private health sector and increased cooperation between it and the public sector to improve health service delivery and population health.

The Quality of Urban Environments: Mapping Variation in Access to Community Resources.

ERIC Educational Resources Information Center

Witten, Karen; Exeter, Daniel; Field, Adrian

2003-01-01

Discusses the relationship between community infrastructure and health through the development of the Community Resource Accessibility Index (CRAI) research tool.This area-based index of community services, facilities, and amenities enables comparisons between opportunity structures in the local environment and residents' health and wellbeing. It…

In Situ Simulation in Continuing Education for the Health Care Professions: A Systematic Review

ERIC Educational Resources Information Center

Rosen, Michael A.; Hunt, Elizabeth A.; Pronovost, Peter J.; Federowicz, Molly A.; Weaver, Sallie J.

2012-01-01

Introduction: Education in the health sciences increasingly relies on simulation-based training strategies to provide safe, structured, engaging, and effective practice opportunities. While this frequently occurs within a simulation center, in situ simulations occur within an actual clinical environment. This blending of learning and work…

Guided Lamb wave based 2-D spiral phased array for structural health monitoring of thin panel structures

NASA Astrophysics Data System (ADS)

Yoo, Byungseok

2011-12-01

In almost all industries of mechanical, aerospace, and civil engineering fields, structural health monitoring (SHM) technology is essentially required for providing the reliable information of structural integrity of safety-critical structures, which can help reduce the risk of unexpected and sometimes catastrophic failures, and also offer cost-effective inspection and maintenance of the structures. State of the art SHM research on structural damage diagnosis is focused on developing global and real-time technologies to identify the existence, location, extent, and type of damage. In order to detect and monitor the structural damage in plate-like structures, SHM technology based on guided Lamb wave (GLW) interrogation is becoming more attractive due to its potential benefits such as large inspection area coverage in short time, simple inspection mechanism, and sensitivity to small damage. However, the GLW method has a few critical issues such as dispersion nature, mode conversion and separation, and multiple-mode existence. Phased array technique widely used in all aspects of civil, military, science, and medical industry fields may be employed to resolve the drawbacks of the GLW method. The GLW-based phased array approach is able to effectively examine and analyze complicated structural vibration responses in thin plate structures. Because the phased sensor array operates as a spatial filter for the GLW signals, the array signal processing method can enhance a desired signal component at a specific direction while eliminating other signal components from other directions. This dissertation presents the development, the experimental validation, and the damage detection applications of an innovative signal processing algorithm based on two-dimensional (2-D) spiral phased array in conjunction with the GLW interrogation technique. It starts with general backgrounds of SHM and the associated technology including the GLW interrogation method. Then, it is focused on the fundamentals of the GLW-based phased array approach and the development of an innovative signal processing algorithm associated with the 2-D spiral phased sensor array. The SHM approach based on array responses determined by the proposed phased array algorithm implementation is addressed. The experimental validation of the GLW-based 2-D spiral phased array technology and the associated damage detection applications to thin isotropic plate and anisotropic composite plate structures are presented.

Application of a Subspace-Based Fault Detection Method to Industrial Structures

NASA Astrophysics Data System (ADS)

Mevel, L.; Hermans, L.; van der Auweraer, H.

1999-11-01

Early detection and localization of damage allow increased expectations of reliability, safety and reduction of the maintenance cost. This paper deals with the industrial validation of a technique to monitor the health of a structure in operating conditions (e.g. rotating machinery, civil constructions subject to ambient excitations, etc.) and to detect slight deviations in a modal model derived from in-operation measured data. In this paper, a statistical local approach based on covariance-driven stochastic subspace identification is proposed. The capabilities and limitations of the method with respect to health monitoring and damage detection are discussed and it is explained how the method can be practically used in industrial environments. After the successful validation of the proposed method on a few laboratory structures, its application to a sports car is discussed. The example illustrates that the method allows the early detection of a vibration-induced fatigue problem of a sports car.

Using Computer-Extracted Data from Electronic Health Records to Measure the Quality of Adolescent Well-Care

PubMed Central

Gardner, William; Morton, Suzanne; Byron, Sepheen C; Tinoco, Aldo; Canan, Benjamin D; Leonhart, Karen; Kong, Vivian; Scholle, Sarah Hudson

2014-01-01

Objective To determine whether quality measures based on computer-extracted EHR data can reproduce findings based on data manually extracted by reviewers. Data Sources We studied 12 measures of care indicated for adolescent well-care visits for 597 patients in three pediatric health systems. Study Design Observational study. Data Collection/Extraction Methods Manual reviewers collected quality data from the EHR. Site personnel programmed their EHR systems to extract the same data from structured fields in the EHR according to national health IT standards. Principal Findings Overall performance measured via computer-extracted data was 21.9 percent, compared with 53.2 percent for manual data. Agreement measures were high for immunizations. Otherwise, agreement between computer extraction and manual review was modest (Kappa = 0.36) because computer-extracted data frequently missed care events (sensitivity = 39.5 percent). Measure validity varied by health care domain and setting. A limitation of our findings is that we studied only three domains and three sites. Conclusions The accuracy of computer-extracted EHR quality reporting depends on the use of structured data fields, with the highest agreement found for measures and in the setting that had the greatest concentration of structured fields. We need to improve documentation of care, data extraction, and adaptation of EHR systems to practice workflow. PMID:24471935

Vietnam as a Case Example of School-Based Mental Health Services in Low and Middle Income Countries: Efficacy and Effects of Risk Status

ERIC Educational Resources Information Center

Dang, Hoang-Minh; Weiss, Bahr; Nguyen, Cao Minh; Tran, Nam; Pollack, Amie

2017-01-01

The purposes of this study were to (a) assess the efficacy of a universal classroom-based mental health and social skills program for primary school students in Vietnam, and (b) given the universal nature of the intervention, assess outcomes as a function of risk status (high versus low). RECAP-VN is a semi-structured program that provides…

Inspection of Piezoceramic Transducers Used for Structural Health Monitoring

PubMed Central

Mueller, Inka; Fritzen, Claus-Peter

2017-01-01

The use of piezoelectric wafer active sensors (PWAS) for structural health monitoring (SHM) purposes is state of the art for acousto-ultrasonic-based methods. For system reliability, detailed information about the PWAS itself is necessary. This paper gives an overview on frequent PWAS faults and presents the effects of these faults on the wave propagation, used for active acousto-ultrasonics-based SHM. The analysis of the wave field is based on velocity measurements using a laser Doppler vibrometer (LDV). New and established methods of PWAS inspection are explained in detail, listing advantages and disadvantages. The electro-mechanical impedance spectrum as basis for these methods is discussed for different sensor faults. This way this contribution focuses on a detailed analysis of PWAS and the need of their inspection for an increased reliability of SHM systems. PMID:28772431

The importance of social context in understanding and promoting low-income immigrant women's health.

PubMed

De Jesus, Maria

2009-02-01

Understanding the social context and realities of Cape Verdean women in the U.S. as well as other immigrant and ethnic/racial groups is important to promote their overall health and well-being more effectively. The aim of this study was to gain a contextual understanding from the perspectives of health promoters who work with marginalized women. In-depth, semi-structured interviews were conducted with nine Cape Verdean women health promoters about their perspectives and experiences of health promotion practice with immigrant women in their community. Using a Glaserian grounded theory approach to analysis, six salient themes describing women's social context emerged: community and domestic violence, loss and isolation, economic injustice, immigration-related issues and abuse, unequal gender-based power relations, and cultural taboos. These findings challenge health researchers and practitioners to understand health problems and health promotion not only at an individual level, but at multiple levels of influence including interpersonal, family, neighborhood, and structural levels.

Challenges in health visitor prescribing in a London primary care trust.

PubMed

Thurtle, Val

2007-11-01

In this primary care trust there was limited health visitor prescribing. A case study approach sought to identify reasons for this, to lead to recommendations and changes to develop health visitor prescribing. The situation was examined using qualitative methods to consider the opportunities and challenges in health visitor prescribing. Semi-structured interviews with eighteen health visitors and managers explored their views of health visitor prescribing and its position within the PCT. The findings demonstrated only three health visitors prescribed; yet the majority were positive about prescribing, both for clients and health visitor development. Practitioners recognised their difficult working context and felt that organisational systems were not supportive of prescribing. A culture of prescribing was not felt to be in evidence, but was seen as a realistic possibility. Recommendations for change focused on the organisation and practitioners, with improved communication and structures supportive of prescribing. There was a need for practitioners to be active in learning so that they could share knowledge, experience and commitment to prescribing in locally based groups.

Are community-based pharmacists underused in the care of persons living with HIV? A need for structural and policy changes

PubMed Central

Kibicho, Jennifer; Pinkerton, Steven D.; Owczarzak, Jill; Mkandawire–Valhmu, Lucy; Kako, Peninnah M.

2016-01-01

Objectives To describe community pharmacists' perceptions on their current role in direct patient care services, an expanded role for pharmacists in providing patient care services, and changes needed to optimally use pharmacists' expertise to provide high-quality direct patient care services to people living with human immunodeficiency virus (HIV) infections. Design Cross-sectional study. Setting Four Midwestern cities in the United States in August through October 2009. Participants 28 community-based pharmacists practicing in 17 pharmacies. Interventions Interviews. Main Outcome Measures Opinions of participants about roles of specialty and nonspecialty pharmacists in caring for patients living with human immunodeficiency virus infections. Results Pharmacists noted that although challenges in our health care system characterized by inaccessible health professionals presented opportunities for a greater pharmacist role, there were missed opportunities for greater level of patient care services in many community-based nonspecialty settings. Many pharmacists in semispecialty and nonspecialty pharmacies expressed a desire for an expanded role in patient care congruent with their pharmacy education and training. Conclusion Structural-level policy changes needed to transform community-based pharmacy settings to patient-centered medical homes include recognizing pharmacists as important players in the multidisciplinary health care team, extending the health information exchange highway to include pharmacist-generated electronic therapeutic records, and realigning financial incentives. Comprehensive policy initiatives are needed to optimize the use of highly trained pharmacists in enhancing the quality of health care to an ever-growing number of Americans with chronic conditions who access care in community-based pharmacy settings. PMID:25575148

Design of a piezoelectric-based structural health monitoring system for damage detection in composite materials

NASA Astrophysics Data System (ADS)

Kessler, Seth S.; Spearing, S. Mark

2002-07-01

Cost-effective and reliable damage detection is critical for the utilization of composite materials. This paper presents the conclusions of an experimental and analytical survey of candidate methods for in-situ damage detection in composite structures. Experimental results are presented for the application of modal analysis and Lamb wave techniques to quasi-isotropic graphite/epoxy test specimens containing representative damage. Piezoelectric patches were used as actuators and sensors for both sets of experiments. Modal analysis methods were reliable for detecting small amounts of global damage in a simple composite structure. By comparison, Lamb wave methods were sensitive to all types of local damage present between the sensor and actuator, provided useful information about damage presence and severity, and present the possibility of estimating damage type and location. Analogous experiments were also performed for more complex built-up structures. These techniques are suitable for structural health monitoring applications since they can be applied with low power conformable sensors and can provide useful information about the state of a structure during operation. Piezoelectric patches could also be used as multipurpose sensors to detect damage by a variety of methods such as modal analysis, Lamb wave, acoustic emission and strain based methods simultaneously, by altering driving frequencies and sampling rates. This paper present guidelines and recommendations drawn from this research to assist in the design of a structural health monitoring system for a vehicle. These systems will be an important component in future designs of air and spacecraft to increase the feasibility of their missions.

Understanding the Effects of Mental Health on Reproductive Health Service Use: A Mixed Methods Approach

PubMed Central

Bell, Sue Anne; Lori, Jody; Redman, Richard; Seng, Julia

2016-01-01

Appropriate and woman-led health care for displaced women is essential to respecting basic human rights. In this paper, we describe the results of an analysis of the association between mental health and reproductive health service use from a sample of Congolese refugee women residing in short and long term camps in Rwanda, with a post-hoc qualitative potion added to expand upon the data-based results. Our findings suggest that structural factors including health policy initiatives affect or even inhibit individual care choices. PMID:26086238

Experience of men in the context of Primary Health Care.

PubMed

de Oliveira, Patrícia Peres; dos Santos, Walquíria Jesusmara; Viegas, Selma Maria da Fonseca; da Silveira, Edilene Aparecida Araújo; Rodrigues, Andrea Bezerra

2015-01-01

To know the experience of male users' in the primary health care and to build data based theory that represents this experience. This is a qualitative study, in which was used the reference of Grounded Theory and Symbolic Interactionism, respectively, methodological and theoretical. We interviewed 33 male users of three units of primary health care. After comparative analysis of data was built the data based theory feeling excluded, which includes: living with prejudice; living with the limitations of infra-structure services; reflecting on the health service environment. The analysis showed the need for a change in logistics services and professionals' attitude guided in respectful and effective communication, the problem solving in readiness in attendance, in addressing gender issues. For to take care of men users of the Unified Health System and/or preserve their health, the construction of another rationality in health is imperative, based on reflection and respect for the autonomy and individuality of the male gender.

How to practice person-centred care: A conceptual framework.

PubMed

Santana, Maria J; Manalili, Kimberly; Jolley, Rachel J; Zelinsky, Sandra; Quan, Hude; Lu, Mingshan

2018-04-01

Globally, health-care systems and organizations are looking to improve health system performance through the implementation of a person-centred care (PCC) model. While numerous conceptual frameworks for PCC exist, a gap remains in practical guidance on PCC implementation. Based on a narrative review of the PCC literature, a generic conceptual framework was developed in collaboration with a patient partner, which synthesizes evidence, recommendations and best practice from existing frameworks and implementation case studies. The Donabedian model for health-care improvement was used to classify PCC domains into the categories of "Structure," "Process" and "Outcome" for health-care quality improvement. The framework emphasizes the structural domain, which relates to the health-care system or context in which care is delivered, providing the foundation for PCC, and influencing the processes and outcomes of care. Structural domains identified include: the creation of a PCC culture across the continuum of care; co-designing educational programs, as well as health promotion and prevention programs with patients; providing a supportive and accommodating environment; and developing and integrating structures to support health information technology and to measure and monitor PCC performance. Process domains describe the importance of cultivating communication and respectful and compassionate care; engaging patients in managing their care; and integration of care. Outcome domains identified include: access to care and Patient-Reported Outcomes. This conceptual framework provides a step-wise roadmap to guide health-care systems and organizations in the provision PCC across various health-care sectors. © 2017 The Authors Health Expectations published by John Wiley & Sons Ltd.

High-Fidelity Modeling for Health Monitoring in Honeycomb Sandwich Structures

NASA Technical Reports Server (NTRS)

Luchinsky, Dimitry G.; Hafiychuk, Vasyl; Smelyanskiy, Vadim; Tyson, Richard W.; Walker, James L.; Miller, Jimmy L.

2011-01-01

High-Fidelity Model of the sandwich composite structure with real geometry is reported. The model includes two composite facesheets, honeycomb core, piezoelectric actuator/sensors, adhesive layers, and the impactor. The novel feature of the model is that it includes modeling of the impact and wave propagation in the structure before and after the impact. Results of modeling of the wave propagation, impact, and damage detection in sandwich honeycomb plates using piezoelectric actuator/sensor scheme are reported. The results of the simulations are compared with the experimental results. It is shown that the model is suitable for analysis of the physics of failure due to the impact and for testing structural health monitoring schemes based on guided wave propagation.

Evaluation of community level interventions to address social and structural determinants of health: a cluster randomised controlled trial

PubMed Central

Wall, Martin; Hayes, Richard; Moore, Derek; Petticrew, Mark; Clow, Angela; Schmidt, Elena; Draper, Alizon; Lock, Karen; Lynch, Rebecca; Renton, Adrian

2009-01-01

Background In London and the rest of the UK, diseases associated with poor diet, inadequate physical activity and mental illness account for a large proportion of area based health inequality. There is a lack of evidence on interventions promoting healthier behaviours especially in marginalised populations, at a structural or ecological level and utilising a community development approach. The Well London project financed by the Big Lottery 'Wellbeing' Fund and implemented by a consortium of London based agencies led by the Greater London Authority and the London Health Commission is implementing a set of complex interventions across 20 deprived areas of London. The interventions focus on healthy eating, healthy physical activity and mental health and wellbeing and are designed and executed with community participation complementing existing facilities and services. Methods/Design The programme will be evaluated through a cluster randomised controlled trial. Forty areas across London were chosen based on deprivation scores. Areas were characterised by high proportion of Black and Minority Ethnic residents, worklessness, ill-health and poor physical environments. Twenty areas were randomly assigned to the intervention arm of Well London project and twenty 'matched' areas assigned as controls. Measures of physical activity, diet and mental health are collected at start and end of the project and compared to assess impact. The quantitative element will be complemented by a longitudinal qualitative study elucidating pathways of influence between intervention activities and health outcomes. A related element of the study investigates the health-related aspects of the structural and ecological characteristics of the project areas. The project 'process' will also be evaluated. Discussion The size of the project and the fact that the interventions are 'complex' in the sense that firstly, there are a number of interacting components with a wide range of groups and organisational levels targeted by the intervention, and secondly, a degree of flexibility or tailoring of the intervention, makes this trial potentially very useful in providing evidence of the types of activities that can be used to address chronic health problems in communities suffering from multiple deprivation. Trial Registration Current Controlled Trials ISRCTN68175121 PMID:19558712

Carbon nanotube-based structural health monitoring for fiber reinforced composite materials

NASA Astrophysics Data System (ADS)

Liu, Hao; Liu, Kan; Mardirossian, Aris; Heider, Dirk; Thostenson, Erik

2017-04-01

In fiber reinforced composite materials, the modes of damage accumulation, ranging from microlevel to macro-level (matrix cracks development, fiber breakage, fiber-matrix de-bonding, delamination, etc.), are complex and hard to be detected through conventional non-destructive evaluation methods. Therefore, in order to assure the outstanding structural performance and high durability of the composites, there has been an urgent need for the design and fabrication smart composites with self-damage sensing capabilities. In recent years, the macroscopic forms of carbon nanotube materials have been maturely investigated, which provides the opportunity for structural health monitoring based on the carbon nanotubes that are integrated in the inter-laminar areas of advanced fiber composites. Here in this research, advanced fiber composites embedded with laminated carbon nanotube layers are manufactured for damage detection due to the relevant spatial electrical property changes once damage occurs. The mechanical-electrical coupling response is recorded and analyzed during impact test. The design and manufacturing of integrating the carbon nanotubes intensely affect the detecting sensitivity and repeatability of the integrated multifunctional sensors. The ultimate goal of the reported work is to develop a novel structural health monitoring method with the capability of reporting information on the damage state in a real-time way.

An object-oriented mobile health system with usability features.

PubMed

Escarfullet, Krystle; Moore, Cantera; Tucker, Shari; Wei, June

2012-01-01

Mobile health (m-health) comprises the concept of utilising mobile devices to carry out the task of viewing electronic medical records, reserving medical appointments with a patient's medical provider and electronically refilling prescriptions. This paper aims at developing a m-health system to improve usability from a user's perspective. Specifically, it first developed a m-health model by logically linking characteristics of the m-health system together based on information flows. Then, the system requirements were collected by using a developed questionnaire. These requirements were structured and further in-depth analysis was conducted by using an object-oriented approach based on unified modelling language, such as use-case, sequence and analysis class diagrams. This research will be beneficial to decision makers and developers in the mobile healthcare industry.

How can activity-based costing methodology be performed as a powerful tool to calculate costs and secure appropriate patient care?

PubMed

Lin, Blossom Yen-Ju; Chao, Te-Hsin; Yao, Yuh; Tu, Shu-Min; Wu, Chun-Ching; Chern, Jin-Yuan; Chao, Shiu-Hsiung; Shaw, Keh-Yuong

2007-04-01

Previous studies have shown the advantages of using activity-based costing (ABC) methodology in the health care industry. The potential values of ABC methodology in health care are derived from the more accurate cost calculation compared to the traditional step-down costing, and the potentials to evaluate quality or effectiveness of health care based on health care activities. This project used ABC methodology to profile the cost structure of inpatients with surgical procedures at the Department of Colorectal Surgery in a public teaching hospital, and to identify the missing or inappropriate clinical procedures. We found that ABC methodology was able to accurately calculate costs and to identify several missing pre- and post-surgical nursing education activities in the course of treatment.

Primary Care and Public Health Services Integration in Brazil’s Unified Health System

PubMed Central

Wall, Melanie; Yu, Gary; Penido, Cláudia; Schmidt, Clecy

2012-01-01

Objectives. We examined associations between transdisciplinary collaboration, evidence-based practice, and primary care and public health services integration in Brazil’s Family Health Strategy. We aimed to identify practices that facilitate service integration and evidence-based practice. Methods. We collected cross-sectional data from community health workers, nurses, and physicians (n = 262). We used structural equation modeling to assess providers’ service integration and evidence-based practice engagement operationalized as latent factors. Predictors included endorsement of team meetings, access to and consultations with colleagues, familiarity with community, and previous research experience. Results. Providers’ familiarity with community and team meetings positively influenced evidence-based practice engagement and service integration. More experienced providers reported more integration and engagement. Physicians reported less integration than did community health workers. Black providers reported less evidence-based practice engagement than did Pardo (mixed races) providers. After accounting for all variables, evidence-based practice engagement and service integration were moderately correlated. Conclusions. Age and race of providers, transdisciplinary collaboration, and familiarity with the community are significant variables that should inform design and implementation of provider training. Promising practices that facilitate service integration in Brazil may be used in other countries. PMID:22994254

Case mix management education in a Canadian hospital.

PubMed

Moffat, M; Prociw, M

1992-01-01

The Sunnybrook Health Science Centre's matrix organization model includes a traditional departmental structure, a strategic program-based structure and a case management-based structure--the Clinical Unit structure. The Clinical Unit structure allows the centre to give responsibility for the management of case mix and volume to decentralized Clinical Unit teams, each of which manages its own budget. To train physicians and nurses in their respective roles of Medical Unit directors and Nursing Unit directors, Sunnybrook designed unique short courses on financial management and budgeting, and case-costing and case mix management. This paper discusses how these courses were organized, details their contents and explains how they fit into Sunnybrook's program of decentralized management.

Experimental study on Statistical Damage Detection of RC Structures based on Wavelet Packet Analysis

NASA Astrophysics Data System (ADS)

Zhu, X. Q.; Law, S. S.; Jayawardhan, M.

2011-07-01

A novel damage indicator based on wavelet packet transform is developed in this study for structural health monitoring. The response signal of a structure under an impact load is normalized and then decomposed into wavelet packet components. Energies of these wavelet packet components are then calculated to obtain the energy distribution. A statistical indicator is developed to describe the damage extent of the structure. This approach is applied to the test results from simply supported reinforced concrete beams in the laboratory. Cases with single damage are created from static loading, and accelerations of the structure from under impact loads are analyzed. Results show that the method can be used for the damage monitoring and assessment of the structure.

The assumed relation between occupation and inequality in health.

PubMed

Madsen, Jacob; Kanstrup, Anne Marie; Josephsson, Staffan

2016-01-01

Occupational science and therapy scholars have argued that research on inequality in health is needed. Simultaneously, a knowledge gap between how to understand and take action on health inequalities exists in occupational science and therapy. To identify how inequality in health, high-risk areas of health, and engagement in health for low-income adult citizens have been described and conceptualized in contemporary occupational science and therapy literature. A structured literature review of 37 publications in occupational science and therapy literature, published from 2004 to 2014. The review revealed several descriptions and conceptualizations based on environmental, social, cultural, historical, and personal perspectives on occupation and already existing occupational science concepts. However, these descriptions were mainly based on assumptions regarding the relation between occupation and inequality in health, and statements on the need to explore this relation. Basic theory and reasoning, as well as empirical studies, on inequality in health are missing in occupational science and therapy. Based on the findings and theoretical trends, the authors suggest a transactional perspective on occupation is a possible frame for understanding inequality in health and related issues.

A community-based epidemiological study of health anxiety and generalized anxiety disorder.

PubMed

Lee, Sing; Lam, Ivy M H; Kwok, Kathleen P S; Leung, Candi M C

2014-03-01

This community-based study examined the frequency of worry about personal health in respondents with and without generalized anxiety disorder (GAD), and the impact of health anxiety on the disorder. A random community-based telephone survey of 5118 Chinese respondents aged 18-64 was conducted. A fully structured questionnaire covered the DSM-IV-TR criteria of GAD, major depressive episode (MDE), eight domains of worry, the seven-item Whiteley Index (WI-7), health service use, and socio-demographic information. Worry about personal health ranked fifth (75.6%) among eight domains of worries examined. GAD respondents with high level of health anxiety were significantly older, less educated, and had lower family income. High health anxiety significantly increased the occurrence of one-year MDE, previous persistent worry, previous persistent low mood, number of domains of worries, number of non-core DSM-IV-TR GAD symptoms, health service use, and mistrust of doctors. Health anxiety is common in GAD and may signify greater severity of the disorder. Copyright © 2013 Elsevier Ltd. All rights reserved.

Research of diagnosis sensors fault based on correlation analysis of the bridge structural health monitoring system

NASA Astrophysics Data System (ADS)

Hu, Shunren; Chen, Weimin; Liu, Lin; Gao, Xiaoxia

2010-03-01

Bridge structural health monitoring system is a typical multi-sensor measurement system due to the multi-parameters of bridge structure collected from the monitoring sites on the river-spanning bridges. Bridge structure monitored by multi-sensors is an entity, when subjected to external action; there will be different performances to different bridge structure parameters. Therefore, the data acquired by each sensor should exist countless correlation relation. However, complexity of the correlation relation is decided by complexity of bridge structure. Traditionally correlation analysis among monitoring sites is mainly considered from physical locations. unfortunately, this method is so simple that it cannot describe the correlation in detail. The paper analyzes the correlation among the bridge monitoring sites according to the bridge structural data, defines the correlation of bridge monitoring sites and describes its several forms, then integrating the correlative theory of data mining and signal system to establish the correlation model to describe the correlation among the bridge monitoring sites quantificationally. Finally, The Chongqing Mashangxi Yangtze river bridge health measurement system is regards as research object to diagnosis sensors fault, and simulation results verify the effectiveness of the designed method and theoretical discussions.

System Transformation Under the California Mental Health Services Act: Implementation of Full-Service Partnerships in L.A. County.

PubMed

Starks, Sarah L; Arns, Paul G; Padwa, Howard; Friedman, Jack R; Marrow, Jocelyn; Meldrum, Marcia L; Bromley, Elizabeth; Kelly, Erin L; Brekke, John S; Braslow, Joel T

2017-06-01

The study evaluated the effect of California's Mental Health Services Act (MHSA) on the structure, volume, location, and patient centeredness of Los Angeles County public mental health services. This prospective mixed-methods study (2006-2013) was based in five Los Angeles County public mental health clinics, all with usual care and three with full-service partnerships (FSPs). FSPs are MHSA-funded programs designed to "do whatever it takes" to provide intensive, recovery-oriented, team-based, integrated services for clients with severe mental illness. FSPs were compared with usual care on outpatient services received (claims data) and on organizational climate, recovery orientation, and provider-client working alliance (surveys and semistructured interviews), with regression adjustment for client and provider characteristics. In the first year after admission, FSP clients (N=174) received significantly more outpatient services than did usual care clients (N=298) (5,238 versus 1,643 minutes, p<.001), and a larger proportion of these services were field based (22% versus 2%, p<.001). Compared with usual care clients, FSP clients reported more recovery-oriented services (p<.001) and a better provider-client working alliance (p=.01). Compared with usual care providers (N=130), FSP providers (N=42) reported more stress (p<.001) and lower morale (p<.001). Los Angeles County's public mental health system was able to transform service delivery in response to well-funded policy mandates. For providers, a structure emphasizing accountability and patient centeredness was associated with greater stress, despite smaller caseloads. For clients, service structure and volume created opportunities to build stronger provider-client relationships and address their needs and goals.

Development of clinical contents model markup language for electronic health records.

PubMed

Yun, Ji-Hyun; Ahn, Sun-Ju; Kim, Yoon

2012-09-01

To develop dedicated markup language for clinical contents models (CCM) to facilitate the active use of CCM in electronic health record systems. Based on analysis of the structure and characteristics of CCM in the clinical domain, we designed extensible markup language (XML) based CCM markup language (CCML) schema manually. CCML faithfully reflects CCM in both the syntactic and semantic aspects. As this language is based on XML, it can be expressed and processed in computer systems and can be used in a technology-neutral way. CCML HAS THE FOLLOWING STRENGTHS: it is machine-readable and highly human-readable, it does not require a dedicated parser, and it can be applied for existing electronic health record systems.

Health Literacy in Transitions of Care: An Innovative Objective Structured Clinical Examination for Fourth-Year Medical Students in an Internship Preparation Course.

PubMed

Bloom-Feshbach, Kimberly; Casey, Dana; Schulson, Lucy; Gliatto, Peter; Giftos, Jonathan; Karani, Reena

2016-02-01

Low health literacy is associated with adverse health outcomes, especially during transitions of care. Competency-based assessments may improve communication during this time. To develop an Objective Structured Clinical Examination (OSCE) for medical students to demonstrate communication skills to be used during the hospital discharge process with patients of low health literacy. The OSCE was integrated into the curriculum of an internship preparatory clerkship. One hundred and one fourth-year medical students participated. Students received a skills-based health literacy workshop. In the OSCE, learners counseled standardized patients regarding initiation of anticoagulation at discharge and wrote discharge instructions. Fifty-seven students completed the workshop prior to the OSCE, and 44 participated in the workshop after the completing the OSCE. Participants who completed the workshop first outperformed their peers on the checklist (15.1 vs. 13.4, p < 0.0001) and on the reading level of their written instructions (9.9 vs. 10.6, p = 0.01); 82% felt confident communicating with patients of low health literacy after the workshop and OSCE. This OSCE is a tool to train and evaluate future interns' ability to communicate with patients of limited health literacy levels at hospital discharge. Such innovations may make this period of time safer for patients, improving health outcomes.

Development of a Cloud Computing-Based Pier Type Port Structure Stability Evaluation Platform Using Fiber Bragg Grating Sensors.

PubMed

Jo, Byung Wan; Jo, Jun Ho; Khan, Rana Muhammad Asad; Kim, Jung Hoon; Lee, Yun Sung

2018-05-23

Structure Health Monitoring is a topic of great interest in port structures due to the ageing of structures and the limitations of evaluating structures. This paper presents a cloud computing-based stability evaluation platform for a pier type port structure using Fiber Bragg Grating (FBG) sensors in a system consisting of a FBG strain sensor, FBG displacement gauge, FBG angle meter, gateway, and cloud computing-based web server. The sensors were installed on core components of the structure and measurements were taken to evaluate the structures. The measurement values were transmitted to the web server via the gateway to analyze and visualize them. All data were analyzed and visualized in the web server to evaluate the structure based on the safety evaluation index (SEI). The stability evaluation platform for pier type port structures involves the efficient monitoring of the structures which can be carried out easily anytime and anywhere by converging new technologies such as cloud computing and FBG sensors. In addition, the platform has been successfully implemented at “Maryang Harbor” situated in Maryang-Meyon of Korea to test its durability.

Tennessee and Its Children: Unmet Needs, 2001.

ERIC Educational Resources Information Center

Brown, Pam; Delk, Fay L.; Petty, Steve; Wynn, Debbie; O'Neal, Linda

Based on the view that the tax structure in Tennessee is inadequate and produces chronic problems, especially for the state's children, this Kids Count report identifies unmet education, health care, and resource needs of the children in Tennessee. Following introductory remarks discussing the current tax structure and state spending, Section 1 of…

Differences in self-rated health by employment contract and household structure among Japanese employees: a nationwide cross-sectional study.

PubMed

Kachi, Yuko; Inoue, Mariko; Nishikitani, Mariko; Yano, Eiji

2014-01-01

The aim of this study was to examine whether the association between employment contract and self-rated health differs by household structure in a representative sample of employees in Japan. The participants were 81,441 male and 64,471 female employees aged 18-59 years who had participated in the 2010 Comprehensive Survey of Living Conditions. We assessed the interactive effect of employment contract (permanent or precarious) and household structure (couple only, couple with children, single parent, single person, or other multi-person) on fair/poor health, adjusting for covariates by using logistic regression. We then calculated the relative poverty rate by employment contract and household structure. The interaction effect was significant for women (p<0.001) but not for men (p=0.413). A higher percentage of female precarious workers who lived in single-parent households (20.2%) reported fair/poor health compared with those in other types of households (10.4-13.2%), although the prevalence of fair/poor health did not differ substantially by household structure among female permanent workers. The relative poverty rates of female precarious workers who lived in single-parent households were higher compared with those of other female workers. Our results suggest that female precarious workers are not a homogeneous group and that those living in single-parent households suffer from poor health due to low income and insufficient coverage by insurance firms and family-based safety nets.

Does the organizational structure of health care systems influence care-seeking decisions? A qualitative analysis of Danish cancer patients' reflections on care-seeking

PubMed Central

Andersen, Rikke Sand; Vedsted, Peter; Olesen, Frede; Bro, Flemming; Søndergaard, Jens

2011-01-01

Objective The absence of a more significant improvement in cancer survival in countries such as the UK and Denmark may be partly rooted in delayed care-seeking among cancer patients. Past research on patient delay has mainly focused on patient characteristics (e.g. sociodemographic and psychological factors and symptom recognition) as causes of delayed care-seeking, while few studies have examined how the organizational structure of health care systems may influence patients’ reflections on seeking care. The aim of this study was to explore this relationship. Design The analysis presented is based on semi-structured interviews with 30 cancer patients and their families. Results The article raises two hypotheses on the relationship between structural elements of a health care system and people's reflections on seeking health care: (1) Gatekeeping introduces an asymmetrical relationship between the patient and the GP which potentially results in self-restricting care-seeking, (2) Continuity in the doctor–patient relationship may negatively influence patient reflections on access to health care, as the focus shifts from the medical issues of the consultation to reflections on how to properly interact with the GP and the system in which she/he is situated. Conclusion It is concluded that these hypotheses form a sound basis for further primary care research on how the organizational structure of health care systems influences patient reflections on access to medical care. PMID:21861597

Biphasic DC measurement approach for enhanced measurement stability and multi-channel sampling of self-sensing multi-functional structural materials doped with carbon-based additives

NASA Astrophysics Data System (ADS)

Downey, Austin; D'Alessandro, Antonella; Ubertini, Filippo; Laflamme, Simon; Geiger, Randall

2017-06-01

Investigation of multi-functional carbon-based self-sensing structural materials for structural health monitoring applications is a topic of growing interest. These materials are self-sensing in the sense that they can provide measurable electrical outputs corresponding to physical changes such as strain or induced damage. Nevertheless, the development of an appropriate measurement technique for such materials is yet to be achieved, as many results in the literature suggest that these materials exhibit a drift in their output when measured with direct current (DC) methods. In most of the cases, the electrical output is a resistance and the reported drift is an increase in resistance from the time the measurement starts due to material polarization. Alternating current methods seem more appropriate at eliminating the time drift. However, published results show they are not immune to drift. Moreover, the use of multiple impedance measurement devices (LCR meters) does not allow for the simultaneous multi-channel sampling of multi-sectioned self-sensing materials due to signal crosstalk. The capability to simultaneously monitor multiple sections of self-sensing structural materials is needed to deploy these multi-functional materials for structural health monitoring. Here, a biphasic DC measurement approach with a periodic measure/discharge cycle in the form of a square wave sensing current is used to provide consistent, stable resistance measurements for self-sensing structural materials. DC measurements are made during the measurement region of the square wave while material depolarization is obtained during the discharge region of the periodic signal. The proposed technique is experimentally shown to remove the signal drift in a carbon-based self-sensing cementitious material while providing simultaneous multi-channel measurements of a multi-sectioned self-sensing material. The application of the proposed electrical measurement technique appears promising for real-time utilization of self-sensing materials in structural health monitoring.

Advanced instrumentation for acousto-ultrasonic based structural health monitoring

NASA Astrophysics Data System (ADS)

Smithard, Joel; Galea, Steve; van der Velden, Stephen; Powlesland, Ian; Jung, George; Rajic, Nik

2016-04-01

Structural health monitoring (SHM) systems using structurally-integrated sensors potentially allow the ability to inspect for damage in aircraft structures on-demand and could provide a basis for the development of condition-based maintenance approaches for airframes. These systems potentially offer both substantial cost savings and performance improvements over conventional nondestructive inspection (NDI). Acousto-ultrasonics (AU), using structurallyintegrated piezoelectric transducers, offers a promising basis for broad-field damage detection in aircraft structures. For these systems to be successfully applied in the field the hardware for AU excitation and interrogation needs to be easy to use, compact, portable, light and, electrically and mechanically robust. Highly flexible and inexpensive instrumentation for basic background laboratory investigations is also required to allow researchers to tackle the numerous scientific and engineering issues associated with AU based SHM. The Australian Defence Science and Technology Group (DST Group) has developed the Acousto Ultrasonic Structural health monitoring Array Module (AUSAM+), a compact device for AU excitation and interrogation. The module, which has the footprint of a typical current generation smart phone, provides autonomous control of four send and receive piezoelectric elements, which can operate in pitch-catch or pulse-echo modes and can undertake electro-mechanical impedance measurements for transducer and structural diagnostics. Modules are designed to operate synchronously with other units, via an optical link, to accommodate larger transducer arrays. The module also caters for fibre optic sensing of acoustic waves with four intensity-based optical inputs. Temperature and electrical resistance strain gauge inputs as well as external triggering functionality are also provided. The development of a Matlab hardware object allows users to easily access the full hardware functionality of the device and provides enormous flexibility for the creation of custom interfaces. This paper discusses the impetus for the concept, and outlines key aspects of the hardware design and the module capabilities. The efficacy of the system is demonstrated through the results of first-of-class testing, as well as laboratory AU studies on a flat plate using an array of piezoelectric elements.

Disentangling the causal relationships between work-home interference and employee health.

PubMed

van Hooff, Madelon L M; Geurts, Sabine A E; Taris, Toon W; Kompier, Michiel A J; Dikkers, Josje S E; Houtman, Irene L D; van den Heuvel, Floor M M

2005-02-01

The present study was designed to investigate the causal relationships between (time- and strain-based) work-home interference and employee health. The effort-recovery theory provided the theoretical basis for this study. Two-phase longitudinal data (with a 1-year time lag) were gathered from 730 Dutch police officers to test the following hypotheses with structural equation modeling: (i) work-home interference predicts health deterioration, (ii) health complaints precede increased levels of such interference, and (iii) both processes operate. The relationship between stable and changed levels of work-home interference across time and their relationships with the course of health were tested with a group-by-time analysis of variance. Four subgroups were created that differed in starting point and the development of work-home interference across time. The normal causal model, in which strain-based (but not time-based) work-home interference was longitudinally related to increased health complaints 1 year later, fit the data well and significantly better than the reversed causal model. Although the reciprocal model also provided a good fit, it was less parsimonious than the normal causal model. In addition, both an increment in (strain-based) work-home interference across time and a long-lasting experience of high (strain-based) work-home interference were associated with a deterioration in health. It was concluded that (strain-based) work-home interference acts as a precursor of health impairment and that different patterns of (strain-based) work-home interference across time are related to different health courses. Particularly long-term experience of (strain-based) work-home interference seems responsible for an accumulation of health complaints.

Assessing communications effectiveness in meeting corporate goals of public health organizations.

PubMed

Brown, Gordon D; Bopp, Kenneth D; Boren, Suzanne Austin

2005-01-01

Much evaluation of health communications in public health is considered from a program perspective of smoking cessation, weight reduction, education on sexually transmitted diseases, etc. These studies have advanced the knowledge base of communications theory and evaluation and have contributed to program effectiveness. In program-based evaluation the communications process is structured as part of the program itself. This article extends program-based communications evaluation to view communications from the perspective of the consumer and how effectively public health departments respond to consumer expectations. It develops a conceptual model for evaluating elements of communications such as its importance in defining mission and goals within the community, managing strategic constituencies, and enlisting individuals and groups as customers and co-producers of health. It gives a broader perspective on how communications in public heath organizations are managed and a basis for assessing whether they are being managed effectively.

Strain-Based Damage Determination Using Finite Element Analysis for Structural Health Management

NASA Technical Reports Server (NTRS)

Hochhalter, Jacob D.; Krishnamurthy, Thiagaraja; Aguilo, Miguel A.

2016-01-01

A damage determination method is presented that relies on in-service strain sensor measurements. The method employs a gradient-based optimization procedure combined with the finite element method for solution to the forward problem. It is demonstrated that strains, measured at a limited number of sensors, can be used to accurately determine the location, size, and orientation of damage. Numerical examples are presented to demonstrate the general procedure. This work is motivated by the need to provide structural health management systems with a real-time damage characterization. The damage cases investigated herein are characteristic of point-source damage, which can attain critical size during flight. The procedure described can be used to provide prognosis tools with the current damage configuration.

Innovations in health service organization and delivery in northern rural and remote regions: a review of the literature.

PubMed

Mitton, Craig; Dionne, Francois; Masucci, Lisa; Wong, Sabrina; Law, Susan

2011-01-01

To identify and review innovations relevant to improving access, quality, efficiency and/or effectiveness in the organization and delivery of health care services in rural and remote areas. Literature review. Key bibliographic databases that index health research were searched: MEDLINE, EMBASE and CINAHL. Other databases relevant to Arctic health were also accessed. Abstracts were assessed for relevancy and full articles were reviewed and categorized according to emergent themes. Many innovations in delivering services to rural and remote areas were identified, particularly in the public health realm. These innovations were grouped into 4 key themes: organizational structure of health services; utilization of telehealth and ehealth; medical transportation; and public health challenges. Despite the challenges facing rural and remote regions, there is a distinctly positive message from this broad literature review. Evidence-based initiatives exist across a range of areas - which include operational efficiency and integration, access to care, organizational structure, public health, continuing education and workforce composition - that have the potential to positively impact health care quality and health-related outcomes.

[Analysis of the effectiveness of the public health system with special reference to the health of children].

PubMed

Köhler, L; Brogren, P O

1990-01-01

A well structured, efficient health service is an important component of the welfare state, in Sweden for example. But its significance for the state of the nation's health is limited and will be affected, inter alia, by life styles and the environment. A progressive health policy must be based on cooperation between various sectors of society, and here the health service plays a central part. Therefore social policy must be well documented and subjected to continuous review. This is an important prerequisite for planning and correction at different levels. The analysis must take account of society as a whole, organization, and the individual! In so doing, greater significance should be attributed to the effectiveness and quality of the health service than to structures, capacity and statistics. With reference to the health of children in the Nordic countries, it is encouraging to see that this conception of evaluation has also gained greater acceptance in preventive care, firstly in the field of paediatric health care and more recently in the school health service as well.

A novel manifold-manifold distance index applied to looseness state assessment of viscoelastic sandwich structures

NASA Astrophysics Data System (ADS)

Sun, Chuang; Zhang, Zhousuo; Guo, Ting; Luo, Xue; Qu, Jinxiu; Zhang, Chenxuan; Cheng, Wei; Li, Bing

2014-06-01

Viscoelastic sandwich structures (VSS) are widely used in mechanical equipment; their state assessment is necessary to detect structural states and to keep equipment running with high reliability. This paper proposes a novel manifold-manifold distance-based assessment (M2DBA) method for assessing the looseness state in VSSs. In the M2DBA method, a manifold-manifold distance is viewed as a health index. To design the index, response signals from the structure are firstly acquired by condition monitoring technology and a Hankel matrix is constructed by using the response signals to describe state patterns of the VSS. Thereafter, a subspace analysis method, that is, principal component analysis (PCA), is performed to extract the condition subspace hidden in the Hankel matrix. From the subspace, pattern changes in dynamic structural properties are characterized. Further, a Grassmann manifold (GM) is formed by organizing a set of subspaces. The manifold is mapped to a reproducing kernel Hilbert space (RKHS), where support vector data description (SVDD) is used to model the manifold as a hypersphere. Finally, a health index is defined as the cosine of the angle between the hypersphere centers corresponding to the structural baseline state and the looseness state. The defined health index contains similarity information existing in the two structural states, so structural looseness states can be effectively identified. Moreover, the health index is derived by analysis of the global properties of subspace sets, which is different from traditional subspace analysis methods. The effectiveness of the health index for state assessment is validated by test data collected from a VSS subjected to different degrees of looseness. The results show that the health index is a very effective metric for detecting the occurrence and extension of structural looseness. Comparison results indicate that the defined index outperforms some existing state-of-the-art ones.

Structural Interventions in HIV Prevention: A Taxonomy and Descriptive Systematic Review

PubMed Central

Sipe, Theresa Ann; Barham, Terrika L.; Johnson, Wayne; Joseph, Heather; Tungol-Ashmon, Maria Luisa; O’Leary, Ann

2018-01-01

One of the four national HIV prevention goals is to incorporate combinations of effective, evidence-based approaches to prevent HIV infection. In fields of public health, techniques that alter environment and affect choice options are effective. Structural approaches may be effective in preventing HIV infection. Existing frameworks for structural interventions were lacking in breadth and/or depth. We conducted a systematic review and searched CDC’s HIV/AIDS Prevention Research Synthesis Project’s database for relevant interventions during 1988–2013. We used an iterative process to develop the taxonomy. We identified 213 structural interventions: Access (65%), Policy/Procedure (32%), Mass Media (29%), Physical Structure (27%), Capacity Building (24%), Community Mobilization (9%), and Social Determinants of Health (8%). Forty percent targeted high-risk populations (e.g., people who inject drugs [12%]). This paper describes a comprehensive, well-defined taxonomy of structural interventions with 7 categories and 20 subcategories. The taxonomy accommodated all interventions identified. PMID:29159594

Finite-difference simulation and visualization of elastodynamics in time-evolving generalized curvilinear coordinates

NASA Technical Reports Server (NTRS)

Kaul, Upender K. (Inventor)

2009-01-01

Modeling and simulation of free and forced structural vibrations is essential to an overall structural health monitoring capability. In the various embodiments, a first principles finite-difference approach is adopted in modeling a structural subsystem such as a mechanical gear by solving elastodynamic equations in generalized curvilinear coordinates. Such a capability to generate a dynamic structural response is widely applicable in a variety of structural health monitoring systems. This capability (1) will lead to an understanding of the dynamic behavior of a structural system and hence its improved design, (2) will generate a sufficiently large space of normal and damage solutions that can be used by machine learning algorithms to detect anomalous system behavior and achieve a system design optimization and (3) will lead to an optimal sensor placement strategy, based on the identification of local stress maxima all over the domain.

Vfold: a web server for RNA structure and folding thermodynamics prediction.

PubMed

Xu, Xiaojun; Zhao, Peinan; Chen, Shi-Jie

2014-01-01

The ever increasing discovery of non-coding RNAs leads to unprecedented demand for the accurate modeling of RNA folding, including the predictions of two-dimensional (base pair) and three-dimensional all-atom structures and folding stabilities. Accurate modeling of RNA structure and stability has far-reaching impact on our understanding of RNA functions in human health and our ability to design RNA-based therapeutic strategies. The Vfold server offers a web interface to predict (a) RNA two-dimensional structure from the nucleotide sequence, (b) three-dimensional structure from the two-dimensional structure and the sequence, and (c) folding thermodynamics (heat capacity melting curve) from the sequence. To predict the two-dimensional structure (base pairs), the server generates an ensemble of structures, including loop structures with the different intra-loop mismatches, and evaluates the free energies using the experimental parameters for the base stacks and the loop entropy parameters given by a coarse-grained RNA folding model (the Vfold model) for the loops. To predict the three-dimensional structure, the server assembles the motif scaffolds using structure templates extracted from the known PDB structures and refines the structure using all-atom energy minimization. The Vfold-based web server provides a user friendly tool for the prediction of RNA structure and stability. The web server and the source codes are freely accessible for public use at "http://rna.physics.missouri.edu".

Care Seeking Patterns Among Women Who Have Experienced Gender-Based Violence in Afghanistan.

PubMed

Stokes, Sonya; Seritan, Andreea L; Miller, Elizabeth

2016-06-01

This study explored patterns of abuse and care seeking among women victims of gender-based violence (GBV) in Afghanistan. Individual, semi-structured interviews were conducted with 22 Afghan women (M age = 19 years) living in a shelter for victims of GBV. Interviews were analyzed thematically. Participants reported experiencing multiple forms of abuse. The majority received medical treatment for abuse-related health concerns. However, less than half reported abuse to health care providers or were asked by health care providers about the context of their injuries. Strategies to improve health care responses to GBV are needed to ensure safety and support for Afghan women. © The Author(s) 2015.

Innovation in values based public health nursing student selection: A qualitative evaluation of candidate and selection panel member perspectives.

PubMed

McGraw, Caroline; Abbott, Stephen; Brook, Judy

2018-02-19

Values based recruitment emerges from the premise that a high degree of value congruence, or the extent to which an individual's values are similar to those of the health organization in which they work, leads to organizational effectiveness. The aim of this evaluation was to explore how candidates and selection panel members experienced and perceived innovative methods of values based public health nursing student selection. The evaluation was framed by a qualitative exploratory design involving semi-structured interviews and a group exercise. Data were thematically analyzed. Eight semi-structured interviews were conducted with selection panel members. Twenty-two successful candidates took part in a group exercise. The use of photo elicitation interviews and situational judgment questions in the context of selection to a university-run public health nursing educational program was explored. While candidates were ambivalent about the use of photo elicitation interviews, with some misunderstanding the task, selection panel members saw the benefits for improving candidate expression and reducing gaming and deception. Situational interview questions were endorsed by candidates and selection panel members due to their fidelity to real-life problems and the ability of panel members to discern value congruence from candidates' responses. Both techniques offered innovative solutions to candidate selection for entry to the public health nursing education program. © 2018 Wiley Periodicals, Inc.

Factors associated with local public health agency participation in obesity prevention in southern States.

PubMed

Hatala, Jeffrey J; Fields, Tina T

2015-05-01

Obesity rates in the southern US states are higher than in other states. Historically, large-scale community-based interventions in the United States have not proven successful. With local public health agencies (LPHAs) tasked with prevention, their role in obesity prevention is important, yet little research exists regarding what predicts the participation of LPHAs. Cross-sectional data from the 2008 National Association of City and County Health Officials profile study and two public health conceptual frameworks were used to assess structural and environmental predictors of LPHA participation in obesity prevention. The predictors were compared between southern and nonsouthern states. Univariate and weighted logistic regressions were performed. Analysis revealed that more LPHAs in southern states were engaged in nearly all of the 10 essential public health functions related to obesity prevention compared with nonsouthern states. Presence of community-based organizations and staffing levels were the only significant variables in two of the six logistic regression models. This study provides insights into the success rates of the obesity prevention efforts of LPHAs in southern and nonsouthern states. Future research is needed to understand why and how certain structural elements and any additional factors influence LPHA participation in obesity prevention.

Environmental Determinants of Cardiovascular Diseases Risk Factors: A Qualitative Directed Content Analysis

PubMed Central

Sabzmakan, Leila; Mohammadi, Eesa; Morowatisharifabad, Mohammad Ali; Afaghi, Ahmad; Naseri, Mohammad Hassan; Mirzaei, Masoud

2014-01-01

Background: Cardiovascular diseases (CVDs) are the number one cause of death in the world. In most analyses of health problems, environment plays a significant and modifiable role in causing the problem either directly or indirectly through behavior. Objectives: This study aims to understand the patients and healthcare providers’ experiences about the environmental determinants of CVD risk factors based on the Precede Model. Patients and Methods: This qualitative study conducted over six months in 2012 at Diabetes Units of Health Centers associated with Alborz University of Medical Sciences and Health Services which is located in Karaj, Iran. The data were collected based on individual semi-structured interviews with 50 patients and 12 healthcare providers. Data analysis was performed simultaneous with data collection using the content analysis directed method. Results: Lack of behaviors like stress control, healthy eating and physical activity were the roots of the risk factors for CVD. The environmental factor is one of the barriers for conducting these behaviors. The environmental barriers included of structural environment including “availability and accessibility of health resources”, “new skills”, and “law and policies” which are located in enabling category and social environment including “social support”, “motivation to comply” and “consequences of behavior” which are located in reinforcing category. The most barriers to performing health behaviors were often structural. Conclusions: The environmental factors were barriers for doing healthy behaviors. These factors need to be considered to design health promotion interventions. Policymakers should not only focus on patients’ education but also should provide specific facilities to enhance economic, social and cultural status. PMID:25031848

Health e-mavens: identifying active online health information users.

PubMed

Sun, Ye; Liu, Miao; Krakow, Melinda

2016-10-01

Given the rapid increase of Internet use for effective health communication, it is important for health practitioners to be able to identify and mobilize active users of online health information across various web-based health intervention programmes. We propose the concept 'health e-mavens' to characterize individuals actively engaged in online health information seeking and sharing activities. This study aimed to address three goals: (i) to test the factor structure of health e-mavenism, (ii) to assess the reliability and validity of this construct and (iii) to determine what predictors are associated with health e-mavenism. This study was a secondary analysis of nationally representative data from the 2010 Health Tracking Survey. We assessed the factor structure of health e-mavenism using confirmatory factor analysis and examined socio-demographic variables, health-related factors and use of technology as potential predictors of health e-mavenism through ordered regression analysis. Confirmatory factor analyses showed that a second-order two-factor structure best captured the health e-maven construct. Health e-mavenism comprised two second-order factors, each encompassing two first-order dimensions: information acquisition (consisting of information tracking and consulting) and information transmission (consisting of information posting and sharing). Both first-order and second-order factors exhibited good reliabilities. Several factors were found to be significant predictors of health e-mavenism. This study offers a starting point for further inquiries about health e-mavens. It is a fruitful construct for health promotion research in the age of new media technologies. We conclude with specific recommendations to further develop the health e-maven concept through continued empirical research. © 2015 The Authors. Health Expectations. Published by John Wiley & Sons Ltd.

Race-based job discrimination, disparities in job control, and their joint effects on health.

PubMed

Meyer, John D

2014-05-01

To examine disparities between job control scores in Black and White subjects and attempt to discern whether self-rated low job control in Blacks may arise from structural segregation into different jobs, or represents individual responses to race-based discrimination in hiring or promotion. Data from the National Survey of Midlife in the United States (MIDUS) were analyzed by mixed-effects linear regression and variance regression to determine the effects of grouping by occupation, and racial discrimination in hiring or promotion, on control scores from the Job Content Questionnaire in Black and White subjects. Path analyses were constructed to determine the mediating effect of discrimination on pathways from education and job control to self-rated health. Black subjects exhibited lower mean job control scores compared to Whites (mean score difference 2.26, P < 0.001) adjusted for age, sex, education, and income. This difference narrowed to 1.86 when adjusted for clustering by occupation, and was greatly reduced by conditioning on race-based discrimination (score difference 1.03, P = 0.12). Path analyses showed greater reported discrimination in Blacks with increasing education, and a stronger effect of job control on health in Black subjects. Individual racially-based discrimination appears a stronger determinant than structural segregation in reduced job control in Black workers, and may contribute to health disparities consequent on work. © 2013 Wiley Periodicals, Inc.

Design elements in implementation research: a structured review of child welfare and child mental health studies.

PubMed

Landsverk, John; Brown, C Hendricks; Rolls Reutz, Jennifer; Palinkas, Lawrence; Horwitz, Sarah McCue

2011-01-01

Implementation science is an emerging field of research with considerable penetration in physical medicine and less in the fields of mental health and social services. There remains a lack of consensus on methodological approaches to the study of implementation processes and tests of implementation strategies. This paper addresses the need for methods development through a structured review that describes design elements in nine studies testing implementation strategies for evidence-based interventions addressing mental health problems of children in child welfare and child mental health settings. Randomized trial designs were dominant with considerable use of mixed method designs in the nine studies published since 2005. The findings are discussed in reference to the limitations of randomized designs in implementation science and the potential for use of alternative designs.

The role of advocacy in occasioning community and organizational change in a medical-legal partnership.

PubMed

Anderson-Carpenter, Kaston D; Collie-Akers, Vicki; Colvin, Jeffrey D; Cronin, Katie

2013-01-01

Health disparities among low-income individuals remain a significant problem. A number of social determinants are associated with adverse health outcomes. Medical-legal partnerships address legal concerns of low-income individuals to improve health and wellness in adults and children. The Medical-Legal Partnership at Legal Aid of Western Missouri provides free direct legal services for patients with legal concerns affecting health. There is limited evidence regarding the association between advocacy-related efforts and changes within both the medical-legal partnership structure and in health-care facilities. Three health-care organizations in Kansas City, MO participated in implementing the medical-legal partnership model between 2007 and 2010. Advocacy efforts conducted by key medical-legal partnership personnel were strongly associated with changes in health-care organizations and within the medical-legal partnership structure. This study extends the current evidence base by examining the types of advocacy efforts required to bring about community and organizational changes.

A Way Forward: How Higher Education Can Learn from Health Care

ERIC Educational Resources Information Center

Brooks, Beth A.

2017-01-01

Despite vigorous lobbying by advocacy groups at the federal and state levels, policies, and practices that are structurally very similar to those being opposed currently by university presidents--health care scorecards, value-based payments, and risk-sharing (i.e., "skin in the game" initiatives) are now very much realities in health…

Managing ecosystems for forest health: An approach and the effects on uses and values

Treesearch

Chadwick D. Oliver; Dennis E. Ferguson; Alan E. Harvey; Herbert S. Malany; John M. Mandzak; Robert W. Mutch

1994-01-01

Forest health is most appropriately based on the scientific paradigm of dynamic, constantly changing forest ecosystems. Many forests in the Inland West now support high levels of insect infestations, disease epidemics, fire susceptibilities, and imbalances in stand structures and habitats because of natural processes and past management practices. Impending,...

A Psychology Fulbright Year in China

ERIC Educational Resources Information Center

Portnoy, Robert N.

2013-01-01

This article shares a series of personal observations and anecdotes about central issues in college mental health in China based on my Fulbright year there. There are many cultural and structural forces that both support and constrain the growth of the mental health field in China. This article addresses these forces in terms of their impact on…

Primary Mental Health in Elementary Schools: Its Impact on Psychosocial Measures.

ERIC Educational Resources Information Center

Munoz, Marco A.

The Primary Mental Health Project (PMHP) is a research-based, selective program implemented by the Jefferson County Public Schools. The goal of the program is to enhance learning and other school-related competencies. Key structural components of the program include a focus on young children, early screening and selection, use of paraprofessionals…

Scaling up Comprehensive Sexuality Education in Nigeria: From National Policy to Nationwide Application

ERIC Educational Resources Information Center

Huaynoca, Silvia; Chandra-Mouli, Venkatraman; Yaqub, Nuhu, Jr.; Denno, Donna Marie

2014-01-01

Nigeria is one of few countries that reports having translated national policies on school-based comprehensive sexuality education (CSE) into near-nationwide implementation. We analysed data using the World Health Organization-ExpandNet framework, which provides a systematic structure for planning and managing the scaling up of health innovations.…

Nanotechnology and dentistry

PubMed Central

Ozak, Sule Tugba; Ozkan, Pelin

2013-01-01

Nanotechnology deals with the physical, chemical, and biological properties of structures and their components at nanoscale dimensions. Nanotechnology is based on the concept of creating functional structures by controlling atoms and molecules on a one-by-one basis. The use of this technology will allow many developments in the health sciences as well as in materials science, bio-technology, electronic and computer technology, aviation, and space exploration. With developments in materials science and biotechnology, nanotechnology is especially anticipated to provide advances in dentistry and innovations in oral health-related diagnostic and therapeutic methods. PMID:23408486

Model-Based Fatigue Prognosis of Fiber-Reinforced Laminates Exhibiting Concurrent Damage Mechanisms

NASA Technical Reports Server (NTRS)

Corbetta, M.; Sbarufatti, C.; Saxena, A.; Giglio, M.; Goebel, K.

2016-01-01

Prognostics of large composite structures is a topic of increasing interest in the field of structural health monitoring for aerospace, civil, and mechanical systems. Along with recent advancements in real-time structural health data acquisition and processing for damage detection and characterization, model-based stochastic methods for life prediction are showing promising results in the literature. Among various model-based approaches, particle-filtering algorithms are particularly capable in coping with uncertainties associated with the process. These include uncertainties about information on the damage extent and the inherent uncertainties of the damage propagation process. Some efforts have shown successful applications of particle filtering-based frameworks for predicting the matrix crack evolution and structural stiffness degradation caused by repetitive fatigue loads. Effects of other damage modes such as delamination, however, are not incorporated in these works. It is well established that delamination and matrix cracks not only co-exist in most laminate structures during the fatigue degradation process but also affect each other's progression. Furthermore, delamination significantly alters the stress-state in the laminates and accelerates the material degradation leading to catastrophic failure. Therefore, the work presented herein proposes a particle filtering-based framework for predicting a structure's remaining useful life with consideration of multiple co-existing damage-mechanisms. The framework uses an energy-based model from the composite modeling literature. The multiple damage-mode model has been shown to suitably estimate the energy release rate of cross-ply laminates as affected by matrix cracks and delamination modes. The model is also able to estimate the reduction in stiffness of the damaged laminate. This information is then used in the algorithms for life prediction capabilities. First, a brief summary of the energy-based damage model is provided. Then, the paper describes how the model is embedded within the prognostic framework and how the prognostics performance is assessed using observations from run-to-failure experiments

[Policies and mental health action plans in OECD: lessons for Quebec?].

PubMed

Thiebaut, Georges-Charles; Farand, Lambert; Fleury, Marie-Josée

2014-01-01

The objectives of this research are: 1) to provide a conceptual framework for analyzing mental health policies; 2) to compare mental health policies across a sample of OECD jurisdictions; 3) to describe configurations of mental health policies; 4) to identify practical implications for the Province of Quebec. This research is a comparative synthetic study of mental health policies. The web sites of the Ministries of health of the thirty-four OECD countries and ten Canadian Provinces were searched for mental health policies proposed within the last fifteen years. Twenty one such policies (with an English or French version) were retrieved, covering thirteen OECD countries, six Canadian Provinces and the WHO. Content analysis was performed based on the categories (differentiation, integration, governance) and sub-categories of the aforementioned conceptual framework. Eight policies that together cover the variations encountered between all policies were used to identify typical configurations. A conceptual framework derived from Parsons' Theory of Social Action posits that social action systems must exhibit a level of internal differentiation that corresponds to the heterogeneity of their external environment and also a level of integration that allows them to remain coherent despite the complexity of their environment. Governance mechanisms help them maintain an equilibrium between differentiation and integration.In terms of differentiation, mental health policies exhibit much variation between the needs and the groups that are prioritized (age, gender, ethnicity, culture, etc.), the types of interventions that are proposed (promotion, prevention, treatment, rehabilitation, etc.), the systemic levels at which interventions take place (society, government as a whole, health care system, organizations, programs, individuals), and the level of specification and scientific basis of proposed interventions. In terms of integration, policies promote various mechanisms belonging to four general categories of increasing effectiveness from hierarchical separation of mandates, to exchange of information, to collaborative planning, and to complete structural integration and co-localisation of certain components (ex. dependence and mental health services). In terms of governance, policies present program theories of varying explicitness and scientific bases, and with different emphases on structures, processes or outcomes. Management models also vary in terms of precision, accountability, financing mechanisms, information systems, and the importance of clinical governance and quality improvement.Five configurations of mental health policies are identified (the public health, the professional, the structural technocratic, the functional technocratic, and the political), each comprising typical combinations of the preceding ingredients. The current Quebec mental health policy belongs to the structural technocratic configuration. It specifies fragmented mental health structures with mild integration mechanisms. In the future, it should consider improving its public health aspects (inter-sector work on the determinants of mental health), professional aspects (emphasis on scientific evidence, clinical governance and quality), and functional aspects (integrated specialized community mental health and addiction services). But political factors may prevent it from doing so.

A cluster-randomised controlled trial of values-based training to promote autonomously held recovery values in mental health workers.

PubMed

Williams, Virginia; Deane, Frank P; Oades, Lindsay G; Crowe, Trevor P; Ciarrochi, Joseph; Andresen, Retta

2016-02-02

The implementation and use of evidence-based practices is a key priority for recovery-oriented mental health service provision. Training and development programmes for employees continue to be a key method of knowledge and skill development, despite acknowledged difficulties with uptake and maintenance of behaviour change. Self-determination theory suggests that autonomy, or a sense that behaviour is self-generated, is a key motivator to sustained behaviour change, in this case practices in mental health services. This study examined the utility of values-focused staff intervention as a specific, reproducible method of autonomy support. Mental health workers (n = 146) were assigned via cluster randomisation to either a values clarification condition or an active problem-solving control condition. Results demonstrated that a structured values clarification exercise was useful in promoting integrated motivation for the changed practice and resulted in increased implementation planning. Structured values clarification intervention demonstrates utility as a reproducible means of autonomy support within the workplace. We discuss future directions for the study of autonomous motivation in the field of implementation science. ACTRN12613000353796.

CNT-cement based composites: fabrication, self-sensing properties, and prospective applications to structural health monitoring

NASA Astrophysics Data System (ADS)

Rainieri, Carlo; Song, Yi; Fabbrocino, Giovanni; Schulz, Mark J.; Shanov, Vesselin

2013-08-01

Degradation phenomena can affect civil structures over their lifespan. The recent advances in nanotechnology and sensing allow to monitor the behaviour of a structure, assess its performance and identify damage at an early stage. Thus, maintenance actions can be carried out in a timely manner, improving structural reliability and safety. Structural Health Monitoring (SHM) is traditionally performed at a global level, with a limited number of sensors distributed over a relatively large area of a structure. Thus, only major damage conditions are detectable. Dense sensor networks and innovative structural neural systems, reproducing the structure and the function of the human nervous system, may overcome this drawback of current SHM systems. Miniaturization and embedment are key requirements for successful implementation of structural neural systems. Carbon nanotubes (CNTs) can play an attractive role in the development of embedded sensors and smart structural materials, since they can provide to traditional cement based materials both structural capability and measurable response to applied stresses, strains, cracks and other flaws. In this paper investigations about CNT/cement composites and their self-sensing capabilities are summarized and critically revised. The analysis of available experimental results and theoretical developments provides useful design criteria for the fabrication of CNT/cement composites optimized for SHM applications in civil engineering. Specific attention is paid to the opportunities provided by new RF plasma technologies for the functionalization of CNTs in view of sensor development and SHM applications.

Social determinants of health among African Americans in a rural community in the Deep South: an ecological exploration.

PubMed

Scott, A J; Wilson, R F

2011-01-01

African Americans living in rural USA experience multiple health disparities as a result of both race and rural geography. An increasing literature suggests that social determinants of health, the social contexts in which people live their lives, are key contributors to these health disparities. Ecological theory provides a valuable conceptual framework for exploring social determinants of health in communities, but few US rural health community-based studies have utilized this approach, or engaged ecological theory to explore rural contexts. This exploratory study blended a community-based, qualitative approach with ecological theory with the objective of identifying potential social determinants of health among African Americans in a rural community in the Deep South, from the perspectives of participants. In-depth interviews were conducted with rural, Deep South African Americans participants who were purposefully sampled to incorporate a range of perspectives. Interview guides structured around five ecological levels (individual, relational, environmental, structural, and superstructural) were used to frame interviews. Iterative content analysis of interview transcripts and field notes identified potential social determinants of health. An 'editing' approach to content analysis was used. Data and analysis quality was tested by triangulation at the level of the researcher, and by member checking with community members. Potential determinants of health were identified at all five levels of the ecological framework. At the individual level, lack of engagement with personal health and health promotion was a recurring theme. Participation in preventive health activities and education was minimal, even when offered in community settings. At the relational level, lack of social capital emerged as another potential social determinant of health, with estrangement between the younger and elder generations as one source, and fractiousness among churches (key institutions in the community) representing another. At the environmental level, the community built environment was an area of concern as it lacked opportunities for physical activity and access to healthy foods. The local job environment was identified as a potential social determinant of health, given the strong ties between income and health. At the structural level, participants complained of cronyism and nepotism favoring Whites in access to jobs, including those where local policies and funding allocations were made (eg funding for the local health department). In education, school system tracking policies were perceived to discourage African Americans from university education. At the superstructural level, high rates of poverty and racism emerged as potential social determinants. Poverty directly limited many African Americans' access to quality health care, and subtle racism was perceived in some delivery of care. Persistent stress from poverty and racism was reported, which creates health risks through physiologic pathways. This study identified potential social determinants of health, at multiple ecological levels, among African Americans in a rural community in the Deep South. The social determinants identified had the ability to impact a variety of health behaviors and health outcomes. The results demonstrate the value of this approach to conducting rural, community-based research. This descriptive and exploratory study highlights the need for quantitative exploration of these issues, as well as the development of context-appropriate, community-based health interventions that address multiple ecological levels.

Structural health monitoring of civil infrastructure.

PubMed

Brownjohn, J M W

2007-02-15

Structural health monitoring (SHM) is a term increasingly used in the last decade to describe a range of systems implemented on full-scale civil infrastructures and whose purposes are to assist and inform operators about continued 'fitness for purpose' of structures under gradual or sudden changes to their state, to learn about either or both of the load and response mechanisms. Arguably, various forms of SHM have been employed in civil infrastructure for at least half a century, but it is only in the last decade or two that computer-based systems are being designed for the purpose of assisting owners/operators of ageing infrastructure with timely information for their continued safe and economic operation. This paper describes the motivations for and recent history of SHM applications to various forms of civil infrastructure and provides case studies on specific types of structure. It ends with a discussion of the present state-of-the-art and future developments in terms of instrumentation, data acquisition, communication systems and data mining and presentation procedures for diagnosis of infrastructural 'health'.

Electronic Health Record Phenotypes for Precision Medicine: Perspectives and Caveats From Treatment of Breast Cancer at a Single Institution

PubMed Central

Liu, Hongfang; Maxwell, Kara N.; Pathak, Jyotishman; Zhang, Rui

2018-01-01

Abstract Precision medicine is at the forefront of biomedical research. Cancer registries provide rich perspectives and electronic health records (EHRs) are commonly utilized to gather additional clinical data elements needed for translational research. However, manual annotation is resource‐intense and not readily scalable. Informatics‐based phenotyping presents an ideal solution, but perspectives obtained can be impacted by both data source and algorithm selection. We derived breast cancer (BC) receptor status phenotypes from structured and unstructured EHR data using rule‐based algorithms, including natural language processing (NLP). Overall, the use of NLP increased BC receptor status coverage by 39.2% from 69.1% with structured medication information alone. Using all available EHR data, estrogen receptor‐positive BC cases were ascertained with high precision (P = 0.976) and recall (R = 0.987) compared with gold standard chart‐reviewed patients. However, status negation (R = 0.591) decreased 40.2% when relying on structured medications alone. Using multiple EHR data types (and thorough understanding of the perspectives offered) are necessary to derive robust EHR‐based precision medicine phenotypes. PMID:29084368

Active Wireless System for Structural Health Monitoring Applications.

PubMed

Perera, Ricardo; Pérez, Alberto; García-Diéguez, Marta; Zapico-Valle, José Luis

2017-12-11

The use of wireless sensors in Structural Health Monitoring (SHM) has increased significantly in the last years. Piezoelectric-based lead zirconium titanate (PZT) sensors have been on the rise in SHM due to their superior sensing abilities. They are applicable in different technologies such as electromechanical impedance (EMI)-based SHM. This work develops a flexible wireless smart sensor (WSS) framework based on the EMI method using active sensors for full-scale and autonomous SHM. In contrast to passive sensors, the self-sensing properties of the PZTs allow interrogating with or exciting a structure when desired. The system integrates the necessary software and hardware within a service-oriented architecture approach able to provide in a modular way the services suitable to satisfy the key requirements of a WSS. The framework developed in this work has been validated on different experimental applications. Initially, the reliability of the EMI method when carried out with the proposed wireless sensor system is evaluated by comparison with the wireless counterpart. Afterwards, the performance of the system is evaluated in terms of software stability and reliability of functioning.

Developing an Evidence Base for Policies and Interventions to Address Health Inequalities: The Analysis of “Public Health Regimes”

PubMed Central

Asthana, Sheena; Halliday, Joyce

2006-01-01

Systematic reviews have become an important methodology in the United Kingdom by which research informs health policy, and their use now extends beyond evidence-based medicine to evidence-based public health and, particularly, health inequalities policies. This article reviews the limitations of systematic reviews as stand-alone tools for this purpose and suggests a complementary approach to make better use of the evidence. That is, systematic reviews and other sources of evidence should be incorporated into a wider analytical framework, the public health regime (defined here as the specific legislative, social, political, and economic structures that have an impact on both public health and the appropriateness and effectiveness of public health interventions adopted). At the national level this approach would facilitate analysis at all levels of the policy framework, countering the current focus on individual interventions. It could also differentiate at the international level between those policies and interventions that are effective in different contexts and are therefore potentially generalizable and those that depend on particular conditions for success. PMID:16953811

A qualitative study exploring adolescents' experiences with a school-based mental health program.

PubMed

Garmy, Pernilla; Berg, Agneta; Clausson, Eva K

2015-10-21

Supporting positive mental health development in adolescents is a major public health concern worldwide. Although several school-based programs aimed at preventing depression have been launched, it is crucial to evaluate these programs and to obtain feedback from participating adolescents. This study aimed to explore adolescents' experiences with a -based cognitive-behavioral depression prevention program. Eighty-nine adolescents aged 13-15 years were divided into 12 focus groups. The focus group interviews were analyzed using qualitative content analysis. Three categories and eight subcategories were found to be related to the experience of the school-based program. The first category, intrapersonal strategies, consisted of the subcategories of directed thinking, improved self-confidence, stress management, and positive activities. The second category, interpersonal awareness, consisted of the subcategories of trusting the group and considering others. The third category, structural constraints, consisted of the subcategories of negative framing and emphasis on performance. The school-based mental health program was perceived as beneficial and meaningful on both individual and group levels, but students expressed a desire for a more health-promoting approach.

[Environmental health: the evolution of Colombia's current regulatory framework].

PubMed

García-Ubaque, Cesar A; García-Ubaque, Juan C; Vaca-Bohórquez, Martha L

2013-01-01

This essay presents an analysis of the evolution of environmental health management in Colombia, covering the period from the introduction of the Colombian Healthcare Code (1979) to laws 99 and 100 in 1993 and the introduction of Environmental Health Policy in Bogotá DC (2011). It proposes a conceptual model for environmental health management at three levels: proximal (physical, chemical and biological setting), intermediate (natural and cultural environment) and distal (economic, political and social structures). Relevant aspects of environmental health policy in Bogotá are analysed based on the proposed model.

[The construction of collective portfolios in traditional curriculums: an innovative approach in teaching-learning].

PubMed

Cotta, Rosângela Minardi Mitre; Silva, Luciana Saraiva da; Lopes, Lílian Lelis; Gomes, Karine de Oliveira; Cotta, Fernanda Mitre; Lugarinho, Regina; Mitre, Sandra Minardi

2012-03-01

Education to promote health has traditionally been based on knowledge transmission methodologies. However, the current scenario calls for the training of professionals with a critical-reflective profile, who are able to work in teams. We present the report of an innovative experience using the construction of collective portfolios as instruments of learning, changing attitudes and training of undergraduates, in a traditional subject-based curriculum structure context. It is a descriptive exploratory study, with a qualitative-quantitative approach, based on analysis of collective portfolios (n=9), built by Health Policy students, together with an open questionnaire to students who attended the course (n=58) and also the staging of focus groups (n=3). The use of collective portfolios mobilized students in critical and reflective thinking on Brazilian health policy - the Unified Health System - broadening the concept on the health-disease process and practices related to health services, prioritizing teamwork and the active search for knowledge building, stressing the exercise of otherness, resilience and empowerment.

The nature and structure of supervision in health visiting with victims of child sexual abuse.

PubMed

Scott, L

1999-03-01

Part of a higher research degree to explore professional practice. To explore how health visitors work with victims of child sexual abuse and the supervision systems to support them. To seek the views and experiences of practising health visitors relating to complex care in order to consider the nature and structure of supervision. The research reported in this paper used a qualitative method of research and semi-structured interviews with practising health visitors of varying levels of experience in venues around England. Qualitative research enabled the exploration of experiences. Identification of the need for regular, structured, accountable opportunities in a 'private setting' to discuss whole caseload work and current practice issues. Supervision requires a structured, formalized process, in both regularity and content, as a means to explore and acknowledge work with increasingly complex care, to enable full discussion of whole caseloads. Supervision is demonstrated as a vehicle to enable the sharing of good practices and for weak practices to be identified and managed appropriately. Supervision seeks to fulfil the above whilst promoting a stimulating, learning experience, accommodating the notion that individuals learn at their own pace and bring a wealth of human experience to the service. The size of the study was dictated by the amount of time available within which to complete a research master's degree course primarily in the author's own time, over a 2-year period. The majority of participants volunteered their accounts in their own time. For others I obtained permission from their employers for them to participate once they approached me with an interest in being interviewed. This research provides a model of supervision based on practitioner views and experiences. The article highlights the value of research and evidence-based information to enhance practice accountability and the quality of care. Proactive risk management can safeguard the health and safety of the public, the practitioner and the organization.

Using an integrated knowledge translation approach to build a public health research agenda.

PubMed

Kothari, Anita; Regan, Sandra; Gore, Dana; Valaitis, Ruta; Garcia, John; Manson, Heather; O'Mara, Linda

2014-01-29

Public Health Systems Research is an emerging field of research that is gaining importance in Canada. On October 22 and 23, 2012, public health researchers, practitioners, and policy-makers came together at the Accelerating Public Health Systems Research in Ontario: Building an Agenda think tank to develop a research agenda for the province. This agenda included the identification of the six top priorities for research in Ontario: public health performance, evidence-based practice, public health organization and structure, public health human resources, public health infrastructure, and partnerships/linkages. This paper explores the priorities in detail and hopes to bring more attention to this area of research.

A vibration-based health monitoring program for a large and seismically vulnerable masonry dome

NASA Astrophysics Data System (ADS)

Pecorelli, M. L.; Ceravolo, R.; De Lucia, G.; Epicoco, R.

2017-05-01

Vibration-based health monitoring of monumental structures must rely on efficient and, as far as possible, automatic modal analysis procedures. Relatively low excitation energy provided by traffic, wind and other sources is usually sufficient to detect structural changes, as those produced by earthquakes and extreme events. Above all, in-operation modal analysis is a non-invasive diagnostic technique that can support optimal strategies for the preservation of architectural heritage, especially if complemented by model-driven procedures. In this paper, the preliminary steps towards a fully automated vibration-based monitoring of the world’s largest masonry oval dome (internal axes of 37.23 by 24.89 m) are presented. More specifically, the paper reports on signal treatment operations conducted to set up the permanent dynamic monitoring system of the dome and to realise a robust automatic identification procedure. Preliminary considerations on the effects of temperature on dynamic parameters are finally reported.

The benefit of 3D laser scanning technology in the generation and calibration of FEM models for health assessment of concrete structures.

PubMed

Yang, Hao; Xu, Xiangyang; Neumann, Ingo

2014-11-19

Terrestrial laser scanning technology (TLS) is a new technique for quickly getting three-dimensional information. In this paper we research the health assessment of concrete structures with a Finite Element Method (FEM) model based on TLS. The goal focuses on the benefits of 3D TLS in the generation and calibration of FEM models, in order to build a convenient, efficient and intelligent model which can be widely used for the detection and assessment of bridges, buildings, subways and other objects. After comparing the finite element simulation with surface-based measurement data from TLS, the FEM model is determined to be acceptable with an error of less than 5%. The benefit of TLS lies mainly in the possibility of a surface-based validation of results predicted by the FEM model.

Equity in access to maternal and child health services in five developing countries: what works.

PubMed

Talukder, M D Noorunnabi; Rob, Ubaidur

2010-01-01

People living in rural areas are yet to have equitable access to maternal and child health services in many developing countries. This article examines selected health service delivery models that improved access to services in five developing countries. The article is based on the review of background papers on Bangladesh, Pakistan, Cambodia, Ghana, and Tanzania, prepared as part of a multi-country study on health systems and maternal and child health. Findings suggest that equity in access to health services largely depends on a system that ensures a combination of facility-based service delivery and outreach services with a functioning referral network. A key factor is the availability of health workforce at the community level. Community-based deployment of service providers or recruitment and training of community health workers is critical in enhancing service coverage and linking local populations to a health facility. Incentive is necessary to keep community health workers' interest in providing services. However, health workforce alone cannot ensure good health outcomes. They must be embedded in a functioning service delivery network to transform structural inputs into outcomes. Moreover, local-level health systems should have the ability to allocate resources in strategic ways addressing the pressing health needs of the people.

A secondary data analysis of Internet use in caregivers of persons with dementia.

PubMed

Kim, Heejung; Rose, Karen M; Netemeyer, Richard G; Merwin, Elizabeth I; Williams, Ishan C

2014-12-01

This paper is a secondary data analysis to investigate relationships among caregiver stress appraisal, self-rated health and health-related Internet use. Cross-sectional correlation design. National Alliance for Caregiving telephone survey conducted in the USA was a primary data source collected in 2009 from 258 caregivers of persons with dementia, who used the Internet to perform care-giving tasks. Based on Pearlin's Stress Process Model, structural equation modelling was conducted. Caregivers with poor health reported higher levels of caregiver stress appraised, which was associated with more Internet use for health-related purposes. It is required to develop effective Internet-based resources to meet the needs of highly stressed caregivers of persons with dementia. However, there was no relationship between self-rated health and health-related Internet use in dementia caregiver.

Roots, Shoots, but Too Little Fruit: Assessing the Contribution of COPC in South Africa

PubMed Central

Tollman, Stephen M.; Pick, William M.

2002-01-01

Community-oriented primary care (COPC) originated in South Africa during the 1940s and 1950s, where it served to inform local church-based and nongovernmental organization–based initiatives during the apartheid years. During the 1990s, COPC played an inspirational role in the process of national health policy formulation. Yet COPC’s contribution to current health practice remains more symbolic than substantive. Despite a policy framework that favors the widespread introduction of COPC, various political, structural, managerial, and human resource obstacles constrain its effective implementation. Notwithstanding a rapidly changing health care environment and well-established health transition from infections and nutritional disorders to non-communicable diseases and injury, COPC and its variants remain abidingly relevant to South Africa’s—and Africa’s—health care reality. (Am J Public Health. 2002;92:1725–1728) PMID:12406793

A nonlinear cointegration approach with applications to structural health monitoring

NASA Astrophysics Data System (ADS)

Shi, H.; Worden, K.; Cross, E. J.

2016-09-01

One major obstacle to the implementation of structural health monitoring (SHM) is the effect of operational and environmental variabilities, which may corrupt the signal of structural degradation. Recently, an approach inspired from the community of econometrics, called cointegration, has been employed to eliminate the adverse influence from operational and environmental changes and still maintain sensitivity to structural damage. However, the linear nature of cointegration may limit its application when confronting nonlinear relations between system responses. This paper proposes a nonlinear cointegration method based on Gaussian process regression (GPR); the method is constructed under the Engle-Granger framework, and tests for unit root processes are conducted both before and after the GPR is applied. The proposed approach is examined with real engineering data from the monitoring of the Z24 Bridge.

Cracking the Sugar Code by Mass Spectrometry - An Invited Perspective in Honor of Dr. Catherine E. Costello, Recipient of the 2017 ASMS Distinguished Contribution Award

NASA Astrophysics Data System (ADS)

Mirgorodskaya, Ekaterina; Karlsson, Niclas G.; Sihlbom, Carina; Larson, Göran; Nilsson, Carol L.

2018-04-01

The structural study of glycans and glycoconjugates is essential to assign their roles in homeostasis, health, and disease. Once dominated by nuclear magnetic resonance spectroscopy, mass spectrometric methods have become the preferred toolbox for the determination of glycan structures at high sensitivity. The patterns of such structures in different cellular states now allow us to interpret the sugar codes in health and disease, based on structure-function relationships. Dr. Catherine E. Costello was the 2017 recipient of the American Society for Mass Spectrometry's Distinguished Contribution Award. In this Perspective article, we describe her seminal work in a historical and geographical context and review the impact of her research accomplishments in the field. 8[Figure not available: see fulltext.

Ultrasonic Signal Processing for Structural Health Monitoring

NASA Astrophysics Data System (ADS)

Michaels, Jennifer E.; Michaels, Thomas E.

2004-02-01

Permanently mounted ultrasonic sensors are a key component of systems under development for structural health monitoring. Signal processing plays a critical role in the viability of such systems due to the difficulty in interpreting signals received from structures of complex geometry. This paper describes a differential feature-based approach to classifying signal changes as either "environmental" or "structural". Data are presented from piezoelectric discs bonded to an aluminum specimen subjected to both environmental changes and introduction of artificial defects. The classifier developed as part of this study was able to correctly identify artificial defects that were not part of the initial training and evaluation data sets. Central to the success of the classifier was the use of the Short Time Cross Correlation to measure coherency between the signal and reference as a function of time.

The pillars of well-constructed simulated patient programs: A qualitative study with experienced educators.

PubMed

Pritchard, Shane A; Blackstock, Felicity C; Keating, Jennifer L; Nestel, Debra

2017-11-01

The inclusion of simulated patients (SPs) in health professional education is growing internationally. However, there is limited evidence for best practice in SP methodology. This study investigated how experienced SP educators support SPs in providing SP-based education for health professional students. Experienced SP educators were identified via relevant professional associations, peer-reviewed publications, and peer referral. Semi-structured individual interviews were conducted via telephone. Data were analyzed independently by three researchers using principles of inductive thematic analysis. Four themes were identified that represent the key structural components of SP programs considered by educators seeking to optimize learning for health professional students in SP programs: managing SPs by operationalizing an effective program, selecting SPs by rigorously screening for suitability, preparing SPs by educating for a specific scenario, and directing SPs by leading safe and meaningful interactions. Within these components, subthemes were described, with considerable variation in approaches. Key structural components to SP programs were consistently described by experienced SP educators who operationalize them. A framework has been proposed to assist educators in designing high-quality SP programs that support SPs and learners. Future research is required to evaluate and refine this framework and other evidence-based resources for SP educators.

FRED (a Framework for Reconstructing Epidemic Dynamics): an open-source software system for modeling infectious diseases and control strategies using census-based populations.

PubMed

Grefenstette, John J; Brown, Shawn T; Rosenfeld, Roni; DePasse, Jay; Stone, Nathan T B; Cooley, Phillip C; Wheaton, William D; Fyshe, Alona; Galloway, David D; Sriram, Anuroop; Guclu, Hasan; Abraham, Thomas; Burke, Donald S

2013-10-08

Mathematical and computational models provide valuable tools that help public health planners to evaluate competing health interventions, especially for novel circumstances that cannot be examined through observational or controlled studies, such as pandemic influenza. The spread of diseases like influenza depends on the mixing patterns within the population, and these mixing patterns depend in part on local factors including the spatial distribution and age structure of the population, the distribution of size and composition of households, employment status and commuting patterns of adults, and the size and age structure of schools. Finally, public health planners must take into account the health behavior patterns of the population, patterns that often vary according to socioeconomic factors such as race, household income, and education levels. FRED (a Framework for Reconstructing Epidemic Dynamics) is a freely available open-source agent-based modeling system based closely on models used in previously published studies of pandemic influenza. This version of FRED uses open-access census-based synthetic populations that capture the demographic and geographic heterogeneities of the population, including realistic household, school, and workplace social networks. FRED epidemic models are currently available for every state and county in the United States, and for selected international locations. State and county public health planners can use FRED to explore the effects of possible influenza epidemics in specific geographic regions of interest and to help evaluate the effect of interventions such as vaccination programs and school closure policies. FRED is available under a free open source license in order to contribute to the development of better modeling tools and to encourage open discussion of modeling tools being used to evaluate public health policies. We also welcome participation by other researchers in the further development of FRED.

An academic-health service partnership in nursing: lessons from the field.

PubMed

Granger, Bradi B; Prvu-Bettger, Janet; Aucoin, Julia; Fuchs, Mary Ann; Mitchell, Pamela H; Holditch-Davis, Diane; Roth, Deborah; Califf, Robert M; Gilliss, Catherine L

2012-03-01

To describe the development of an academic-health services partnership undertaken to improve use of evidence in clinical practice. Academic health science schools and health service settings share common elements of their missions: to educate, participate in research, and excel in healthcare delivery, but differences in the business models, incentives, and approaches to problem solving can lead to differences in priorities. Thus, academic and health service settings do not naturally align their leadership structures or work processes. We established a common commitment to accelerate the appropriate use of evidence in clinical practice and created an organizational structure to optimize opportunities for partnering that would leverage shared resources to achieve our goal. A jointly governed and funded institute integrated existing activities from the academic and service sectors. Additional resources included clinical staff and student training and mentoring, a pilot research grant-funding program, and support to access existing data. Emergent developments include an appreciation for a wider range of investigative methodologies and cross-disciplinary teams with skills to integrate research in daily practice and improve patient outcomes. By developing an integrated leadership structure and commitment to shared goals, we developed a framework for integrating academic and health service resources, leveraging additional resources, and forming a mutually beneficial partnership to improve clinical outcomes for patients. Structurally integrated academic-health service partnerships result in improved evidence-based patient care delivery and in a stronger foundation for generating new clinical knowledge, thus improving patient outcomes. © 2012 Sigma Theta Tau International.

[Public Health as an Applied, Multidisciplinary Subject: Is Research-Based Learning the Answer to Challenges in Learning and Teaching?

PubMed

Gerhardus, A; Schilling, I; Voss, M

2017-03-01

Public health education aims at enabling students to deal with complex health-related challenges using appropriate methods based on sound theoretical understanding. Virtually all health-related problems in science and practice require the involvement of different disciplines. However, the necessary interdisciplinarity is only partly reflected in the curricula of public health courses. Also theories, methods, health topics, and their application are often taught side-by-side and not together. For students, it can become an insurmountable challenge to integrate the different disciplines ("horizontal integration") and theories, methods, health topics, and their application ("vertical integration"). This situation is specific for education in public health but is representative for other interdisciplinary fields as well. Several approaches are available to achieve the horizontal integration of different disciplines and vertical integration of theories, methods, health topics, and their application. A curriculum that is structured by topics, rather than disciplines might be more successful in integrating different disciplines. Vertical integration can be achieved by research-based learning. Research-based learning places a student-led research project at the centre of teaching. Students choose a topic and a research question, raise their own questions for theories and methods and will hopefully cross the seeming chasm between science and practice. Challenges of research-based learning are enhanced demands on students, teachers and curriculum design. © Georg Thieme Verlag KG Stuttgart · New York.

Sustaining a Focus on Health Equity at the Centers for Disease Control and Prevention Through Organizational Structures and Functions.

PubMed

Dean, Hazel D; Roberts, George W; Bouye, Karen E; Green, Yvonne; McDonald, Marian

2016-01-01

The public health infrastructure required for achieving health equity is multidimensional and complex. The infrastructure should be responsive to current and emerging priorities and capable of providing the foundation for developing, planning, implementing, and evaluating health initiatives. This article discusses these infrastructure requirements by examining how they are operationalized in the organizational infrastructure for promoting health equity at the Centers for Disease Control and Prevention, utilizing the nation's premier public health agency as a lens. Examples from the history of the Centers for Disease Control and Prevention's work in health equity from its centers, institute, and offices are provided to identify those structures and functions that are critical to achieving health equity. Challenges and facilitators to sustaining a health equity organizational infrastructure, as gleaned from the Centers for Disease Control and Prevention's experience, are noted. Finally, we provide additional considerations for expanding and sustaining a health equity infrastructure, which the authors hope will serve as "food for thought" for practitioners in state, tribal, or local health departments, community-based organizations, or nongovernmental organizations striving to create or maintain an impactful infrastructure to achieve health equity.

[Evaluation auditing of the quality of health care in accreditation of health facilities].

PubMed

Paim, Chennyfer da Rosa Paino; Zucchi, Paola

2011-01-01

This article shows how many health insurance companies operating in the Greater São Paulo have been performing auditing of the quality of their health care services, professionals, and which criteria are being employed to do so. Because of the legislation decreeing that health insurance companies have legal co-responsibility for the health care services and National Health Agency control the health services National Health Agency, auditing evaluations have been implemented since then. The survey was based on electronic forms e-mailed to all health insurance companies operating in the Greater São Paulo. The sample consisted of 125 health insurance companies; 29 confirmed that had monitoring and evaluation processes; 26 performed auditing of their services regularly; from those, 20 used some type of form or protocol for technical visits; all evaluation physical and administrative structure and 22 included functional structure. Regarding the professionals audited 21 were nurses, 13 administrative assistants; 04 managers and 02 doctors. Regarding criteria for accreditation the following were highlighted: region analysis (96%), localization (88.88%) and cost (36%). We conclude that this type of auditing evaluation is rather innovative and is being gradually implemented by the health insurance companies, but is not a systematic process.

Structure, function, and engineering of enzymes in isoflavonoid biosynthesis.

PubMed

Wang, Xiaoqiang

2011-03-01

Isoflavonoids are a large group of plant natural products and play important roles in plant defense. They also possess valuable health-promoting activities with significant health benefits for animals and humans. The isoflavonoids are identified primarily in leguminous plants and are synthesized through the central phenylpropanoid pathway and the specific isoflavonoid branch pathways in legumes. Structural studies of some key enzymes in the central phenylpropanoid pathway shed light on the early stages of the (iso)flavonoid biosynthetic process. Significant impact has also been made on structural studies of enzymes in the isoflavonoid branch pathways. Structures of isoflavonoid-specific NADPH-dependent reductases revealed how the (iso)flavonoid backbones are modified by reduction reactions and how enzymes specifically recognize isoflavonoids and catalyze stereo-specific reductions. Structural studies of isoflavonoid methyltransferases and glycosyltransferases revealed how isoflavonoids are further decorated with methyl group and sugars in different methylation and glycosylation patterns that determine their bioactivities and functions. In combination with mutagenesis and biochemical studies, the detailed structural information of these enzymes provides a basis for understanding the complex biosynthetic process, enzyme catalytic mechanisms, and substrate specificities. Structure-based homology modeling facilitates the functional characterization of these large groups of biosynthetic enzymes and their homologs. Structure-based enzyme engineering is becoming a new strategy for synthesis of bioactive isoflavonoids and also facilitates plant metabolic engineering towards improvement of quality and production of crop plants.

Defect classification in sparsity-based structural health monitoring

NASA Astrophysics Data System (ADS)

Golato, Andrew; Ahmad, Fauzia; Santhanam, Sridhar; Amin, Moeness G.

2017-05-01

Guided waves have gained popularity in structural health monitoring (SHM) due to their ability to inspect large areas with little attenuation, while providing rich interactions with defects. For thin-walled structures, the propagating waves are Lamb waves, which are a complex but well understood type of guided waves. Recent works have cast the defect localization problem of Lamb wave based SHM within the sparse reconstruction framework. These methods make use of a linear model relating the measurements with the scene reflectivity under the assumption of point-like defects. However, most structural defects are not perfect points but tend to assume specific forms, such as surface cracks or internal cracks. Knowledge of the "type" of defects is useful in the assessment phase of SHM. In this paper, we present a dual purpose sparsity-based imaging scheme which, in addition to accurately localizing defects, properly classifies the defects present simultaneously. The proposed approach takes advantage of the bias exhibited by certain types of defects toward a specific Lamb wave mode. For example, some defects strongly interact with the anti-symmetric modes, while others strongly interact with the symmetric modes. We build model based dictionaries for the fundamental symmetric and anti-symmetric wave modes, which are then utilized in unison to properly localize and classify the defects present. Simulated data of surface and internal defects in a thin Aluminum plate are used to validate the proposed scheme.

Community-based oral health promotion practices targeted at children and adolescents in Finland--developing an assessment tool.

PubMed

Blomqvist, Pia; Ojala, Ellinoora; Kettunen, Tarja; Poskiparta, Marita; Kasila, Kirsti

2014-06-01

To develop an assessment tool for evaluating oral health promotion practices and to evaluate community-based oral health promotion practices targeted at children and adolescents with this tool. A theoretical framework about health promotion planning, implementation and evaluation was made on the basis of a literature review. Then, information about Finnish community-based oral health promotion practices (n=12) targeted at children and adolescents was collected using semi-structured interviews. Also, related documents, for example action plans and reports, were collected when available. Next, an assessment tool based on the theoretical framework was developed, and the recorded and transcribed interview data and other documents were evaluated with this tool. The assessment tool proved to be practical: it pointed out the strengths and weaknesses of the practices. The tool revealed strengths in the implementation and deficiencies in the planning and evaluation of oral health promotion practices. One-quarter of the 12 practices assessed could be considered 'good practices'. There is a need to improve the planning and evaluation of oral health promotion practices. The assessment tool developed in this study might be useful for practitioners both in the field of oral health promotion and general health promotion. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Ranking of healthcare programmes based on health outcome, health costs and safe delivery of care in hospital pharmacy practice.

PubMed

Brisseau, Lionel; Bussières, Jean-François; Bois, Denis; Vallée, Marc; Racine, Marie-Claude; Bonnici, André

2013-02-01

To establish a consensual and coherent ranking of healthcare programmes that involve the presence of ward-based and clinic-based clinical pharmacists, based on health outcome, health costs and safe delivery of care. This descriptive study was derived from a structured dialogue (Delphi technique) among directors of pharmacy department. We established a quantitative profile of healthcare programmes at five sites that involved the provision of ward-based and clinic-based pharmaceutical care. A summary table of evidence established a unique quality rating per inpatient (clinic-based) or outpatient (ward-based) healthcare programme. Each director rated the perceived impact of pharmaceutical care per inpatient or outpatient healthcare programme on three fields: health outcome, health costs and safe delivery of care. They agreed by consensus on the final ranking of healthcare programmes. A ranking was assigned for each of the 18 healthcare programmes for outpatient care and the 17 healthcare programmes for inpatient care involving the presence of pharmacists, based on health outcome, health costs and safe delivery of care. There was a good correlation between ranking based on data from a 2007-2008 Canadian report on hospital pharmacy practice and the ranking proposed by directors of pharmacy department. Given the often limited human and financial resources, managers should consider the best evidence available on a profession's impact to plan healthcare services within an organization. Data are few on ranking healthcare programmes in order to prioritize which healthcare programme would mostly benefit from the delivery of pharmaceutical care by ward-based and clinic-based pharmacists. © 2012 The Authors. IJPP © 2012 Royal Pharmaceutical Society.

Roots, shoots, but too little fruit: assessing the contribution of COPC in South Africa.

PubMed

Tollman, Stephen M; Pick, William M

2002-11-01

Community-oriented primary care (COPC) originated in South Africa during the 1940s and 1950s, where it served to inform local church-based and nongovernmental organization-based initiatives during the apartheid years. During the 1990s, COPC played an inspirational role in the process of national health policy formulation. Yet COPC's contribution to current health practice remains more symbolic than substantive. Despite a policy framework that favors the widespread introduction of COPC, various political, structural, managerial, and human resource obstacles constrain its effective implementation. Notwithstanding a rapidly changing health care environment and well-established health transition from infections and nutritional disorders to non-communicable diseases and injury, COPC and its variants remain abidingly relevant to South Africa's-and Africa's-health care reality.

Vibration energy harvesting based monitoring of an operational bridge undergoing forced vibration and train passage

NASA Astrophysics Data System (ADS)

Cahill, Paul; Hazra, Budhaditya; Karoumi, Raid; Mathewson, Alan; Pakrashi, Vikram

2018-06-01

The application of energy harvesting technology for monitoring civil infrastructure is a bourgeoning topic of interest. The ability of kinetic energy harvesters to scavenge ambient vibration energy can be useful for large civil infrastructure under operational conditions, particularly for bridge structures. The experimental integration of such harvesters with full scale structures and the subsequent use of the harvested energy directly for the purposes of structural health monitoring shows promise. This paper presents the first experimental deployment of piezoelectric vibration energy harvesting devices for monitoring a full-scale bridge undergoing forced dynamic vibrations under operational conditions using energy harvesting signatures against time. The calibration of the harvesters is presented, along with details of the host bridge structure and the dynamic assessment procedures. The measured responses of the harvesters from the tests are presented and the use the harvesters for the purposes of structural health monitoring (SHM) is investigated using empirical mode decomposition analysis, following a bespoke data cleaning approach. Finally, the use of sequential Karhunen Loeve transforms to detect train passages during the dynamic assessment is presented. This study is expected to further develop interest in energy-harvesting based monitoring of large infrastructure for both research and commercial purposes.

Design of a sensor network for structural health monitoring of a full-scale composite horizontal tail

NASA Astrophysics Data System (ADS)

Gao, Dongyue; Wang, Yishou; Wu, Zhanjun; Rahim, Gorgin; Bai, Shengbao

2014-05-01

The detection capability of a given structural health monitoring (SHM) system strongly depends on its sensor network placement. In order to minimize the number of sensors while maximizing the detection capability, optimal design of the PZT sensor network placement is necessary for structural health monitoring (SHM) of a full-scale composite horizontal tail. In this study, the sensor network optimization was simplified as a problem of determining the sensor array placement between stiffeners to achieve the desired the coverage rate. First, an analysis of the structural layout and load distribution of a composite horizontal tail was performed. The constraint conditions of the optimal design were presented. Then, the SHM algorithm of the composite horizontal tail under static load was proposed. Based on the given SHM algorithm, a sensor network was designed for the full-scale composite horizontal tail structure. Effective profiles of cross-stiffener paths (CRPs) and uncross-stiffener paths (URPs) were estimated by a Lamb wave propagation experiment in a multi-stiffener composite specimen. Based on the coverage rate and the redundancy requirements, a seven-sensor array-network was chosen as the optimal sensor network for each airfoil. Finally, a preliminary SHM experiment was performed on a typical composite aircraft structure component. The reliability of the SHM result for a composite horizontal tail structure under static load was validated. In the result, the red zone represented the delamination damage. The detection capability of the optimized sensor network was verified by SHM of a full-scale composite horizontal tail; all the diagnosis results were obtained in two minutes. The result showed that all the damage in the monitoring region was covered by the sensor network.

10 CFR 52.157 - Contents of applications; technical information in final safety analysis report.

Code of Federal Regulations, 2010 CFR

2010-01-01

... analysis of the structures, systems, and components of the reactor to be manufactured, with emphasis upon... assumed for this evaluation should be based upon a major accident, hypothesized for purposes of site... structures, systems, and components with the objective of assessing the risk to public health and safety...

MODELING AGGREGATE EXPOSURE AND DOSE OF CHILDREN TO A WOOD TREATMENT PRESERVATIVE FROM PLAYSETS AND HOME DECKS

EPA Science Inventory

Pressure- or non-pressure- treated lumber may pose a potential health hazard to children if the children contact certain chemicals in soils around leaching wood structures and/or in dislodgeable residues that may form on the wood surfaces of the structures. A physically-based,...

Cross-Validation of the Implementation Leadership Scale (ILS) in Child Welfare Service Organizations.

PubMed

Finn, Natalie K; Torres, Elisa M; Ehrhart, Mark G; Roesch, Scott C; Aarons, Gregory A

2016-08-01

The Implementation Leadership Scale (ILS) is a brief, pragmatic, and efficient measure that can be used for research or organizational development to assess leader behaviors and actions that actively support effective implementation of evidence-based practices (EBPs). The ILS was originally validated with mental health clinicians. This study validates the ILS factor structure with providers in community-based organizations (CBOs) providing child welfare services. Participants were 214 service providers working in 12 CBOs that provide child welfare services. All participants completed the ILS, reporting on their immediate supervisor. Confirmatory factor analyses were conducted to examine the factor structure of the ILS. Internal consistency reliability and measurement invariance were also examined. Confirmatory factor analyses showed acceptable fit to the hypothesized first- and second-order factor structure. Internal consistency reliability was strong and there was partial measurement invariance for the first-order factor structure when comparing child welfare and mental health samples. The results support the use of the ILS to assess leadership for implementation of EBPs in child welfare organizations. © The Author(s) 2016.

Structural health monitoring methodology for aircraft condition-based maintenance

NASA Astrophysics Data System (ADS)

Saniger, Jordi; Reithler, Livier; Guedra-Degeorges, Didier; Takeda, Nobuo; Dupuis, Jean Pierre

2001-06-01

Reducing maintenance costs while keeping a constant level of safety is a major issue for Air Forces and airlines. The long term perspective is to implement condition based maintenance to guarantee a constant safety level while decreasing maintenance costs. On this purpose, the development of a generalized Structural Health Monitoring System (SHMS) is needed. The objective of such a system is to localize the damages and to assess their severity, with enough accuracy to allow low cost corrective actions. The present paper describes a SHMS based on acoustic emission technology. This choice was driven by its reliability and wide use in the aerospace industry. The described SHMS uses a new learning methodology which relies on the generation of artificial acoustic emission events on the structure and an acoustic emission sensor network. The calibrated acoustic emission events picked up by the sensors constitute the knowledge set that the system relies on. With this methodology, the anisotropy of composite structures is taken into account, thus avoiding the major cause of errors of classical localization methods. Moreover, it is adaptive to different structures as it does not rely on any particular model but on measured data. The acquired data is processed and the event's location and corrected amplitude are computed. The methodology has been demonstrated and experimental tests on elementary samples presented a degree of accuracy of 1cm.

Promoting a structural view of biology for varied audiences: an overview of RCSB PDB resources and experiences

PubMed Central

Dutta, Shuchismita; Zardecki, Christine; Goodsell, David S.; Berman, Helen M.

2010-01-01

The Research Collaboratory for Structural Bioinformatics Protein Data Bank (RCSB PDB) supports scientific research and education worldwide by providing an essential resource of information on biomolecular structures. In addition to serving as a deposition, data-processing and distribution center for PDB data, the RCSB PDB offers resources and online materials that different audiences can use to customize their structural biology instruction. These include resources for general audiences that present macromolecular structure in the context of a biological theme, method-based materials for researchers who take a more traditional approach to the presentation of structural science, and materials that mix theme-based and method-based approaches for educators and students. Through these efforts the RCSB PDB aims to enable optimal use of structural data by researchers, educators and students designing and understanding experiments in biology, chemistry and medicine, and by general users making informed decisions about their life and health. PMID:20877496

New Textile Sensors for In Situ Structural Health Monitoring of Textile Reinforced Thermoplastic Composites Based on the Conductive Poly(3,4-ethylenedioxythiophene)-poly(styrenesulfonate) Polymer Complex

PubMed Central

Jerkovic, Ivona; Koncar, Vladan; Grancaric, Ana Marija

2017-01-01

Many metallic structural and non-structural parts used in the transportation industry can be replaced by textile-reinforced composites. Composites made from a polymeric matrix and fibrous reinforcement have been increasingly studied during the last decade. On the other hand, the fast development of smart textile structures seems to be a very promising solution for in situ structural health monitoring of composite parts. In order to optimize composites’ quality and their lifetime all the production steps have to be monitored in real time. Textile sensors embedded in the composite reinforcement and having the same mechanical properties as the yarns used to make the reinforcement exhibit actuating and sensing capabilities. This paper presents a new generation of textile fibrous sensors based on the conductive polymer complex poly(3,4-ethylenedioxythiophene)-poly(styrenesulfonate) developed by an original roll to roll coating method. Conductive coating for yarn treatment was defined according to the preliminary study of percolation threshold of this polymer complex. The percolation threshold determination was based on conductive dry films’ electrical properties analysis, in order to develop highly sensitive sensors. A novel laboratory equipment was designed and produced for yarn coating to ensure effective and equally distributed coating of electroconductive polymer without distortion of textile properties. The electromechanical properties of the textile fibrous sensors confirmed their suitability for in situ structural damages detection of textile reinforced thermoplastic composites in real time. PMID:28994733

Characterization and Design of Spiral Frequency Steerable Acoustic Transducers

NASA Astrophysics Data System (ADS)

Repale, Rohan

Structural Health Monitoring (SHM) is an emerging research area devoted to improving the safety and maintainability of civil structures. Guided wave structural testing method is an effective approach used for SHM of plate-like structures using piezoelectric transducers. These transducers are attached to the surface of the structure and are capable of sensing its health by using surface waves. Transducers with beam steering i.e. electronic scanning capabilities can perform surface interrogation with higher precision and ease. A frequency steerable acoustic transducer (FSAT) is capable of beam steering and directional surface wave sensing to detect and localize damage in structures. The objective of this research is to further explore the possibilities of FSAT technology by designing and testing new FSAT designs. The beam steering capability of FSAT can be controlled by manipulating its design parameters. These design parameters therefore play a significant role in FSAT's performance. Studying the design parameters and documenting the performance improvements based on parameter variation is the primary goal of this research. Design and characterization of spiral FSAT was performed and results were simulated. Array FSAT documented results were validated. Modified designs were modeled based on design parameter variations. Characterization of these designs was done and their performance was recorded. Plate simulation results confirm direct relationship between design parameters and beam steering. A set of guidelines for future designs was also proposed. Two designs developed based on the set guidelines were sent to our collaborator Genziko Inc. for fabrication.

New Textile Sensors for In Situ Structural Health Monitoring of Textile Reinforced Thermoplastic Composites Based on the Conductive Poly(3,4-ethylenedioxythiophene)-poly(styrenesulfonate) Polymer Complex.

PubMed

Jerkovic, Ivona; Koncar, Vladan; Grancaric, Ana Marija

2017-10-10

Many metallic structural and non-structural parts used in the transportation industry can be replaced by textile-reinforced composites. Composites made from a polymeric matrix and fibrous reinforcement have been increasingly studied during the last decade. On the other hand, the fast development of smart textile structures seems to be a very promising solution for in situ structural health monitoring of composite parts. In order to optimize composites' quality and their lifetime all the production steps have to be monitored in real time. Textile sensors embedded in the composite reinforcement and having the same mechanical properties as the yarns used to make the reinforcement exhibit actuating and sensing capabilities. This paper presents a new generation of textile fibrous sensors based on the conductive polymer complex poly(3,4-ethylenedioxythiophene)-poly(styrenesulfonate) developed by an original roll to roll coating method. Conductive coating for yarn treatment was defined according to the preliminary study of percolation threshold of this polymer complex. The percolation threshold determination was based on conductive dry films' electrical properties analysis, in order to develop highly sensitive sensors. A novel laboratory equipment was designed and produced for yarn coating to ensure effective and equally distributed coating of electroconductive polymer without distortion of textile properties. The electromechanical properties of the textile fibrous sensors confirmed their suitability for in situ structural damages detection of textile reinforced thermoplastic composites in real time.

Damage evaluation by a guided wave-hidden Markov model based method

NASA Astrophysics Data System (ADS)

Mei, Hanfei; Yuan, Shenfang; Qiu, Lei; Zhang, Jinjin

2016-02-01

Guided wave based structural health monitoring has shown great potential in aerospace applications. However, one of the key challenges of practical engineering applications is the accurate interpretation of the guided wave signals under time-varying environmental and operational conditions. This paper presents a guided wave-hidden Markov model based method to improve the damage evaluation reliability of real aircraft structures under time-varying conditions. In the proposed approach, an HMM based unweighted moving average trend estimation method, which can capture the trend of damage propagation from the posterior probability obtained by HMM modeling is used to achieve a probabilistic evaluation of the structural damage. To validate the developed method, experiments are performed on a hole-edge crack specimen under fatigue loading condition and a real aircraft wing spar under changing structural boundary conditions. Experimental results show the advantage of the proposed method.

Incorporation of project-based learning into an occupational health course.

PubMed

Dehdashti, Alireza; Mehralizadeh, Semira; Kashani, Masoud Motalebi

2013-01-01

Use of an appropriate teaching approach is a major concern for faculty members who are involved in occupational health and safety academic education. The challenge is to explore teaching tools to equip students with knowledge and skills to prepare them for their practices, in which they will encounter occupational health and safety issues in various occupational settings. The current study presents the design and implementation of a team project-based learning approach for undergraduate occupational health students to examine the appropriateness and perceptions of students and educators with regard to such a learning experience. Steps were taken to guide the educators and students through the learning process based on projects completed in teams. The research tools for collecting data were a questionnaire and semi-structured interviews with participants. The results illustrated that use of the proposed teaching approach as part of occupational health education may have the potential to motivate and enhance the active roles of educators and students in the learning process, and improve students' technical and social skills that are crucial for practice in the occupational health field. The study findings showed that project-based learning may provide a promising teaching strategy in the education and training of occupational health students. In addition, academic institutions should encourage educators to plan, introduce and evaluate the effectiveness of project-based learning.

[Clinical Management: Basics and organization].

PubMed

Torres, Juan; Mingo, Carlos

2015-01-01

Many strategies have been proposed over the last years to ensure the Health Care System sustainability, mainly after the recent global economic crisis. One of the most attractive approaches is clinical management, which is a way of organizing health care units based on active participation of professionals who receive the transference of responsibilities dispoto achieve the objectives with the mission of ensuring a proper patient centered care, taking into consideration the rational use of resources (Efficiency) For the start up of Health Care structures based on clinical management, it is necessary a previous management culture within the departments involved and the center's executive board. Furthermore, to achieve the objectives proposed various tools must be used, such as evidence based medicine, clinical practice variability analysis, process management, in addition of quality and safety strategies. The units involved have to propose a management plan that will result in a management contract with the center's executive board. This agreement will establish some activity, expense and quality objectives that will be quantifiable through various indicators. Risk transference to the unit must include certain budget allocation and incentive decision capacity. Clinical management must not be employed as a savings tool from the part of macro and meso management. There is not a health care structure based on clinical management that have a general character for all health care organizations, existing a great variability in the adoption of various organizational formulas, so that every center must perform its own analysis and decide the most adequate model. In our country there are many clinical management experiences, although there is a long way to go.

Development of Clinical Contents Model Markup Language for Electronic Health Records

PubMed Central

Yun, Ji-Hyun; Kim, Yoon

2012-01-01

Objectives To develop dedicated markup language for clinical contents models (CCM) to facilitate the active use of CCM in electronic health record systems. Methods Based on analysis of the structure and characteristics of CCM in the clinical domain, we designed extensible markup language (XML) based CCM markup language (CCML) schema manually. Results CCML faithfully reflects CCM in both the syntactic and semantic aspects. As this language is based on XML, it can be expressed and processed in computer systems and can be used in a technology-neutral way. Conclusions CCML has the following strengths: it is machine-readable and highly human-readable, it does not require a dedicated parser, and it can be applied for existing electronic health record systems. PMID:23115739

An Emotional Awareness Based Parenting Group for Parents with Mental Illness: A Mixed Methods Feasibility Study of Community Mental Health Nurse Facilitation.

PubMed

Isobel, Sophie; Meehan, Felicity; Pretty, Danielle

2016-02-01

There has been limited examination of the use of relationship based structured parenting programs that focus on emotional interactions in the parent-child dyad in families where a parent has a mental illness. There is also a lack of awareness of the practicalities of providing such interventions within adult mental health services. This study explores the process and outcomes of a nurse led emotional awareness based parenting program for adult clients of a mental health service. Participants demonstrated a significant reduction in difficult parenting moments and associated stress and distress as well as promising improvements in overall distress and emotional awareness. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

A Simple Demonstration of Concrete Structural Health Monitoring Framework

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mahadevan, Sankaran; Agarwal, Vivek; Cai, Guowei

Assessment and management of aging concrete structures in nuclear power plants require a more systematic approach than simple reliance on existing code margins of safety. Structural health monitoring of concrete structures aims to understand the current health condition of a structure based on heterogeneous measurements to produce high confidence actionable information regarding structural integrity that supports operational and maintenance decisions. This ongoing research project is seeking to develop a probabilistic framework for health diagnosis and prognosis of aging concrete structures in a nuclear power plant subjected to physical, chemical, environment, and mechanical degradation. The proposed framework consists of four elements—damagemore » modeling, monitoring, data analytics, and uncertainty quantification. This report describes a proof-of-concept example on a small concrete slab subjected to a freeze-thaw experiment that explores techniques in each of the four elements of the framework and their integration. An experimental set-up at Vanderbilt University’s Laboratory for Systems Integrity and Reliability is used to research effective combination of full-field techniques that include infrared thermography, digital image correlation, and ultrasonic measurement. The measured data are linked to the probabilistic framework: the thermography, digital image correlation data, and ultrasonic measurement data are used for Bayesian calibration of model parameters, for diagnosis of damage, and for prognosis of future damage. The proof-of-concept demonstration presented in this report highlights the significance of each element of the framework and their integration.« less

[A good investment: promoting health in cities and neighbourhoods].

PubMed

Díez, Elia; Aviñó, Dory; Paredes-Carbonell, Joan J; Segura, Javier; Suárez, Óscar; Gerez, Maria Dolores; Pérez, Anna; Daban, Ferran; Camprubí, Lluís

2016-11-01

Local administration is responsible for health-related areas, and evidence of the health impact of urban policies is available. Barriers and recommendations for the full implementation of health promotion in cities and neighbourhoods have been described. The barriers to the promotion of urban health are broad: the lack of leadership and political will, reflectes the allocation of health outcomes to health services, as well as technical, political and public misconceptions about the root causes of health and wellbeing. Ideologies and prejudices, non-evidence-based policies, narrow sectoral cultures, short political periods, lack of population-based health information and few opportunities for participation limit the opportunities for urban health. Local policies on early childhood, healthy schools, employment, active transport, parks, leisure and community services, housing, urban planning, food protection and environmental health have great positive impacts on health. Key tools include the political prioritisation of health and equity, the commitment to «Health in All Policies» and the participation of communities, social movements and civil society. This requires well organised and funded structures and processes, as well as equity-based health information and capacity building in the health sector, other sectors and society. We conclude that local policies have a great potential for maximising health and equity and equity. The recommendations for carrying them out are increasingly solid and feasible. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Developing Tomorrow's Integrated Community Health Systems: A Leadership Challenge for Public Health and Primary Care

PubMed Central

Welton, William E.; Kantner, Theodore A.; Katz, Sheila Moriber

1997-01-01

As the nation's health system moves away from earlier models to one grounded in population health and market-based systems of care, new challenges arise for public health professionals, primary care practitioners, health plan and institutional managers, and community leaders. Among the challenges are the need to develop creative concepts of organization and accountability and to assure that dynamic, system-oriented structures support the new kind of leadership that is required. Developing tomorrow's integrated community health systems will challenge the leadership skills and integrative abilities of public health professionals, primary care practitioners, and managers. These leaders and their new organizations must, in turn, assume increased accountability for improving community health. PMID:9184684

The case for transforming governmental public health.

PubMed

Salinsky, Eileen; Gursky, Elin A

2006-01-01

Changing threats to the public's health necessitate a profound transformation of the public health enterprise. Despite recent attention to the biodefense role of public health, policymakers have not developed a clear, realistic vision for the structure and functionality of the governmental public health system. Lack of leadership and organizational disconnects across levels of government have prevented strategic alignment of resources and undermined momentum for meaningful change. A transformed public health system is needed to address the demands of emergency preparedness and health protection. Such transformation should include focused, risk-based resource allocation; regional planning; technological upgrades; workforce restructuring; improved integration of private-sector assets; and better performance monitoring.

Chapter 16: text mining for translational bioinformatics.

PubMed

Cohen, K Bretonnel; Hunter, Lawrence E

2013-04-01

Text mining for translational bioinformatics is a new field with tremendous research potential. It is a subfield of biomedical natural language processing that concerns itself directly with the problem of relating basic biomedical research to clinical practice, and vice versa. Applications of text mining fall both into the category of T1 translational research-translating basic science results into new interventions-and T2 translational research, or translational research for public health. Potential use cases include better phenotyping of research subjects, and pharmacogenomic research. A variety of methods for evaluating text mining applications exist, including corpora, structured test suites, and post hoc judging. Two basic principles of linguistic structure are relevant for building text mining applications. One is that linguistic structure consists of multiple levels. The other is that every level of linguistic structure is characterized by ambiguity. There are two basic approaches to text mining: rule-based, also known as knowledge-based; and machine-learning-based, also known as statistical. Many systems are hybrids of the two approaches. Shared tasks have had a strong effect on the direction of the field. Like all translational bioinformatics software, text mining software for translational bioinformatics can be considered health-critical and should be subject to the strictest standards of quality assurance and software testing.

Fatigue Damage Monitoring of a Composite Step Lap Joint Using Distributed Optical Fibre Sensors

PubMed Central

Wong, Leslie; Chowdhury, Nabil; Wang, John; Chiu, Wing Kong; Kodikara, Jayantha

2016-01-01

Over the past few decades, there has been a considerable interest in the use of distributed optical fibre sensors (DOFS) for structural health monitoring of composite structures. In aerospace-related work, health monitoring of the adhesive joints of composites has become more significant, as they can suffer from cracking and delamination, which can have a significant impact on the integrity of the joint. In this paper, a swept-wavelength interferometry (SWI) based DOFS technique is used to monitor the fatigue in a flush step lap joint composite structure. The presented results will show the potential application of distributed optical fibre sensor for damage detection, as well as monitoring the fatigue crack growth along the bondline of a step lap joint composite structure. The results confirmed that a distributed optical fibre sensor is able to enhance the detection of localised damage in a structure. PMID:28773496

Gender equity and sexual and reproductive health in Eastern and Southern Africa: a critical overview of the literature.

PubMed

MacPherson, Eleanor E; Richards, Esther; Namakhoma, Ireen; Theobald, Sally

2014-01-01

Gender inequalities are important social determinants of health. We set out to critically review the literature relating to gender equity and sexual and reproductive health (SRH) in Eastern and Southern Africa with the aim of identifying priorities for action. During November 2011, we identified studies relating to SRH and gender equity through a comprehensive literature search. We found gender inequalities to be common across a range of health issues relating to SRH with women being particularly disadvantaged. Social and biological determinants combined to increase women's vulnerability to maternal mortality, HIV, and gender-based violence. Health systems significantly disadvantaged women in terms of access to care. Men fared worse in relation to HIV testing and care with social norms leading to men presenting later for treatment. Gender inequity in SRH requires multiple complementary approaches to address the structural drivers of unequal health outcomes. These could include interventions that alter the structural environment in which ill-health is created. Interventions are required both within and beyond the health system.

Study of distributed fiber-optic laser-ultrasound generation based on ghost-mode of tilted fiber Bragg gratings

NASA Astrophysics Data System (ADS)

Tian, Jiajun; Zhang, Qi; Han, Ming

2013-05-01

Fiber-optic ultrasonic transducers are an important component of an active ultrasonic testing system for structural health monitoring. Fiber-optic transducers have several advantages such as small size, light weight, and immunity to electromagnetic interference that make them much more attractive than the current available piezoelectric transducers, especially as embedded and permanent transducers in active ultrasonic testing for structural health monitoring. In this paper, a distributed fiber-optic laser-ultrasound generation based on the ghost-mode of tilted fiber Bragg gratings is studied. The influences of the laser power and laser pulse duration on the laser-ultrasound generation are investigated. The results of this paper are helpful to understand the working principle of this laser-ultrasound method and improve the ultrasonic generation efficiency.

Integration of community structure data reveals observable effects below sediment guideline thresholds in a large estuary.

PubMed

Tremblay, Louis A; Clark, Dana; Sinner, Jim; Ellis, Joanne I

2017-09-20

The sustainable management of estuarine and coastal ecosystems requires robust frameworks due to the presence of multiple physical and chemical stressors. In this study, we assessed whether ecological health decline, based on community structure composition changes along a pollution gradient, occurred at levels below guideline threshold values for copper, zinc and lead. Canonical analysis of principal coordinates (CAP) was used to characterise benthic communities along a metal contamination gradient. The analysis revealed changes in benthic community distribution at levels below the individual guideline values for the three metals. These results suggest that field-based measures of ecological health analysed with multivariate tools can provide additional information to single metal guideline threshold values to monitor large systems exposed to multiple stressors.

Wake-up transceivers for structural health monitoring of bridges

NASA Astrophysics Data System (ADS)

Kumberg, T.; Kokert, J.; Younesi, V.; Koenig, S.; Reindl, L. M.

2016-04-01

In this article we present a wireless sensor network to monitor the structural health of a large-scale highway bridge in Germany. The wireless sensor network consists of several sensor nodes that use wake-up receivers to realize latency free and low-power communication. The sensor nodes are either equipped with very accurate tilt sensor developed by Northrop Grumman LITEF GmbH or with a Novatel OEM615 GNSS receiver. Relay nodes are required to forward measurement data to a base station located on the bridge. The base station is a gateway that transmits the local measurement data to a remote server where it can be further analyzed and processed. Further on, we present an energy harvesting system to supply the energy demanding GNSS sensor nodes to realize long term monitoring.

Machine Learning for Knowledge Extraction from PHR Big Data.

PubMed

Poulymenopoulou, Michaela; Malamateniou, Flora; Vassilacopoulos, George

2014-01-01

Cloud computing, Internet of things (IOT) and NoSQL database technologies can support a new generation of cloud-based PHR services that contain heterogeneous (unstructured, semi-structured and structured) patient data (health, social and lifestyle) from various sources, including automatically transmitted data from Internet connected devices of patient living space (e.g. medical devices connected to patients at home care). The patient data stored in such PHR systems constitute big data whose analysis with the use of appropriate machine learning algorithms is expected to improve diagnosis and treatment accuracy, to cut healthcare costs and, hence, to improve the overall quality and efficiency of healthcare provided. This paper describes a health data analytics engine which uses machine learning algorithms for analyzing cloud based PHR big health data towards knowledge extraction to support better healthcare delivery as regards disease diagnosis and prognosis. This engine comprises of the data preparation, the model generation and the data analysis modules and runs on the cloud taking advantage from the map/reduce paradigm provided by Apache Hadoop.

Hungary: a health system in transition.

PubMed

Mendoza, E M; Henderson, B J

1996-03-01

Hungary has an area of 93,030 square kilometers (35,900 square miles), the size of the state of Indiana in the United States. It is landlocked by the Czech Republic and the Slovak Republic to the north, Austria to the west, Yugoslavia to the south, and Romania and the Soviet Union to the east. Although the health care system is based on the Soviet system, there have been dramatic changes since 1991, when the soviet Union and its Eastern European partners discarded their communist structures and the Soviet empire was disbanded. In this report, the current Hungarian health care system and the political structure in which it is housed will be described in terms of a key set of characteristics and their subparts. The purpose of this approach is to facilitate comparison of the Hungarian system with other national health care systems. An expanded version of this article will appear in an upcoming second edition of the College's book, International Health Care: A Framework for Comparing National Health Care Systems, by Drs. Mendoza and Henderson.

Perspectives of Patients, Clinicians, and Health System Leaders on Changes Needed to Improve the Health Care and Outcomes of Older Adults With Multiple Chronic Conditions.

PubMed

Ferris, Rosie; Blaum, Caroline; Kiwak, Eliza; Austin, Janet; Esterson, Jessica; Harkless, Gene; Oftedahl, Gary; Parchman, Michael; Van Ness, Peter H; Tinetti, Mary E

2018-06-01

To ascertain perspectives of multiple stakeholders on contributors to inappropriate care for older adults with multiple chronic conditions. Perspectives of 36 purposively sampled patients, clinicians, health systems, and payers were elicited. Data analysis followed a constant comparative method. Structural factors triggering burden and fragmentation include disease-based quality metrics and need to interact with multiple clinicians. The key cultural barrier identified is the assumption that "physicians know best." Inappropriate decision making may result from inattention to trade-offs and adherence to multiple disease guidelines. Stakeholders recommended changes in culture, structure, and decision making. Care options and quality metrics should reflect a focus on patients' priorities. Clinician-patient partnerships should reflect patients knowing their health goals and clinicians knowing how to achieve them. Access to specialty expertise should not require visits. Stakeholders' recommendations suggest health care redesigns that incorporate patients' health priorities into care decisions and realign relationships across patients and clinicians.

A 17-Month Review of the Care Model, Service Structure, and Design of THRIVE, a Community Mental Health Initiative in Northern Singapore.

PubMed

Cheang, K M; Cheok, C C S

2015-12-01

Effective delivery of psychiatric care requires the development of a range of services. The existing Singapore health care system provides a comprehensive range of psychiatric services based in restructured hospitals. The Ministry of Health Community Mental Health Masterplan (2012-2017) aims to build novel services for the community. This Masterplan envisions the development of ASCATs (Assessment Shared Care Teams) and COMITs (Community Intervention Teams) to build the capacity and capability for psychiatric care to be delivered outside the hospital in the community. A community mental health plan comprising a fast access clinic, internet-delivered self-help and building a community network of providers was devised for the North of Singapore through the THRIVE (Total Health Rich In Vitality and Energy) programme. This article provides an introduction to the care model, service structure and design of the THRIVE, and reviews its milestones and achievements from its inception in August 2012 until December 2013.

Racial and Cultural Factors Affecting the Mental Health of Asian Americans

PubMed Central

Miller, Matthew J.; Yang, Minji; Farrell, Jerome A.; Lin, Li-Ling

2011-01-01

In this study, we employed structural equation modeling to test the degree to which racism-related stress, acculturative stress, and bicultural self-efficacy were predictive of mental health in a predominantly community-based sample of 367 Asian American adults. We also tested whether bicultural self-efficacy moderated the relationship between acculturative stress and mental health. Finally, we examined whether generational status moderated the impact of racial and cultural predictors of mental health by testing our model across immigrant and U.S.-born samples. Results indicated that our hypothesized structural model represented a good fit to the total sample data. While racism-related stress, acculturative stress, and bicultural self-efficacy were significant predictors of mental health in the total sample analyses, our generational analyses revealed a differential predictive pattern across generational status. Finally, we found that the buffering effect of bicultural self-efficacy on the relationship between acculturative stress and mental health was significant for U.S.-born individuals only. Implications for research and service delivery are explored. PMID:21977934

Lean thinking in health and nursing: an integrative literature review 1

PubMed Central

Magalhães, Aline Lima Pestana; Erdmann, Alacoque Lorenzini; da Silva, Elza Lima; dos Santos, José Luís Guedes

2016-01-01

ABSTRACT Objectives: to demonstrate the scientific knowledge developed on lean thinking in health, highlighting the impact and contributions in health care and nursing. Method: an integrative literature review in the PubMed, CINAHL, Scopus, Web of Science, Emerald, LILACS and SciELO electronic library databases, from 2006 to 2014, with syntax keywords for each data base, in which 47 articles were selected for analysis. Results: the categories were developed from the quality triad proposed by Donabedian: structure, process and outcome. Lean thinking is on the rise in health surveys, particularly internationally, especially in the USA and UK, improving the structure, process and outcome of care and management actions. However, it is an emerging theme in nursing. Conclusion: this study showed that the use of lean thinking in the context of health has a transforming effect on care and organizational aspects, promoting advantages in terms of quality, safety and efficiency of health care and nursing focused on the patient. PMID:27508906

Structural health monitoring on medium rise reinforced concrete building using ambient vibration method

NASA Astrophysics Data System (ADS)

Kamarudin, A. F.; Mokhatar, S. N.; Zainal Abidin, M. H.; Daud, M. E.; Rosli, M. S.; Ibrahim, A.; Ibrahim, Z.; Noh, M. S. Md

2018-04-01

Monitoring of structural health from initial stage of building construction to its serviceability is an ideal practise to assess for any structural defects or damages. Structural integrity could be intruded by natural destruction or structural deterioration, and worse if without remedy action on monitoring, building re-assessment or maintenance is taken. In this study the application of ambient vibration (AV) testing is utilized to evaluate the health of eighth stories medium rise reinforced concrete building in Universiti Tun Hussein Onn Malaysia (UTHM), based comparison made between the predominant frequency, fo, determined in year 2012 and 2017. For determination of fo, popular method of Fourier Amplitude Spectra (FAS) was used to transform the ambient vibration time series by using 1 Hz tri-axial seismometer sensors and City SharkII data recorder. From the results, it shows the first mode frequencies from FAS curves indicate at 2.04 Hz in 2012 and 1.97 Hz in 2017 with only 3.14% of frequency reduction. However, steady state frequencies shown at the second and third modes frequencies of 2.42 Hz and 3.31 Hz by both years. Two translation mode shapes were found at the first and second mode frequencies in the North-South (NS-parallel to building transverse axis) and East-West (EsW-parallel to building longitudinal axis) components, and the torsional mode shape shows as the third mode frequency in both years. No excessive deformation amplitude was found at any selective floors based on comparison made between three mode shapes produced, that could bring to potential feature of structural deterioration. Low percentages of natural frequency disparity within five years of duration interval shown by the first mode frequencies under ambient vibration technique was considered in good health state, according to previous researchers recommendation at acceptable percentages below 5 to 10% over the years.

Research and its governance in health research institutions in sub-Saharan African countries: results of a questionnaire-based survey.

PubMed

Kebede, Derege; Zielinski, Chris; Mbondji, Peter Ebongue; Sanou, Issa; Kouvividila, Wenceslas; Lusamba-Dikassa, Paul-Samson

2014-05-01

Objective: To describe governance and stewardship of research in health research institutions in the World Health Organization (WHO) African Region. Design: A structured questionnaire was used to solicit information on governance and stewardship from health research institutions. Setting: Forty-two Member States of the WHO African Region. Participants: Key informants from the respondent health research institutions in the respondent sub-Saharan African countries. Main outcome measures: Institutions' participation in setting the national health research agenda. Institutional research priorities, scientific reviews and governance structure. Results: During the previous 12 months, the heads of 49% of respondent health research institutions participated in the setting or coordination of national research priorities. The most frequently cited priorities for contributing to or performing research were improving health programmes, producing new knowledge, influencing health policies and conducting operational research. For 78% of respondent institutions, scientific review was required for research funded directly by the institution, and for 73% of respondent institutions, scientific review was required for research not funded by the institution. However, most respondent institutions did not have written policies or guidelines, either for the scientific review of proposals (70%) or regarding conflict of interest on scientific review committees (80%). Conclusions: Some health research institutions demonstrate good practice in terms of the establishment of structures and processes for governance and stewardship, many others do not. There is a need for the strengthening of the stewardship capacity of research institutions in the Region. © The Royal Society of Medicine.

Research and its governance in health research institutions in sub-Saharan African countries: results of a questionnaire-based survey

PubMed Central

Zielinski, Chris; Mbondji, Peter Ebongue; Sanou, Issa; Kouvividila, Wenceslas; Lusamba-Dikassa, Paul-Samson

2014-01-01

Summary Objective: To describe governance and stewardship of research in health research institutions in the World Health Organization (WHO) African Region. Design: A structured questionnaire was used to solicit information on governance and stewardship from health research institutions. Setting: Forty-two Member States of the WHO African Region. Participants: Key informants from the respondent health research institutions in the respondent sub-Saharan African countries. Main outcome measures: Institutions’ participation in setting the national health research agenda. Institutional research priorities, scientific reviews and governance structure. Results: During the previous 12 months, the heads of 49% of respondent health research institutions participated in the setting or coordination of national research priorities. The most frequently cited priorities for contributing to or performing research were improving health programmes, producing new knowledge, influencing health policies and conducting operational research. For 78% of respondent institutions, scientific review was required for research funded directly by the institution, and for 73% of respondent institutions, scientific review was required for research not funded by the institution. However, most respondent institutions did not have written policies or guidelines, either for the scientific review of proposals (70%) or regarding conflict of interest on scientific review committees (80%). Conclusions: Some health research institutions demonstrate good practice in terms of the establishment of structures and processes for governance and stewardship, many others do not. There is a need for the strengthening of the stewardship capacity of research institutions in the Region. PMID:24914129

Lessons Learned in Promoting Evidence-Based Public Health: Perspectives from Managers in State Public Health Departments.

PubMed

Allen, Peg; Jacob, Rebekah R; Lakshman, Meenakshi; Best, Leslie A; Bass, Kathryn; Brownson, Ross C

2018-03-02

Evidence-based public health (EBPH) practice, also called evidence-informed public health, can improve population health and reduce disease burden in populations. Organizational structures and processes can facilitate capacity-building for EBPH in public health agencies. This study involved 51 structured interviews with leaders and program managers in 12 state health department chronic disease prevention units to identify factors that facilitate the implementation of EBPH. Verbatim transcripts of the de-identified interviews were consensus coded in NVIVO qualitative software. Content analyses of coded texts were used to identify themes and illustrative quotes. Facilitator themes included leadership support within the chronic disease prevention unit and division, unit processes to enhance information sharing across program areas and recruitment and retention of qualified personnel, training and technical assistance to build skills, and the ability to provide support to external partners. Chronic disease prevention leaders' role modeling of EBPH processes and expectations for staff to justify proposed plans and approaches were key aspects of leadership support. Leaders protected staff time in order to identify and digest evidence to address the common barrier of lack of time for EBPH. Funding uncertainties or budget cuts, lack of political will for EBPH, and staff turnover remained challenges. In conclusion, leadership support is a key facilitator of EBPH capacity building and practice. Section and division leaders in public health agencies with authority and skills can institute management practices to help staff learn and apply EBPH processes and spread EBPH with partners.

[Municipal Health Promotion in Germany: Duties, Rights and Potential].

PubMed

Walter, U; Volkenand, K

2017-04-01

Municipalities have an overarching structure in health promotion. Due to the right to self-government, municipalities are in charge of both voluntary and obligatory tasks. Some of the original and fundamental tasks can be summarized as "services to the public". Current common definitions do not include the term "health promotion". In the present study, a sub-target of a joint project, legal acts, requirements and recommendations were researched and analyzed. The results show substantive cornerstones of health promotion in various regulations of different disciplines. Based on these findings, health promotion can be interpreted as being part of services to the public. Currently the regulations for education, social tasks, environmental and consumer protection constitute the legal framework for community health promotion, but also include constitutions. They range from public international law to municipal resolutions. Quality management and also quality development are already an integral part in some communal departments. The management of structures, processes and results arises from commitments or measurable targets. In contrast, quality management for health promotion is not based on binding requirements. Specifications of other neighboring sectors (e. g. education, social sector) demonstrate the potential and effectiveness of legal policy guidelines, seen as a frame. A transparent communication about the current regulations is indispensable for formulating future guidelines. The German National Prevention Act opens opportunities for municipalities. However, its interpretation and local engagement will still guide the practice of communal health promotion. © Georg Thieme Verlag KG Stuttgart · New York.

[Social determinants of health and convergence in health agendas of regional agencies in South America].

PubMed

Díaz-Bermúdez, Ximena Pamela; Bueno, Flavia; Otero, Luis Francisco Sánchez; Auer, Annela Jean

2016-11-01

Characterize areas of interinstitutional cooperation and converging health agendas of the Pan American Health Organization/World Health Organization (PAHO/WHO), the Health Council of the Union of South American Nations (UNASUR), and the Amazon Cooperation Treaty Organization (ACTO) in South America based on social determinants of health. A qualitative study based on official documentary sources from the three organizations, using a comparative analysis of the health agendas of these agencies and the Rio Political Declaration on Social Determinants of Health (2011). Information was systematized using an analytical matrix that identifies convergences in the respective agendas. Development of the health agendas of these agencies is influenced by various international forces such as Member States' foreign policy, international cooperation strategies and models, and the institutions' political and strategic guidelines. These agendas reveal efforts to strengthen blocs, cooperation mechanisms, and coordinated programmatic actions. The agendas of PAHO/WHO, the UNASUR Health Council, and ACTO point towards opportunities for convergence in various programmatic areas, emphasizing social determinants of health. Based on the overall agreements of the Rio Declaration as an analytical framework with recommendations in five decision-making spheres, structural cooperation actions can be carried out in the region's countries, jointly mediated by these agencies.

In situ monitoring of the integrity of bonded repair patches on aircraft and civil infrastructures

NASA Astrophysics Data System (ADS)

Kumar, Amrita; Roach, Dennis; Beard, Shawn; Qing, Xinlin; Hannum, Robert

2006-03-01

Monitoring the continued health of aircraft subsystems and identifying problems before they affect airworthiness has been a long-term goal of the aviation industry. Because in-service conditions and failure modes experienced by structures are generally complex and unknown, conservative calendar-based or usage-based scheduled maintenance practices are overly time-consuming, labor-intensive and expensive. Metal structures such as helicopters and other transportation systems are likely to develop fatigue cracks under cyclic loads and corrosive service environments. Early detection of cracks is a key element to prevent catastrophic failure and prolong structural life. Furthermore, as structures age, maintenance service frequency and costs increase while performance and availability decrease. Current non-destructive inspection (NDI) techniques that can potentially be used for this purpose typically involve complex, time-intensive procedures, which are labor-intensive and expensive. Most techniques require access to the damaged area on at least one side, and sometimes on both sides. This can be very difficult for monitoring of certain inaccessible regions. In those cases, inspection may require removal of access panels or even structural disassembly. Once access has been obtained, automated inspection techniques likely will not be practical due to the bulk of the required equipment. Results obtained from these techniques may also be sensitive to the sweep speed, tool orientation, and downward pressure. This can be especially problematic for hand-held inspection tools where none of these parameters is mechanically controlled. As a result, data can vary drastically from one inspection to the next, from one technician to the next, and even from one sweep to the next. Structural health monitoring (SHM) offers the promise of a paradigm shift from schedule-driven maintenance to condition-based maintenance (CBM) of assets. Sensors embedded permanently in aircraft safety critical structures that can monitor damage can provide for improved reliability and streamlining of aircraft maintenance. Early detection of damage such as fatigue crack initiation can improve personnel safety and prolong service life. This paper presents the testing of an acousto-ultrasonic piezoelectric sensor based structural health monitoring system for real-time monitoring of fatigue cracks and disbonds in bonded repairs. The system utilizes a network of distributed miniature piezoelectric sensors/actuators embedded on a thin dielectric carrier film, to query, monitor and evaluate the condition of a structure. The sensor layers are extremely flexible and can be integrated with any type of metal or composite structure. Diagnostic signals obtained from a structure during structural monitoring are processed by a portable diagnostic unit. With appropriate diagnostic software, the signals can be analyzed to ascertain the integrity of the structure being monitored. Details on the system, its integration and examples of detection of fatigue crack and disbond growth and quantification for bonded repairs will be presented here.

[Analysis of barriers to therapeutic adherence for Colombian women with HIV/AIDS: a question of health rights].

PubMed

Arrivillaga-Quintero, Marcela

2010-01-01

To identify and analyze HIV/AIDS treatment adherence among Colombian women. A qualitative, descriptive-interpretative study with content analysis was developed between 2008 and 2009. Sixty six women participated in five focus group discussions. To complement data, semi-structured interviews with seven key informants were conducted. Main barriers are determined structurally by the current Colombian health system, based on insurance market. The right to access to treatment in a timely and continuous manner, the rights to confidentiality and non discrimination, and the right to quality care with gender focus are affected among participant women. Consequently, adherence is negatively affected. The current Colombian health system determines critical processes affecting HIV/AIDS treatment adherence in women. However, further research must be conducted to identify specific associations with non-universal health systems.

A Critical Review of Mode of Action (MOA) Assignment Classifications for Ecotoxicology

EPA Science Inventory

There are various structure-based classification schemes to categorize chemicals based on mode of action (MOA) which have been applied for both eco and human health toxicology. With increasing calls to assess thousands of chemicals, some of which have little available informatio...

AN EXAMPLE OF MODEL STRUCTURE DIFFERENCES USING SENSITIVITY ANALYSES IN PHYSIOLOGICALLY BASED PHARMACOKINETIC MODELS OF TRICHLOROETHYLENE IN HUMANS

EPA Science Inventory

Abstract Trichloroethylene (TCE) is an industrial chemical and an environmental contaminant. TCE and its metabolites may be carcinogenic and affect human health. Physiologically based pharmacokinetic (PBPK) models that differ in compartmentalization are developed for TCE metabo...

The Role of Lean Process Improvement in Implementation of Evidence-Based Practices in Behavioral Health Care.

PubMed

Steinfeld, Bradley; Scott, Jennifer; Vilander, Gavin; Marx, Larry; Quirk, Michael; Lindberg, Julie; Koerner, Kelly

2015-10-01

To effectively implement evidence-based practices (EBP) in behavioral health care, an organization needs to have operating structures and processes that can address core EBP implementation factors and stages. Lean, a widely used quality improvement process, can potentially address the factors crucial to successful implementation of EBP. This article provides an overview of Lean and the relationship between Lean process improvement steps, and EBP implementation models. Examples of how Lean process improvement methodologies can be used to help plan and carry out implementation of EBP in mental health delivery systems are presented along with limitations and recommendations for future research and clinical application.

International comparison of experience-based health state values at the population level.

PubMed

Heijink, Richard; Reitmeir, Peter; Leidl, Reiner

2017-07-07

Decision makers need to know whether health state values, an important component of summary measures of health, are valid for their target population. A key outcome is the individuals' valuation of their current health. This experience-based perspective is increasingly used to derive health state values. This study is the first to compare such experience-based valuations at the population level across countries. We examined the relationship between respondents' self-rated health as measured by the EQ-VAS, and the different dimensions and levels of the EQ-5D-3 L. The dataset included almost 32,000 survey respondents from 15 countries. We estimated generalized linear models with logit link function, including country-specific models and pooled-data models with country effects. The results showed significant and meaningful differences in the valuation of health states and individual health dimensions between countries, even though similarities were present too. Between countries, coefficients correlated positively for the values of mobility, self-care and usual activities, but not for the values of pain and anxiety, thus underlining structural differences. The findings indicate that, ideally, population-specific experience-based value sets are developed and used for the calculation of health outcomes. Otherwise, sensitivity analyses are needed. Furthermore, transferring the results of foreign studies into the national context should be performed with caution. We recommend future studies to investigate the causes of differences in experience-based health state values through a single international study possibly complemented with qualitative research on the determinants of valuation.

Perceptions of middle school educators in Hawai'i about school-based gardening and child health.

PubMed

Ahmed, Ameena T; Oshiro, Caryn E; Loharuka, Sheila; Novotny, Rachel

2011-07-01

Childhood obesity prevention is a national priority. School-based gardening has been proposed as an innovative obesity prevention intervention. Little is known about the perceptions of educators about school-based gardening for child health. As the success of a school-based intervention depends on the support of educators, we investigated perceptions of educators about the benefits of gardening programs to child health. Semi-structured interviews of 9 middle school educators at a school with a garden program in rural Hawai'i were conducted. Data were analyzed using a grounded theory approach. Perceived benefits of school-based gardening included improving children's diet, engaging children in physical activity, creating a link to local tradition, mitigating hunger, and improving social skills. Poverty was cited as a barrier to adoption of healthy eating habits. Opinions about obesity were contradictory; obesity was considered both a health risk, as well as a cultural standard of beauty and strength. Few respondents framed benefits of gardening in terms of health. In order to be effective at obesity prevention, school-based gardening programs in Hawai'i should be framed as improving diet, addressing hunger, and teaching local tradition. Explicit messages about obesity prevention are likely to alienate the population, as these are in conflict with local standards of beauty. Health researchers and advocates need to further inform educators regarding the potential connections between gardening and health.

Opportunities for and constraints to integration of health services in Poland*

PubMed Central

Sobczak, Alicja

2002-01-01

Abstract At the beginning of the article the typologies, expected outcomes and forces aiming at health care integration are discussed. Integration is recognised as a multidimensional concept. The suggested typologies of integration are based on structural configurations, co-ordination mechanisms (including clinical co-ordination), and driving forces. A review of the Polish experience in integration/disintegration of health care systems is the main part of the article. Creation of integrated health care management units (ZOZs) in the beginning of the 1970s serves as an example of structural vertical integration missing co-ordination mechanisms. ZOZs as huge, costly and inflexible organisations became subjects of public criticism and discredited the idea of health care integration. At the end of the 1980s and in the decade of the 1990s, management of public health care was decentralised, the majority of ZOZs dismantled, and many health care public providers got the status of independent entities. The private sector developed rapidly. Sickness funds, which in 1999 replaced the previous state system, introduced “quasi-market” conditions where health providers have to compete for contracts. Some providers developed strategies of vertical and horizontal integration to get a competitive advantage. Consolidation of private ambulatory clinics, the idea of “integrated care” as a “contracting package”, development of primary health care and ambulatory specialist clinics in hospitals are the examples of such strategies. The new health policy declared in 2002 has recognised integration as a priority. It stresses the development of payment mechanisms and information base (Register of Health Services – RUM) that promote integration. The Ministry of Health is involved directly in integrated emergency system designing. It seems that after years of disintegration and deregulation the need for effective integration has become obvious. PMID:16896398

Social capital and self-rated health in Colombia: the good, the bad and the ugly.

PubMed

Hurtado, David; Kawachi, Ichiro; Sudarsky, John

2011-02-01

Although there is increasing evidence supporting the associations between social capital and health, less is known of potential effects in Latin American countries. Our objective was to examine associations of different components of social capital with self-rated health in Colombia. The study had a cross-sectional design, using data of a survey applied to a nationally representative sample of 3025 respondents, conducted in 2004-2005. Stratified random sampling was performed, based on town size, urban/rural origin, age, and sex. Examined indicators of social capital were interpersonal trust, reciprocity, associational membership, non-electoral political participation, civic activities and volunteering. Principal components analysis including different indicators of social capital distinguished three components: structural-formal (associational membership and non-electoral political participation), structural-informal (civic activities and volunteering) and cognitive (interpersonal trust and reciprocity). Multilevel analyses showed no significant variations of self-rated health at the regional level. After adjusting for sociodemographic covariates, interpersonal trust was statistically significantly associated with lower odds of poor/fair health, as well as the cognitive social capital component. Members of farmers/agricultural or gender-related groups had higher odds of poor/fair health, respectively. Excluding these groups, however, associational membership was associated with lower odds of poor/fair health. Likewise, in Colombians with educational attainment higher than high school, reciprocity was associated with lower odds of fair/poor health. Nevertheless, among rural respondents non-electoral political participation was associated with worse health. In conclusion, cognitive social capital and associational membership were related to better health, and could represent important notions for health promotion. Human rights violations related to political violence and gender based discrimination may explain adverse associations with health. Copyright © 2010 Elsevier Ltd. All rights reserved.

Banking for health: opportunities in cooperation between banking and health applying innovation from other sectors.

PubMed

Kickbusch, Ilona; Krech, Rüdiger; Franz, Christian; Wells, Nadya

2018-01-01

The annual funding need for global health SDG targets is estimated by WHO at US$134 billion per year, rising to US$274-$371bn by 2030. This paper examines the challenge of making sustainable investment structures in global health more attractive for mainstream financial markets. The objective is a framework for targeted future debate with financial sector actors. Four case studies of innovative sustainable investment mechanisms are analysed, elaborating potential transfer of green and impact investment models in order to channel additional private sector funds to health. To increase private sector involvement, profit must accrue to providers of finance. The paper shows how health criteria can be incorporated into structures, which create triple bottom line return opportunities. Health infrastructure projects based on risk sharing models with governments or multilateral agencies could use long-term funding, with better credit ratings and lower cost of capital. Outcomes based investment, similar to green or social impact bonds, with third-party certification of measurable health impact, satisfy the private sector need for return with social interest objectives. Responsible investment could expand by adding a 'health' (H) criterion to the Environmental, Social and Governance (ESG) framework, implementing ESG+H for mainstream investment screening. These models are scalable, satisfy the need to dedicate funds to health and incorporate consistent critical success metrics. The conclusion finds that strong legal frameworks and exploration of fiscal incentives will be critical next steps to facilitate scaling up and broadening of interest from private sector financial actors. The impact these investments have on overall population health is a positive externality of sustainable global health investment.

Distributed health literacy among people living with type 2 diabetes in Portugal: Defining levels of awareness and support.

PubMed

Abreu, Liliana; Nunes, João Arriscado; Taylor, Peter; Silva, Susana

2018-01-01

This study embraces a patient-centred and narrative-oriented notion of health literacy, exploring how social networks and personal experiences constitute distributed health literacy (DHL) by mapping out health literacy mediators of each individual and how they enable self-management skills and knowledge of health conditions. Semi-structured interviews with 26 patients with type 2 diabetes were conducted in a Primary Care Center of Porto (Portugal) from October 2014 to December 2015. Data were collected based on McGill Illness Narrative Interview (MINI). Following the grounded theory, interviews were analysed as case-based and process-tracing-oriented. Three awareness narratives emerged: (i) a narrative of minimisation revealing minimal impact of diabetes in patients' lives and daily routines, resignation towards "inevitable" consequences of the diagnosis and dependence of a large network of health literacy mediators; (ii) a narrative of empathy, where patients tended to mention readjustments in their lives by following medical recommendations regarding medication without criticism and with few health literacy mediators; (iii) a narrative of disruption, with patients highlighting the huge impact of diabetes on their lives and their individual responsibility and autonomy with respect to the management of diabetes and the search for alternatives to medication, relying on a very restrictive network of mediators. Exploring meanings given to diagnosis, identifying health mediators and analysing the structure of social networks can contribute to understand the distributed nature of health literacy. Assessing DHL can assist health professionals and those providing care in the community in promoting health literacy and providing models for a more patient-centred health system. © 2017 John Wiley & Sons Ltd.

Examining construct and predictive validity of the Health-IT Usability Evaluation Scale: confirmatory factor analysis and structural equation modeling results

PubMed Central

Yen, Po-Yin; Sousa, Karen H; Bakken, Suzanne

2014-01-01

Background In a previous study, we developed the Health Information Technology Usability Evaluation Scale (Health-ITUES), which is designed to support customization at the item level. Such customization matches the specific tasks/expectations of a health IT system while retaining comparability at the construct level, and provides evidence of its factorial validity and internal consistency reliability through exploratory factor analysis. Objective In this study, we advanced the development of Health-ITUES to examine its construct validity and predictive validity. Methods The health IT system studied was a web-based communication system that supported nurse staffing and scheduling. Using Health-ITUES, we conducted a cross-sectional study to evaluate users’ perception toward the web-based communication system after system implementation. We examined Health-ITUES's construct validity through first and second order confirmatory factor analysis (CFA), and its predictive validity via structural equation modeling (SEM). Results The sample comprised 541 staff nurses in two healthcare organizations. The CFA (n=165) showed that a general usability factor accounted for 78.1%, 93.4%, 51.0%, and 39.9% of the explained variance in ‘Quality of Work Life’, ‘Perceived Usefulness’, ‘Perceived Ease of Use’, and ‘User Control’, respectively. The SEM (n=541) supported the predictive validity of Health-ITUES, explaining 64% of the variance in intention for system use. Conclusions The results of CFA and SEM provide additional evidence for the construct and predictive validity of Health-ITUES. The customizability of Health-ITUES has the potential to support comparisons at the construct level, while allowing variation at the item level. We also illustrate application of Health-ITUES across stages of system development. PMID:24567081

Using community-based evidence for decentralized health planning: insights from Maharashtra, India.

PubMed

Shukla, Abhay; Khanna, Renu; Jadhav, Nitin

2018-01-01

Health planning is generally considered a technical subject, primarily the domain of health officials with minimal involvement of community representatives. The National Rural Health Mission launched in India in 2005 recognized this gap and mandated mechanisms for decentralized health planning. However, since planning develops in the context of highly unequal power relations, formal spaces for participation are necessary but not sufficient. Hence a project on capacity building for decentralized health planning was implemented in selected districts of Maharashtra, India during 2010-13. This process developed on the platform of officially supported community-based monitoring and planning, a process for community feedback and participation towards health system change. A specific project on capacity building for decentralized planning included a structured learning course and workshops for major stakeholders. An evaluation of the project, including in-depth interviews of various participants and analysis of change in local health planning processes, revealed positive changes in intervention areas, including increased capacity of key stakeholders leading to preparation of evidence-based, innovative planning proposals, significant community oriented changes in utilization of health facility funds, and inclusion of community-based proposals in village, health facility-based block and district plans. Transparency related to planning increased along with responsiveness of health providers to community suggestions. A key lesson is that active facilitation of decentralized health planning and influencing the health system to expand participation, are essential to ensure changes in planning. Effective strategies included: identifying people's health service related priorities through community-based monitoring, capacity building of diverse stakeholders regarding local health planning, and advocacy to enable participation of community-based actors in the planning process. This combination of strategies draws upon the framework of 'empowered participatory governance' which necessitates combining a degree of 'countervailing power' and acceptance of participation by the system, for new forms of governance to emerge. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Self-learning health monitoring algorithm in composite structures

NASA Astrophysics Data System (ADS)

Grassia, Luigi; Iannone, Michele; Califano, America; D'Amore, Alberto

2018-02-01

The paper describes a system that it is able of monitoring the health state of a composite structure in real time. The hardware of the system consists of a wire of strain sensors connected to a control unit. The software of the system elaborates the strain data and in real time is able to detect the presence of an eventual damage of the structures monitored with the strain sensors. The algorithm requires as input only the strains of the monitored structured measured on real time, i.e. those strains coming from the deformations of the composite structure due to the working loads. The health monitoring system does not require any additional device to interrogate the structure as often used in the literature, instead it is based on a self-learning procedure. The strain data acquired when the structure is healthy are used to set up the correlations between the strain in different positions of structure by means of neural network. Once the correlations between the strains in different position have been set up, these correlations act as a fingerprint of the healthy structure. In case of damage the correlation between the strains in the position of the structure near the damage will change due to the change of the stiffness of the structure caused by the damage. The developed software is able to recognize the change of the transfer function between the strains and consequently is able to detect the damage.

Practice to Evidence: Using Evaluability Assessment to Generate Practice-Based Evidence in Rural South Georgia

ERIC Educational Resources Information Center

Honeycutt, Sally; Hermstad, April; Carvalho, Michelle L.; Arriola, Kimberly R. Jacob; Ballard, Denise; Escoffery, Cam; Kegler, Michelle C.

2017-01-01

Evidence from formal evaluation of real-world practice can address gaps in the public health knowledge base and provide information about feasible, relevant strategies for varied settings. Interest in evaluability assessment (EA) as an approach for generating practice-based evidence has grown. EA has been central to several structured assessment…

Promoting Community Health and Eliminating Health Disparities Through Community-Based Participatory Research.

PubMed

Xia, Ruiping; Stone, John R; Hoffman, Julie E; Klappa, Susan G

2016-03-01

In physical therapy, there is increasing focus on the need at the community level to promote health, eliminate disparities in health status, and ameliorate risk factors among underserved minorities. Community-based participatory research (CBPR) is the most promising paradigm for pursuing these goals. Community-based participatory research stresses equitable partnering of the community and investigators in light of local social, structural, and cultural elements. Throughout the research process, the CBPR model emphasizes coalition and team building that joins partners with diverse skills/expertise, knowledge, and sensitivities. This article presents core concepts and principles of CBPR and the rationale for its application in the management of health issues at the community level. Community-based participatory research is now commonly used to address public health issues. A literature review identified limited reports of its use in physical therapy research and services. A published study is used to illustrate features of CBPR for physical therapy. The purpose of this article is to promote an understanding of how physical therapists could use CBPR as a promising way to advance the profession's goals of community health and elimination of health care disparities, and social responsibility. Funding opportunities for the support of CBPR are noted. © 2016 American Physical Therapy Association.

Workplace-based health and wellness programs: the intersection of aging, work, and health.

PubMed

Pitt-Catsouphes, Marcie; James, Jacquelyn Boone; Matz-Costa, Christina

2015-04-01

Workplace-based health and wellness programs (HWPs) may be an obvious yet under-utilized strategy for promoting positive health-related behaviors among older workers and for increasing their ability to continue to work. Given the unprecedented number of older adults who extend their labor force attachment beyond traditional retirement ages, a new vision of older adults' economic security and overall quality-of-life should take into account the intersections of aging, work, and health. The purpose of this article is to: (a) discuss the workplace as an increasingly important setting that can expand the reach and effectiveness of health promotion efforts; (b) examine current knowledge of barriers and facilitators that can affect older workers' participation in workplace-based HWPs; and (c) suggest new incentive structures that may increase older workers' engagement in these programs. We develop a rationale for our proposition that sustained participation in HWPs may improve the health status of older workers and reduce health care costs. It is our conclusion that there is significant potential for workplace-based HWPs to support older adults who want to or need to work. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Probabilistic modeling of condition-based maintenance strategies and quantification of its benefits for airliners

NASA Astrophysics Data System (ADS)

Pattabhiraman, Sriram

Airplane fuselage structures are designed with the concept of damage tolerance, wherein small damage are allowed to remain on the airplane, and damage that otherwise affect the safety of the structure are repaired. The damage critical to the safety of the fuselage are repaired by scheduling maintenance at pre-determined intervals. Scheduling maintenance is an interesting trade-off between damage tolerance and cost. Tolerance of larger damage would require less frequent maintenance and hence, a lower cost, to maintain a certain level of reliability. Alternatively, condition-based maintenance techniques have been developed using on-board sensors, which track damage continuously and request maintenance only when the damage size crosses a particular threshold. This effects a tolerance of larger damage than scheduled maintenance, leading to savings in cost. This work quantifies the savings of condition-based maintenance over scheduled maintenance. The work also quantifies converting the cost savings into weight savings. Structural health monitoring will need time to be able to establish itself as a stand-alone system for maintenance, due to concerns on its diagnosis accuracy and reliability. This work also investigates the effect of synchronizing structural health monitoring system with scheduled maintenance. This work uses on-board SHM equipment skip structural airframe maintenance (a subsect of scheduled maintenance), whenever deemed unnecessary while maintain a desired level of safety of structure. The work will also predict the necessary maintenance for a fleet of airplanes, based on the current damage status of the airplanes. The work also analyses the possibility of false alarm, wherein maintenance is being requested with no critical damage on the airplane. The work use SHM as a tool to identify lemons in a fleet of airplanes. Lemons are those airplanes that would warrant more maintenance trips than the average behavior of the fleet.

The Exploration Atmospheres Working Group's Report on Space Radiation Shielding Materials

NASA Technical Reports Server (NTRS)

Barghouty, A. F.; Thibeault, S. A.

2006-01-01

This part of Exploration Atmospheres Working Group analyses focuses on the potential use of nonmetallic composites as the interior walls and structural elements exposed to the atmosphere of the spacecraft or habitat. The primary drive to consider nonmetallic, polymer-based composites as an alternative to aluminum structure is due to their superior radiation shielding properties. But as is shown in this analysis, these composites can also be made to combine superior mechanical properties with superior shielding properties. In addition, these composites can be made safe; i.e., with regard to flammability and toxicity, as well as "smart"; i.e., embedded with sensors for the continuous monitoring of material health and conditions. The analysis main conclusions are that (1) smart polymer-based composites are an enabling technology for safe and reliable exploration missions, and (2) an adaptive, synergetic systems approach is required to meet the missions requirements from structure, properties, and processes to crew health and protection for exploration missions.

Driving with roadmaps and dashboards: using information resources to structure the decision models in service organizations.

PubMed

Chorpita, Bruce F; Bernstein, Adam; Daleiden, Eric L

2008-03-01

This paper illustrates the application of design principles for tools that structure clinical decision-making. If the effort to implement evidence-based practices in community services organizations is to be effective, attention must be paid to the decision-making context in which such treatments are delivered. Clinical research trials commonly occur in an environment characterized by structured decision making and expert supports. Technology has great potential to serve mental health organizations by supporting these potentially important contextual features of the research environment, through organization and reporting of clinical data into interpretable information to support decisions and anchor decision-making procedures. This article describes one example of a behavioral health reporting system designed to facilitate clinical and administrative use of evidence-based practices. The design processes underlying this system-mapping of decision points and distillation of performance information at the individual, caseload, and organizational levels-can be implemented to support clinical practice in a wide variety of settings.

Commercial insurance vs community-based health plans: time for a policy option with clinical emphasis to address the cost spiral.

PubMed

Amundson, Bruce

2005-01-01

The nation continues its ceaseless struggle with the spiraling cost of health care. Previous efforts (regulation, competition, voluntary action) have included almost every strategy except clinical. Insurers have largely failed in their cost-containment efforts. There is a strong emerging body of literature that demonstrates the relationship between various clinical strategies and reductions in utilization and costs. This article describes the organization of health services, including integration of delivery and financing systems, at the community level as a model that effectively addresses the critical structural flaws that have frustrated control of costs. Community-based health plans (CHPs) have been developed and have demonstrated viability. The key elements of CHPs are a legal organizational structure, a full provider network, advanced care-management systems, and the ability to assume financial risk. Common misconceptions regarding obstacles to CHP development are the complexity of the undertaking, difficulty assuming the insurance function, and insured pools that are too small to be viable. The characteristics of successful CHPs and 2 case studies are described, including the types of advanced care-management systems that have resulted in strong financial performance. The demonstrated ability of CHPs to establish financial viability with small numbers of enrollees challenges the common assumption that there is a fixed relationship between health plan enrollment size and financial performance. Organizing the health system at the community/regional level provides an attractive alternative model in the health-reform debate. There is an opportunity for clinical systems and state and federal leaders to support the development of community-based integrated delivery and financing system models that, among other advantages, have significant potential to modulate the pernicious cost spiral.

Physicians' and nurses' attitudes towards performance-based financial incentives in Burundi: a qualitative study in the province of Gitega.

PubMed

Rudasingwa, Martin; Uwizeye, Marie Rose

2017-01-01

Performance-based financing (PBF) was first implemented in Burundi in 2006 as a pilot programme in three provinces and was rolled out nationwide in 2010. PBF is a reform approach to improve the quality, quantity, and equity of health services and aims at achieving universal health coverage. It focuses on how to best motivate health practitioners. To elicit physicians' and nurses' experiences and views on how PBF influenced and helped them in healthcare delivery. A qualitative cross-sectional study was carried out among frontline health workers such as physicians and nurses. The data was gathered through individual face-to-face, in-depth, semi-structured interviews with 6 physicians and 30 nurses from February to March 2011 in three hospitals in Gitega Province. A simple framework approach and thematic analysis using a combination of manual technique and MAXQDA software guided the analysis of the interview data. Overall, the interviewees felt that the PBF scheme had provided positive motivation to improve the quality of care, mainly in the structures and process of care. The utilization of health services and the relationship between health practitioners and patients also improved. The salary top-ups were recognized as the most significant impetus to increase effort in improving the quality of care. The small and sometimes delayed financial incentives paid to physicians and nurses were criticized. The findings of this study also indicate that the positive interaction between performance-based incentive schemes and other health policies is crucial in achieving comprehensive improvement in healthcare delivery. PBF has the potential to motivate medical staff to improve healthcare provision. The views of medical staff and the context of the area of implementation have to be taken into consideration when designing and implementing PBF schemes.

Structural Health Monitoring of a Composite Panel Based on PZT Sensors and a Transfer Impedance Framework.

PubMed

Dziendzikowski, Michal; Niedbala, Patryk; Kurnyta, Artur; Kowalczyk, Kamil; Dragan, Krzysztof

2018-05-11

One of the ideas for development of Structural Health Monitoring (SHM) systems is based on excitation of elastic waves by a network of PZT piezoelectric transducers integrated with the structure. In the paper, a variant of the so-called Transfer Impedance (TI) approach to SHM is followed. Signal characteristics, called the Damage Indices (DIs), were proposed for data presentation and analysis. The idea underlying the definition of DIs was to maintain most of the information carried by the voltage induced on PZT sensors by elastic waves. In particular, the DIs proposed in the paper should be sensitive to all types of damage which can influence the amplitude or the phase of the voltage induced on the sensor. Properties of the proposed DIs were investigated experimentally using a GFRP composite panel equipped with PZT networks attached to its surface and embedded into its internal structure. Repeatability and stability of DI indications under controlled conditions were verified in tests. Also, some performance indicators for surface-attached and structure-embedded sensors were obtained. The DIs' behavior was dependent mostly on the presence of a simulated damage in the structure. Anisotropy of mechanical properties of the specimen, geometrical properties of PZT network as well as, to some extent, the technology of sensor integration with the structure were irrelevant for damage indication. This property enables the method to be used for damage detection and classification.

The right location? Experiences of refugee adolescents seen by school-based mental health services.

PubMed

Fazel, Mina; Garcia, Jo; Stein, Alan

2016-07-01

Access to needed mental health services can be particularly difficult for newly arrived refugee and asylum-seeking adolescents, although many attend school. This study examined young refugees' impressions and experience of mental health services integrated within the school system. Semi-structured interviews were conducted with 40 adolescent refugees discharged by three school-based mental health services across the United Kingdom. Two-thirds preferred to be seen at school. Rumination and worry about insecurity in the asylum process had a negative impact particularly on the adolescents' social functioning and ability to focus at school. The important role played by teachers in supporting and mediating contact with mental health services was valued by those interviewed. The study confirms that schools offer an important location for mental health services for adolescent refugees and provide an important portal for integration of services. © The Author(s) 2016.

Quality of Mental Health Care for Nursing Home Residents: A Literature Review

PubMed Central

Grabowski, David C.; Aschbrenner, Kelly A.; Rome, Vincent F.; Bartels, Stephen J.

2010-01-01

Because of the high proportion of nursing home residents with a mental illness other than dementia, the quality of mental health care in nursing homes is a major clinical and policy issue. The authors apply Donabedian's framework for assessing quality of care based on the triad of structure, process, and outcome-based measures in reviewing the literature on the quality of mental health care in nursing homes. Quality measures used within the literature include mental health consultations and hospitalizations, inappropriate use of medications, and mental health survey deficiencies. Factors related to the resident's welfare (nurse staffing), provider norms (locality), and financial factors (payer mix) were associated with the quality of mental health care. Although future research is necessary, the extant literature suggests that persons with mental illness are frequently admitted to nursing homes and their care is often of poor quality and related to a series of resident and facility factors. PMID:20223943

Perception of primary school teachers to school children's mental health problems in Southwest Ethiopia.

PubMed

Kerebih, Habtamu; Abrha, Hailay; Frank, Reiner; Abera, Mubarek

2016-11-12

Teachers perception of child mental health problems and their attitude to school-based mental health services helps in designing early intervention strategies aimed at promoting the service. However, little is known in this regard among primary school teachers in Ethiopia. Therefore, this study assessed perceptions and attitude of primary school teachers to child mental health problem and school-based mental health programs in Jimma town, southwest Ethiopia in 2013. A cross-sectional study design was implemented among 568 primary school teachers in Jimma town, from 1 to 30 October 2013. Perceptions and attitude of teachers to children with mental health problems and school mental health related information were assessed using a structured self- administered questionnaire. About 40% of teachers recognized the list of psychopathology items presented to them as child mental health problems while 54.4% of them rated child mental health problem as severe. Externalizing behaviors were perceived as the most severe problems. Teaching experience and teaching in public schools were significantly associated with the perception of severe type of child mental health problems. About 95% of teachers acknowledged that school-based mental health programs are important but limited availability was reported. Despite the high problem severity ratings, teachers' perception of the psychopathology as a mental health problem in children was low. There was also a favorable attitude on the importance and the need of school-based child mental health programs. Thus, creating mental health awareness for teachers and establishing school mental health services to intervene in child mental health problem is crucial.

Nursing domain of CI governance: recommendations for health IT adoption and optimization.

PubMed

Collins, Sarah A; Alexander, Dana; Moss, Jacqueline

2015-05-01

There is a lack of recommended models for clinical informatics (CI) governance that can facilitate successful health information technology implementation. To understand existing CI governance structures and provide a model with recommended roles, partnerships, and councils based on perspectives of nursing informatics leaders. We conducted a cross-sectional study through administering a survey via telephone to facilitate semistructured interviews from June 2012 through November 2012. We interviewed 12 nursing informatics leaders, across the United States, currently serving in executive- or director-level CI roles at integrated health care systems that have pioneered electronic health records implementation projects. We found the following 4 themes emerge: (1) Interprofessional partnerships are essential. (2) Critical role-based levels of practice and competencies need to be defined. (3) Integration into existing clinical infrastructure facilitates success. (4) CI governance is an evolving process. We described specific lessons learned and a model of CI governance with recommended roles, partnerships, and councils from the perspective of nursing informatics leaders. Applied CI work is highly interprofessional with patient safety implications that heighten the need for best practice models for governance structures, adequate resource allocation, and role-based competencies. Overall, there is a notable lack of a centralized CI group comprised of formally trained informaticians to provide expertise and promote adherence to informatics principles within EHR implementation governance structures. Our model of the nursing domain of CI governance with recommended roles, partnerships, and councils provides a starting point that should be further explored and validated. Not only can the model be used to understand, shape, and standardize roles, competencies, and structures within CI practice for nursing, it can be used within other clinical domains and by other informaticians. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Intervention mapping protocol for developing a theory-based diabetes self-management education program.

PubMed

Song, Misoon; Choi, Suyoung; Kim, Se-An; Seo, Kyoungsan; Lee, Soo Jin

2015-01-01

Development of behavior theory-based health promotion programs is encouraged with the paradigm shift from contents to behavior outcomes. This article describes the development process of the diabetes self-management program for older Koreans (DSME-OK) using intervention mapping (IM) protocol. The IM protocol includes needs assessment, defining goals and objectives, identifying theory and determinants, developing a matrix to form change objectives, selecting strategies and methods, structuring the program, and planning for evaluation and pilot testing. The DSME-OK adopted seven behavior objectives developed by the American Association of Diabetes Educators as behavioral outcomes. The program applied an information-motivation-behavioral skills model, and interventions were targeted to 3 determinants to change health behaviors. Specific methods were selected to achieve each objective guided by IM protocol. As the final step, program evaluation was planned including a pilot test. The DSME-OK was structured as the 3 determinants of the IMB model were intervened to achieve behavior objectives in each session. The program has 12 weekly 90-min sessions tailored for older adults. Using the IM protocol in developing a theory-based self-management program was beneficial in terms of providing a systematic guide to developing theory-based and behavior outcome-focused health education programs.

Using an integrated knowledge translation approach to build a public health research agenda

PubMed Central

2014-01-01

Background Public Health Systems Research is an emerging field of research that is gaining importance in Canada. Methods On October 22 and 23, 2012, public health researchers, practitioners, and policy-makers came together at the Accelerating Public Health Systems Research in Ontario: Building an Agenda think tank to develop a research agenda for the province. Results This agenda included the identification of the six top priorities for research in Ontario: public health performance, evidence-based practice, public health organization and structure, public health human resources, public health infrastructure, and partnerships/linkages. Conclusions This paper explores the priorities in detail and hopes to bring more attention to this area of research. PMID:24475759

Prison Health Care Governance: Guaranteeing Clinical Independence

PubMed Central

Pont, Jörg; Enggist, Stefan; Stöver, Heino; Williams, Brie; Greifinger, Robert

2018-01-01

Clinical independence is an essential component of good health care and health care professionalism, particularly in correctional settings (jails, prisons, and other places of detention), where the relationship between patients and caregivers is not based on free choice and where the punitive correctional setting can challenge optimal medical care. Independence for the delivery of health care services is defined by international standards as a critical element for quality health care in correctional settings, yet many correctional facilities do not meet these standards because of a lack of awareness, persisting legal regulations, contradictory terms of employment for health professionals, or current health care governance structures. We present recommendations for the implementation of independent health care in correctional settings. PMID:29470125

Developing a Comprehensive Animal Care Occupational Health and Safety Program at a Land-Grant Institution

PubMed Central

Goodly, Lyndon J; Jarrell, Vickie L; Miller, Monica A; Banks, Maureen C; Anderson, Thomas J; Branson, Katherine A; Woodward, Robert T; Peper, Randall L; Myers, Sara J

2016-01-01

The Public Health Service Policy on the Humane Care and Use of Laboratory Animals and sound ethical practices require institutions to provide safe working environments for personnel working with animals; this mandate is achieved in part by establishing an effective animal care Occupational Health and Safety Program (OHSP). Land-grant institutions often face unique organizational challenges in fulfilling this requirement. For example, responsibilities for providing health and safety programs often have historically been dispersed among many different divisions scattered around the campus. Here we describe how our institutional management personnel overcame organizational structure and cultural obstacles during the formation of a comprehensive campus-wide animal care OHSP. Steps toward establishing the animal care OHSP included assigning overall responsibility, identifying all stakeholders, creating a leadership group, and hiring a fulltime Animal Care OHSP Specialist. A web-based portal was developed, implemented, and refined over the past 7 y and reflected the unique organizational structures of the university and the needs of our research community. Through this web-based portal, hazards are identified, risks are assessed, and training is provided. The animal care OHSP now provides easy mandatory enrollment, supports timely feedback regarding hazards, and affords enrollees the opportunity to participate in voluntary medical surveillance. The future direction and development of the animal care OHSP will be based on the research trends of campus, identification of emerging health and safety hazards, and ongoing evaluation and refinement of the program. PMID:26817980

Developing a Comprehensive Animal Care Occupational Health and Safety Program at a Land-Grant Institution.

PubMed

Goodly, Lyndon J; Jarrell, Vickie L; Miller, Monica A; Banks, Maureen C; Anderson, Thomas J; Branson, Katherine A; Woodward, Robert T; Peper, Randall L; Myers, Sara J

2016-01-01

The Public Health Service Policy on the Humane Care and Use of Laboratory Animals and sound ethical practices require institutions to provide safe working environments for personnel working with animals; this mandate is achieved in part by establishing an effective animal care Occupational Health and Safety Program (OHSP). Land-grant institutions often face unique organizational challenges in fulfilling this requirement. For example, responsibilities for providing health and safety programs often have historically been dispersed among many different divisions scattered around the campus. Here we describe how our institutional management personnel overcame organizational structure and cultural obstacles during the formation of a comprehensive campus-wide animal care OHSP. Steps toward establishing the animal care OHSP included assigning overall responsibility, identifying all stakeholders, creating a leadership group, and hiring a fulltime Animal Care OHSP Specialist. A web-based portal was developed, implemented, and refined over the past 7 y and reflected the unique organizational structures of the university and the needs of our research community. Through this web-based portal, hazards are identified, risks are assessed, and training is provided. The animal care OHSP now provides easy mandatory enrollment, supports timely feedback regarding hazards, and affords enrollees the opportunity to participate in voluntary medical surveillance. The future direction and development of the animal care OHSP will be based on the research trends of campus, identification of emerging health and safety hazards, and ongoing evaluation and refinement of the program.

Module-based comprehensive approach for addressing heterogeneous mental health sequelae of violent loss survivors.

PubMed

Rheingold, Alyssa A; Williams, Joah L

2018-03-01

Significant strides have been made in the trauma and grief fields to address the unique needs of those who have lost a loved one to violent death. Several treatment techniques have been found to be effective for symptoms of trauma and grief that are prevalent among violent loss survivors including restorative retelling and cognitive behavioral strategies. Current interventions either are tailored for a specific mental health problem or are more universal in nature for grief related to violent loss. This paper presents an evidence-based and guided modular approach for responding to the myriad potential mental health needs of violent loss survivors. A comprehensive module-based structured intervention for violent loss survivors, which specifically targets several common mental health difficulties following traumatic loss, may offer clinicians a thorough and flexible approach guided by clinical assessment to address the distinctive and common issues violent loss survivors often face.

Health care use and costs of adverse drug events emerging from outpatient treatment in Germany: a modelling approach.

PubMed

Stark, Renee G; John, Jürgen; Leidl, Reiner

2011-01-13

This study's aim was to develop a first quantification of the frequency and costs of adverse drug events (ADEs) originating in ambulatory medical practice in Germany. The frequencies and costs of ADEs were quantified for a base case, building on an existing cost-of-illness model for ADEs. The model originates from the U.S. health care system, its structure of treatment probabilities linked to ADEs was transferred to Germany. Sensitivity analyses based on values determined from a literature review were used to test the postulated results. For Germany, the base case postulated that about 2 million adults ingesting medications have will have an ADE in 2007. Health care costs related to ADEs in this base case totalled 816 million Euros, mean costs per case were 381 Euros. About 58% of costs resulted from hospitalisations, 11% from emergency department visits and 21% from long-term care. Base case estimates of frequency and costs of ADEs were lower than all estimates of the sensitivity analyses. The postulated frequency and costs of ADEs illustrate the possible size of the health problems and economic burden related to ADEs in Germany. The validity of the U.S. treatment structure used remains to be determined for Germany. The sensitivity analysis used assumptions from different studies and thus further quantified the information gap in Germany regarding ADEs. This study found costs of ADEs in the ambulatory setting in Germany to be significant. Due to data scarcity, results are only a rough indication.

Development of a Health Information Technology Acceptance Model Using Consumers’ Health Behavior Intention

PubMed Central

2012-01-01

Background For effective health promotion using health information technology (HIT), it is mandatory that health consumers have the behavioral intention to measure, store, and manage their own health data. Understanding health consumers’ intention and behavior is needed to develop and implement effective and efficient strategies. Objective To develop and verify the extended Technology Acceptance Model (TAM) in health care by describing health consumers’ behavioral intention of using HIT. Methods This study used a cross-sectional descriptive correlational design. We extended TAM by adding more antecedents and mediating variables to enhance the model’s explanatory power and to make it more applicable to health consumers’ behavioral intention. Additional antecedents and mediating variables were added to the hypothetical model, based on their theoretical relevance, from the Health Belief Model and theory of planned behavior, along with the TAM. We undertook structural equation analysis to examine the specific nature of the relationship involved in understanding consumers’ use of HIT. Study participants were 728 members recruited from three Internet health portals in Korea. Data were collected by a Web-based survey using a structured self-administered questionnaire. Results The overall fitness indices for the model developed in this study indicated an acceptable fit of the model. All path coefficients were statistically significant. This study showed that perceived threat, perceived usefulness, and perceived ease of use significantly affected health consumers’ attitude and behavioral intention. Health consumers’ health status, health belief and concerns, subjective norm, HIT characteristics, and HIT self-efficacy had a strong indirect impact on attitude and behavioral intention through the mediators of perceived threat, perceived usefulness, and perceived ease of use. Conclusions An extended TAM in the HIT arena was found to be valid to describe health consumers’ behavioral intention. We categorized the concepts in the extended TAM into 3 domains: health zone, information zone, and technology zone. PMID:23026508

Development of a health information technology acceptance model using consumers' health behavior intention.

PubMed

Kim, Jeongeun; Park, Hyeoun-Ae

2012-10-01

For effective health promotion using health information technology (HIT), it is mandatory that health consumers have the behavioral intention to measure, store, and manage their own health data. Understanding health consumers' intention and behavior is needed to develop and implement effective and efficient strategies. To develop and verify the extended Technology Acceptance Model (TAM) in health care by describing health consumers' behavioral intention of using HIT. This study used a cross-sectional descriptive correlational design. We extended TAM by adding more antecedents and mediating variables to enhance the model's explanatory power and to make it more applicable to health consumers' behavioral intention. Additional antecedents and mediating variables were added to the hypothetical model, based on their theoretical relevance, from the Health Belief Model and theory of planned behavior, along with the TAM. We undertook structural equation analysis to examine the specific nature of the relationship involved in understanding consumers' use of HIT. Study participants were 728 members recruited from three Internet health portals in Korea. Data were collected by a Web-based survey using a structured self-administered questionnaire. The overall fitness indices for the model developed in this study indicated an acceptable fit of the model. All path coefficients were statistically significant. This study showed that perceived threat, perceived usefulness, and perceived ease of use significantly affected health consumers' attitude and behavioral intention. Health consumers' health status, health belief and concerns, subjective norm, HIT characteristics, and HIT self-efficacy had a strong indirect impact on attitude and behavioral intention through the mediators of perceived threat, perceived usefulness, and perceived ease of use. An extended TAM in the HIT arena was found to be valid to describe health consumers' behavioral intention. We categorized the concepts in the extended TAM into 3 domains: health zone, information zone, and technology zone.

[Theoretical grounds of a structural and functional model for quality assurance of radiation diagnostics under conditions of development of the modern health care system in Ukraine].

PubMed

Korop, Oleg A; Lenskykh, Sergiy V

2018-01-01

Introduction: Modern changes in the health care system of Ukraine are focused on financial support in providing medical and diagnostic care to the population and are based on deep and consistent structural and functional transformations. They are aimed at providing adequate quality care, which is the main target function and a principal criterion for operation of health care system. The urgency of this problem is increasing in the context of reforming the health care system and global changes in the governmental financial guarantees for the provision of medical services to the population. The aim of the work is to provide theoretical grounds for a structural and functional model of quality assurance of radiation diagnostics at all levels of medical care given to the population under the current health care reform in Ukraine. Materials and methods: The object of the study is organizing the operation of the radiation diagnostic service; the information is based on the actual data on the characteristics of radiation diagnosis at different levels of medical care provision. Methods of systematic approach, system analysis and structural and functional analysis of the operating system of radiation diagnostics are used. Review: The basis of the quality assurance model is the cyclical process, which includes the stages of the problem identifition, planning of its solution, organization of the system for implementation of decisions, monitoring the quality management process of the radiation diagnostics, and factors influencing the quality of the radiation diagnostics service. These factors include the quality of the structure, process, results, organization of management and control of current processes and the results of radiation diagnostics management. Conclusions: The advantages of the proposed model for ensuring the quality of the radiation diagnostics service are its systemacy and complexity, elimination of identified defects and deficiencies, and achievement of profitability through modern redistribution and use of existing resources of the health care system. The results of adequate service quality management activities in radiation diagnostics are the improvement of organizational and economic principles along with legislative regulation, the implementation of a modern system of radiation diagnostics in the state health care at the national and regional levels, the increase of the accessibility, quality and efficiency of the radiation diagnostics service.

Competency-based curriculum and active methodology: perceptions of nursing students.

PubMed

Paranhos, Vania Daniele; Mendes, Maria Manuela Rino

2010-01-01

This study identifies the perceptions of undergraduate students at the University of São Paulo at Ribeirão Preto, Brazil, College of Nursing (EERP-USP) concerning the teaching-learning process in two courses: Integrated Seminar: Health-Disease/Care Process in Health Services Policies and Organization, which was offered to first-year students in 2005 and 2006 and Integrality in Health Care I and II, which was offered to second-year students in 2006. The courses proposal was to adopt active methodology and competency-based curriculum. Data were collected from written tests submitted to 62 students at the end of the curse, focusing on the tests pertinence, development of performance, structure and pedagogical dynamics, organization and settings. Thematic analysis indicated that students enjoyed the courses, highlighted the role of the professor/facilitator at points of the pedagogical cycle and learning recorded in students portfolios. Students valued their experience in the Primary Health Care setting, which was based on, and has since the beginning of the program been based on, the theory-professional practice interlocution and closeness to the principles of the Unified Health System (SUS).

Group-Based Modeling of Time Spent in Structured Activity Trajectories from Middle Childhood into Early Adolescence

ERIC Educational Resources Information Center

Mata, Andrea D.; van Dulmen, Manfred H. M.

2012-01-01

This study investigated trajectories of time spent in structured activities from middle childhood to early adolescence by using data from the National Institute of Child Health & Human Development (NICHD) Study of Early Child Care. We used latent class growth analyses and identified five trajectories (stable low, increasing high, decreasing low,…

Dimensionality of the Latent Structure and Item Selection via Latent Class Multidimensional IRT Models

ERIC Educational Resources Information Center

Bartolucci, F.; Montanari, G. E.; Pandolfi, S.

2012-01-01

With reference to a questionnaire aimed at assessing the performance of Italian nursing homes on the basis of the health conditions of their patients, we investigate two relevant issues: dimensionality of the latent structure and discriminating power of the items composing the questionnaire. The approach is based on a multidimensional item…

Assessing MSW Students' Integrated Behavioral Health Skills Using an Objective Structured Clinical Examination

ERIC Educational Resources Information Center

Sampson, McClain; Parrish, Danielle E.; Washburn, Micki

2018-01-01

Within the last decade, there has been a significant shift in the field of social work toward competency-based education. This article details the use of the Objective Structured Clinical Examination (OSCE) Adapted for Social Work Performance Rating Scale. We used the measure to evaluate specific practice competencies among students (n = 33)…

Institutional analysis of health system governance.

PubMed

Abimbola, Seye; Negin, Joel; Martiniuk, Alexandra L; Jan, Stephen

2017-11-01

It is important that researchers who study health system governance have a set of collective understandings of the meanings of governance, which can then inform the methods used in research. We present an institutional framing and definition of health system governance; that is, governance refers to making, changing, monitoring and enforcing the rules that govern the demand and supply of health services. This pervasive, relational view of governance is to be preferred to approaches that focus primarily on structures of governments and health care organizations, because health system governance involves communities and service users, and because governments in many low- and middle-income countries tend to under-govern. Therefore, the study of health system governance requires institutional analysis; an approach that focuses not only on structures, but also on the rules (both formal and informal) governing demand and supply relations. Using this 'structure-relations' lens, and based on our field experience, we discuss how this focus could be applied to the three approaches to framing and studying health system governance that we identified in the literature. In order of decreasing focus on structures ('hardware') and increasing focus on relations ('software'), they are: (1) the government-centred approach, which focuses on the role of governments, above or to the exclusion of non-government health system actors; (2) the building-block approach, which focuses on the internal workings of health care organizations, and treats governance as one of the several building blocks of organizations; and (3) the institutional approach, which focuses on how the rules governing social and economic interactions are made, changed, monitored and enforced. Notably, either or both qualitative and quantitative methods may be used by researchers in efforts to incorporate the analysis of how rules determine relations among health system actors into these three approaches to health system governance. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Community health workers and home-based care programs for HIV clients.

PubMed Central

Johnson, Becky A.; Khanna, Sunil K.

2004-01-01

In Nyanza Province, Kenya, estimated HIV prevalence is 22%. Given that more than 80% of the population resides in rural areas, the majority of individuals in Nyanza Province do not have access to medical facilities on a regular basis. In response to the growing demands the HIV epidemic has placed on the people and communities in this region, hundreds of lay individuals have been trained as community health workers to provide home-based care to sick or dying HIV/AIDS clients in rural areas. This paper discusses the role and impact of these community health workers in Nyanza Province, Kenya. It outlines the collaborative relationship between community health workers and the Ministry of Health, examining community health workers' use of extant biomedical structures at the district level to provide services that government-run health facilities lack the monetary resources or personnel to provide. Finally, it explores the role played by community health workers in providing HIV/AIDS education to individuals in an attempt to prevent further infections. PMID:15101670

Parent-child communication processes: preventing children's health-risk behavior.

PubMed

Riesch, Susan K; Anderson, Lori S; Krueger, Heather A

2006-01-01

Review individual, family, and environmental factors that predict health-risk behavior among children and to propose parent-child communication processes as a mechanism to mediate them. Improving parent-child communication processes may: reduce individual risk factors, such as poor academic achievement or self-esteem; modify parenting practices such as providing regulation and structure and acting as models of health behavior; and facilitate discussion about factors that lead to involvement in health-risk behaviors. Assessment strategies to identify youth at risk for health-risk behavior are recommended and community-based strategies to improve communication among parents and children need development.

Building Capacity for Evidence-Based Public Health: Reconciling the Pulls of Practice and the Push of Research.

PubMed

Brownson, Ross C; Fielding, Jonathan E; Green, Lawrence W

2018-04-01

Timely implementation of principles of evidence-based public health (EBPH) is critical for bridging the gap between discovery of new knowledge and its application. Public health organizations need sufficient capacity (the availability of resources, structures, and workforce to plan, deliver, and evaluate the preventive dose of an evidence-based intervention) to move science to practice. We review principles of EBPH, the importance of capacity building to advance evidence-based approaches, promising approaches for capacity building, and future areas for research and practice. Although there is general agreement among practitioners and scientists on the importance of EBPH, there is less clarity on the definition of evidence, how to find it, and how, when, and where to use it. Capacity for EBPH is needed among both individuals and organizations. Capacity can be strengthened via training, use of tools, technical assistance, assessment and feedback, peer networking, and incentives. Modest investments in EBPH capacity building will foster more effective public health practice.

Building capacity for evidence-based public health: Reconciling the pulls of practice and the push of research

PubMed Central

Fielding, Jonathan E.; Green, Lawrence W.

2018-01-01

Timely implementation of principles of evidence-based public health (EBPH) is critical for bridging the gap between discovery of new knowledge and application. Public health organizations need sufficient capacity (the availability of resources, structures, and workforce to plan deliver and evaluate the “preventive dose” of an evidence-based intervention) to move science to practice. We review principles of EBPH, the importance of capacity building to advance evidence-based approaches, promising approaches for capacity building, and future areas for research and practice. While there is general agreement on the importance of EBPH, there is less clarity on the definition of evidence, how to find it, and how, when and where to use it. Capacity for EBPH is needed among both individuals and organizations. Capacity can be strengthened via training, use of tools, technical assistance, assessment and feedback, peer networking, and incentives. Modest investments in EBPH capacity-building will foster more effective public health practice. PMID:29166243

Urban environment and children's active lifestyle: softGIS revealing children's behavioral patterns and meaningful places.

PubMed

Kyttä, A Marketta; Broberg, Anna K; Kahila, Maarit H

2012-01-01

To determine the relationship between (1) urban structure characteristics, (2) children's environmental experiences and active behavioral patterns, and (3) perceived health and body mass index (BMI). Cross-sectional study. City of Turku, western coast of Finland, 175,000 inhabitants. Average residential density of the studied settings was 17 housing units per hectare, proportion of green structure 43%, and proportion of population under 15 years old 17%. One thousand eight hundred thirty seven fifth (10-12 years old) and seventh (13-15 years old) graders from 54 schools in Turku. Self-reported behavioral patterns (activity of school travel mode, territorial range, mobility licenses, and distance to meaningful places) and environmental experiences (localized meaningful places, likability index, environmental fears) were gathered on the basis of locality with an Internet-based softGIS method. Self-reported BMI, perceived health, and daily symptoms were also queried. Geographic information system-based measures of urban structure (residential density, proportion of green structure, proportion of children), calculated within a 500-m buffer of each respondent's home, were used as independent variables. Mainly logistic regression analysis. After controlling for gender, age, and neighborhood socioeconomic status (proportion of academically educated), residential density was significantly associated with active travel mode to school and short distances to the meaningful places of children. The proportions of green structure and children had an association with nonactive transport, long distance to meaningful places, and small territorial range. We also found significant associations between active school travel mode and reduced risk of being overweight when controlled for gender and age but not when the proportion of academically educated was also controlled. The negative association between likability index and daily symptoms and positive association with perceived health remained significant after controlling for all three background variables. The only urban structure variable directly associated with good perceived health was the proportion of green structure around the child's home. Moderate urban density seems to have child-friendly characteristics such as an ability to promote active school journeys and to guarantee a short distance to meaningful places. The studied Finnish children expressed very few environmental fears, and the possibilities for them to independently use the opportunities of the urban environment were very high. The limitation of the study was that the socioeconomic background variables were extracted from register-based geographic grid data rather than from respondents. More refined measures of urban structure are also needed in future studies.

[Barriers and facilitators to health care coordination in two integrated health care organizations in Catalonia (Spain)].

PubMed

Vargas Lorenzo, Ingrid; Vázquez Navarrete, M Luisa

2007-01-01

To analyze 2 integrated delivery systems (IDS) in Catalonia and identify areas for future development to improve their effectiveness. An exploratory, descriptive, qualitative study was carried out based on case studies by means of document analysis and semi-structured individual interviews. A criterion sample of cases and, for each case, of documents and informants was selected. Study cases consisted of the Consorci Sanitari del Maresme (CSdM) and the Consorci Sanitari de Terrassa/Fundació Hospital Sant Llàtzer (FHSLL). A total of 127 documents were analyzed and 29 informants were interviewed: IDS managers (n = 10), technical staff (n = 5), operational unit managers (n = 5) and health professionals (n = 9). Content analysis was conducted, with mixed generation of categories and segmentation by cases and subjects. CSdM and CSdT/FHSLL are health care organizations with backward vertical integration, total services production, and real (CSdM) and virtual (CSdT/FHSLL) ownership. Funds are allocated by care level. The governing body is centralized in CSdM and decentralized in CSdT/FHSLL. In both organizations, the global objectives are oriented toward improving coordination and efficiency but are not in line with those of the operational units. Both organizations present a functional structure with integration of support functions and utilize mechanisms for collaboration between care levels based on work processes standardization. Both IDS present facilitators and barriers to health care coordination. To improve coordination, changes in external elements (payment mechanism) and in internal elements (governing body role, organizational structure and coordination mechanisms) are required.

Using Registered Dental Hygienists to Promote a School-Based Approach to Dental Public Health

PubMed Central

Wellever, Anthony; Kelly, Patricia

2017-01-01

We examine a strategy for improving oral health in the United States by focusing on low-income children in school-based settings. Vulnerable children often experience cultural, social, economic, structural, and geographic barriers when trying to access dental services in traditional dental office settings. These disparities have been discussed for more than a decade in multiple US Department of Health and Human Services publications. One solution is to revise dental practice acts to allow registered dental hygienists increased scope of services, expanded public health delivery opportunities, and decreased dentist supervision. We provide examples of how federally qualified health centers have implemented successful school-based dental models within the parameters of two state policies that allow registered dental hygienists varying levels of dentist supervision. Changes to dental practice acts at the state level allowing registered dental hygienists to practice with limited supervision in community settings, such as schools, may provide vulnerable populations greater access to screening and preventive services. We derive our recommendations from expert opinion. PMID:28661808

Health system capacity: maternal health policy implementation in the state of Gujarat, India

PubMed Central

Sanneving, Linda; Kulane, Asli; Iyer, Aditi; Ahgren, Bengt

2013-01-01

Introduction The Government of Gujarat has for the past couple of decades continuously initiated several interventions to improve access to care for pregnant and delivering women within the state. Data from the last District Family Heath survey in Gujarat in 2007–2008 show that 56.4% of women had institutional deliveries and 71.5% had at least one antenatal check-up, indicating that challenges remain in increasing use of and access to maternal health care services. Objective To explore the perceptions of high-level stakeholders on the process of implementing maternal health interventions in Gujarat. Method Using the policy triangle framework developed by Walt and Gilson, the process of implementation was approached using in-depth interviews and qualitative content analysis. Result Based on the analysis, three themes were developed: lack of continuity; the complexity of coordination; and lack of confidence and underutilization of the monitoring system. The findings suggest that decisions made and actions advocated and taken are more dependent on individual actors than on sustainable structures. The findings also indicate that the context in which interventions are implemented is challenged in terms of weak coordination and monitoring systems that are not used to evaluate and develop interventions on maternal health. Conclusions The implementation of interventions on maternal health is dependent on the capacity of the health system to implement evidence-based policies. The capacity of the health system in Gujarat to facilitate implementation of maternal health interventions needs to be improved, both in terms of the role of actors and in terms of structures and processes. PMID:23522352

The role of health-related claims and health-related symbols in consumer behaviour: Design and conceptual framework of the CLYMBOL project and initial results.

PubMed

Hieke, S; Kuljanic, N; Wills, J M; Pravst, I; Kaur, A; Raats, M M; van Trijp, H C M; Verbeke, W; Grunert, K G

2015-03-01

Health claims and symbols are potential aids to help consumers identify foods that are healthier options. However, little is known as to how health claims and symbols are used by consumers in real-world shopping situations, thus making the science-based formulation of new labelling policies and the evaluation of existing ones difficult. The objective of the European Union-funded project R ole of health-related   CLaims   and   sYMBOLs   in consumer behaviour (CLYMBOL) is to determine how health-related information provided through claims and symbols, in their context, can affect consumer understanding, purchase and consumption. To do this, a wide range of qualitative and quantitative consumer research methods are being used, including product sampling, sorting studies ( i.e. how consumers categorise claims and symbols according to concepts such as familiarity and relevance), cross-country surveys, eye-tracking ( i.e. what consumers look at and for how long), laboratory and in-store experiments, structured interviews, as well as analysis of population panel data. EU Member States differ with regard to their history of use and regulation of health claims and symbols prior to the harmonisation of 2006. Findings to date indicate the need for more structured and harmonised research on the effects of health claims and symbols on consumer behaviour, particularly taking into account country-wide differences and individual characteristics such as motivation and ability to process health-related information. Based on the studies within CLYMBOL, implications and recommendations for stakeholders such as policymakers will be provided.

The role of health-related claims and health-related symbols in consumer behaviour: Design and conceptual framework of the CLYMBOL project and initial results

PubMed Central

Hieke, S; Kuljanic, N; Wills, J M; Pravst, I; Kaur, A; Raats, M M; van Trijp, H C M; Verbeke, W; Grunert, K G

2015-01-01

Health claims and symbols are potential aids to help consumers identify foods that are healthier options. However, little is known as to how health claims and symbols are used by consumers in real-world shopping situations, thus making the science-based formulation of new labelling policies and the evaluation of existing ones difficult. The objective of the European Union-funded project Role of health-related CLaims and sYMBOLs in consumer behaviour (CLYMBOL) is to determine how health-related information provided through claims and symbols, in their context, can affect consumer understanding, purchase and consumption. To do this, a wide range of qualitative and quantitative consumer research methods are being used, including product sampling, sorting studies (i.e. how consumers categorise claims and symbols according to concepts such as familiarity and relevance), cross-country surveys, eye-tracking (i.e. what consumers look at and for how long), laboratory and in-store experiments, structured interviews, as well as analysis of population panel data. EU Member States differ with regard to their history of use and regulation of health claims and symbols prior to the harmonisation of 2006. Findings to date indicate the need for more structured and harmonised research on the effects of health claims and symbols on consumer behaviour, particularly taking into account country-wide differences and individual characteristics such as motivation and ability to process health-related information. Based on the studies within CLYMBOL, implications and recommendations for stakeholders such as policymakers will be provided. PMID:25750587

An all fiber-optic multi-parameter structure health monitoring system

DOE PAGES

Hu, Chennan; Yu, Zhihao; Wang, Anbo

2016-08-24

In this article, we present an all fiber-optics based multi-parameter structure health monitoring system, which is able to monitor strain, temperature, crack and thickness of metal structures. This system is composed of two optical fibers, one for laser-acoustic excitation and the other for acoustic detection. A nano-second 1064 nm pulse laser was used for acoustic excitation and a 2 mm fiber Bragg grating was used to detect the acoustic vibration. The feasibility of this system was demonstrated on an aluminum test piece by the monitoring of the temperature, strain and thickness changes, as well as the appearance of an artificialmore » crack. The multiplexing capability of this system was also preliminarily demonstrated.« less

Piezoresistive effect of the carbon nanotube yarn embedded axially into the 3D braided composite

NASA Astrophysics Data System (ADS)

Ma, Xin; Cao, Xiaona

2018-06-01

A new method for monitoring 3D braided composite structure health in real time by embedding the carbon nanotube yarn, based on its piezoresistivity, in the composite axially has been designed. The experimental system for piezoresistive effect detection of the carbon nanotube yarn in the 3D braided composite was built, and the sensing characteristics has been analyzed for further research. Compared with other structural health monitoring methods, the monitoring technique with carbon nanotubes yarns is more suitable for internal damage detection immediately, in addition the strength of the composite can be increased by embedding carbon nanotubes yarns. This method can also be used for strain sensing, the development of intelligent materials and structure systems.

An all fiber-optic multi-parameter structure health monitoring system

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hu, Chennan; Yu, Zhihao; Wang, Anbo

In this article, we present an all fiber-optics based multi-parameter structure health monitoring system, which is able to monitor strain, temperature, crack and thickness of metal structures. This system is composed of two optical fibers, one for laser-acoustic excitation and the other for acoustic detection. A nano-second 1064 nm pulse laser was used for acoustic excitation and a 2 mm fiber Bragg grating was used to detect the acoustic vibration. The feasibility of this system was demonstrated on an aluminum test piece by the monitoring of the temperature, strain and thickness changes, as well as the appearance of an artificialmore » crack. The multiplexing capability of this system was also preliminarily demonstrated.« less

Pipelining in structural health monitoring wireless sensor network

NASA Astrophysics Data System (ADS)

Li, Xu; Dorvash, Siavash; Cheng, Liang; Pakzad, Shamim

2010-04-01

Application of wireless sensor network (WSN) for structural health monitoring (SHM), is becoming widespread due to its implementation ease and economic advantage over traditional sensor networks. Beside advantages that have made wireless network preferable, there are some concerns regarding their performance in some applications. In long-span Bridge monitoring the need to transfer data over long distance causes some challenges in design of WSN platforms. Due to the geometry of bridge structures, using multi-hop data transfer between remote nodes and base station is essential. This paper focuses on the performances of pipelining algorithms. We summarize several prevent pipelining approaches, discuss their performances, and propose a new pipelining algorithm, which gives consideration to both boosting of channel usage and the simplicity in deployment.

Maturing Glycoproteomics Technologies Provide Unique Structural Insights into the N-glycoproteome and Its Regulation in Health and Disease*

PubMed Central

Packer, Nicolle H.; Schulz, Benjamin L.

2016-01-01

The glycoproteome remains severely understudied because of significant analytical challenges associated with glycoproteomics, the system-wide analysis of intact glycopeptides. This review introduces important structural aspects of protein N-glycosylation and summarizes the latest technological developments and applications in LC-MS/MS-based qualitative and quantitative N-glycoproteomics. These maturing technologies provide unique structural insights into the N-glycoproteome and its synthesis and regulation by complementing existing methods in glycoscience. Modern glycoproteomics is now sufficiently mature to initiate efforts to capture the molecular complexity displayed by the N-glycoproteome, opening exciting opportunities to increase our understanding of the functional roles of protein N-glycosylation in human health and disease. PMID:26929216

Assessing mental health clinicians' intentions to adopt evidence-based treatments: reliability and validity testing of the evidence-based treatment intentions scale.

PubMed

Williams, Nathaniel J

2016-05-05

Intentions play a central role in numerous empirically supported theories of behavior and behavior change and have been identified as a potentially important antecedent to successful evidence-based treatment (EBT) implementation. Despite this, few measures of mental health clinicians' EBT intentions exist and available measures have not been subject to thorough psychometric evaluation or testing. This paper evaluates the psychometric properties of the evidence-based treatment intentions (EBTI) scale, a new measure of mental health clinicians' intentions to adopt EBTs. The study evaluates the reliability and validity of inferences made with the EBTI using multi-method, multi-informant criterion variables collected over 12 months from a sample of 197 mental health clinicians delivering services in 13 mental health agencies. Structural, predictive, and discriminant validity evidence is assessed. Findings support the EBTI's factor structure (χ (2) = 3.96, df = 5, p = .556) and internal consistency reliability (α = .80). Predictive validity evidence was provided by robust and significant associations between EBTI scores and clinicians' observer-reported attendance at a voluntary EBT workshop at a 1-month follow-up (OR = 1.92, p < .05), self-reported EBT adoption at a 12-month follow-up (R (2) = .17, p < .001), and self-reported use of EBTs with clients at a 12-month follow-up (R (2) = .25, p < .001). Discriminant validity evidence was provided by small associations with clinicians' concurrently measured psychological work climate perceptions of functionality (R (2) = .06, p < .05), engagement (R (2) = .06, p < .05), and stress (R (2) = .00, ns). The EBTI is a practical and theoretically grounded measure of mental health clinicians' EBT intentions. Scores on the EBTI provide a basis for valid inferences regarding mental health clinicians' intentions to adopt EBTs. Discussion focuses on research and practice applications.

Teamwork in health care: opportunities for gains in quality, productivity, and competitive advantage. What works, what doesn't, and why.

PubMed

Montebello, A R

1994-01-01

Wholesale political, economic, and social change is pressuring health-care organizations to reinvent themselves as they enter a new arena of managed competition. Survival is at stake. Will belt-tightening efforts, combined with structural changes and strategic alliances, achieve the necessary improvements in efficiency and help to secure an adequate patient base? It seems reasonable to expect that health-care institutions can realize the major gains in quality, productivity, efficiency, and competitive edge that organizations in the manufacturing and service industries have enjoyed for the past several years. It seems like a logical next step for health-care organizations to deploy proven methods--such as work redesign, team-based structures, and empowered workforces--that have helped to restore competitiveness to many industrial and service firms. This article describes how to organize teams at all levels and accelerate their development to achieve important organizational objectives--such as improving quality, productivity, and efficiency--while increasing employee satisfaction. Pioneering workplace innovations are reviewed to demonstrate how high-involvement teams integrating strategic planning, research, and health-care delivery processes are not only possible but highly desirable. Enhanced quality, improved productivity, greater efficiency, and employee satisfaction all translate to an undeniable competitive advantage.

Universal access: making health systems work for women.

PubMed

Ravindran, T K Sundari

2012-01-01

Universal coverage by health services is one of the core obligations that any legitimate government should fulfil vis-à-vis its citizens. However, universal coverage may not in itself ensure universal access to health care. Among the many challenges to ensuring universal coverage as well as access to health care are structural inequalities by caste, race, ethnicity and gender. Based on a review of published literature and applying a gender-analysis framework, this paper highlights ways in which the policies aimed at promoting universal coverage may not benefit women to the same extent as men because of gender-based differentials and inequalities in societies. It also explores how 'gender-blind' organisation and delivery of health care services may deny universal access to women even when universal coverage has been nominally achieved. The paper then makes recommendations for addressing these.

Getting from here to there: health IT needs for population health.

PubMed

Vest, Joshua R; Harle, Christopher A; Schleyer, Titus; Dixon, Brian E; Grannis, Shaun J; Halverson, Paul K; Menachemi, Nir

2016-12-01

The United States' decade-long transition from a paper- to technology-based information infrastructure has always been recognized as an initial step-a laying of the foundation-for future changes to the delivery of care. An increasingly important focal area for improvement is population health. Numerous policies and programs now require healthcare organizations to manage the risks, outcomes, utilization, and health of entire groups of individuals. Nonetheless, current health information technology (IT) systems are not ready to support population health improvements effectively and efficiently. Existing health IT systems were designed for organizations that are structurally, operationally, and culturally focused on individual care delivery, rather than improving health for a population. Opportunities exist to align health IT resources and population health management strategies to fill the gaps among technological capabilities, use and the emerging demands of population health. To realize this alignment, healthcare leaders must think differently about the types of data their organizations need, the types of partners with whom they share information, and how they can leverage new information and partnerships for evidence-based action.

Modeling the factors associating with health-related habits among Japanese students.

PubMed

Mato, Mie; Tsukasaki, Keiko

2017-11-23

The aim of the present study was to clarify the structural relationship between health-related habits and psychosocial factors during adolescence/early adulthood. An anonymous, self-administered questionnaire was provided to 1141 third- and fourth-year students at eight academic departments from six universities in regional Japanese cities. Surveys included items addressing participants' demographic characteristics, psychosocial factors (individual-level social capital, self-efficacy, mental health (from health-related quality of life SF-36v2), and sense of coherence (SOC)), and health-related habits. A multiple indicator analysis based on structural equation modeling was conducted to examine the structural relationship between health-related habits and these factors. Valid responses were obtained from 952 participants. The final model demonstrated a high level of goodness of fit. While the path from SOC to health-related habits was significant, those from self-efficacy to health-related habits and from mental health to health-related habits were not significant. The path coefficient from SOC to health-related habits was greater than the path coefficient from background characteristics. In the multiple population comparison that considered gender, a nearly identical model was supported for men and women. Psychosocial factors related to health-related habits were social capital, self-efficacy, mental health, and SOC. Furthermore, it was suggested that SOC functions as an intervening factor for maintaining a healthy lifestyle. It was observed that individual psychosocial factors influence health-related habits more than their background characteristics. Findings highlight that supporting the building of social relationships and social environments is essential to promote a healthy lifestyle among university students. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Mutuality at the center: health promotion with Cape Verdean immigrant women.

PubMed

De Jesus, Maria

2009-02-01

Public health care researchers, policy makers, and providers are increasingly interested in developing more effective and culturally responsive health promotion theories and interventions for diverse immigrant populations. The purpose of this study was to develop health promotion theory that validates the local knowledge and experiences of Cape Verdean women health promoters who work with immigrant women in their community. In-depth, semi-structured interviews were conducted with nine culturally savvy, community-based Cape Verdean women health promoters about their perspectives and daily experiences of health promotion practice with Cape Verdean immigrant women. This study used Glaserian grounded theory to analyze the interviews. This approach identified concepts and developed an integrated process through which to theorize about the practice of health promoters. For Cape Verdean women health promoters, a process of creating relationships was a key to promoting women's health. The relational theory of health promotion practice reflects these dynamic processes, properties, and stages through which Cape Verdean women health promoters develop mutually engaging relationships with immigrant women. CONCLUSION. These findings challenge health care professionals to broaden the repertoire of health promotion strategies to include relationship-building between health promoters and community women. Through these relationships health promoters can understand the complex structural, cultural, and community factors that influence immigrant women's health and incorporate that knowledge into more effective health promotion practices.

Banking for health: opportunities in cooperation between banking and health applying innovation from other sectors

PubMed Central

Kickbusch, Ilona; Franz, Christian; Wells, Nadya

2018-01-01

The annual funding need for global health SDG targets is estimated by WHO at US$134 billion per year, rising to US$274-$371bn by 2030. This paper examines the challenge of making sustainable investment structures in global health more attractive for mainstream financial markets. The objective is a framework for targeted future debate with financial sector actors. Four case studies of innovative sustainable investment mechanisms are analysed, elaborating potential transfer of green and impact investment models in order to channel additional private sector funds to health. To increase private sector involvement, profit must accrue to providers of finance. The paper shows how health criteria can be incorporated into structures, which create triple bottom line return opportunities. Health infrastructure projects based on risk sharing models with governments or multilateral agencies could use long-term funding, with better credit ratings and lower cost of capital. Outcomes based investment, similar to green or social impact bonds, with third-party certification of measurable health impact, satisfy the private sector need for return with social interest objectives. Responsible investment could expand by adding a ‘health’ (H) criterion to the Environmental, Social and Governance (ESG) framework, implementing ESG+H for mainstream investment screening. These models are scalable, satisfy the need to dedicate funds to health and incorporate consistent critical success metrics. The conclusion finds that strong legal frameworks and exploration of fiscal incentives will be critical next steps to facilitate scaling up and broadening of interest from private sector financial actors. The impact these investments have on overall population health is a positive externality of sustainable global health investment. PMID:29915672

Training public health superheroes: five talents for public health leadership.

PubMed

Day, Matthew; Shickle, Darren; Smith, Kevin; Zakariasen, Ken; Moskol, Jacob; Oliver, Thomas

2014-12-01

Public health leaders have been criticized for their policy stances, relationships with governments and failure to train the next generation. New approaches to the identification and training of public health leaders may be required. To inform these, lessons can be drawn from public health 'superheroes'; public health leaders perceived to be the most admired and effective by their peers. Members and Fellows of the UK Faculty of Public Health were contacted via e-newsletter and magazine and asked to nominate their 'Public Health Superhero'. Twenty-six responses were received, nominating 40 different people. Twelve semi-structured interviews were conducted. Thematic analysis, based on 'grounded theory', was conducted. Five leadership 'talents' for public health were identified: mentoring-nurturing, shaping-organizing, networking-connecting, knowing-interpreting and advocating-impacting. Talent-based approaches have been effective for leadership development in other sectors. These talents are the first specific to the practice of public health and align with some aspects of existing frameworks. An increased focus on identifying and developing talents during public health training, as opposed to 'competency'-based approaches, may be effective in strengthening public health leadership. Further research to understand the combination and intensity of talents across a larger sample of public health leaders is required. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Study on bridge checking evaluation based on deformation-Stress data

NASA Astrophysics Data System (ADS)

Shi, Jing Xian; Cheng, Ying Jie

2018-06-01

Bridge structure plays a very important role in human traffic. The evaluation of bridge structure after a certain period of operation has always been the focus of the bridge. Based on the data collected from the health inspection system of a continuous rigid frame bridge on a highway in Yunnan, China, it is found that there is a certain linear relationship between the deformation and stress of the bridge structure. In view of a specific section of the structure, the stress value of this section can be derived according to its deformation value. The coefficient K can be calculated by comparing the estimated value to the actual measured value. According to the range of the K value, the structural state of the bridge can be evaluated to a certain extent.

Straighttalk. Creating a climate of innovation: the healthcare industry's biggest challenge. Panel discussion.

PubMed

Chin, David; Rosenblatt, Alice; Simon, Greg; Lauer, Charles

2007-10-29

The U.S. health system is not sustainable as currently structured--innovation is necessary to fuel reform, according to PricewaterhouseCoopers' report, HealthCast 2020: Creating a Sustainable Health System. But wide-scale innovation--which requires diverse players within the industry to collaborate--is difficult to achieve. In this installment of Straight Talk, leaders from WellPoint, Inc., one of the nation's largest health benefits companies, and FasterCures/The Center for Accelerating Medical Solutions, a think-tank based in Washington, talk about what they're doing to nurture innovation.

Connecting Primary Health Care: A Comprehensive Pilot Study.

PubMed

Maghsoudloo, Mehran; Abolhassani, Farid; Lotfibakhshaiesh, Nasrin

2016-07-01

The collection of data within the primary health care facilities in Iran is essentially paper-based. It is focused on family's health, monitoring of non-infectious and infectious diseases. Clearly due to the paper-based nature of the tasks, timely decision making at most can be difficult if not impossible. As part of an on-going electronic health record implementation project at Tehran University of Medical Sciences, for the first time in the region, based on a comprehensive pilot project, four urban healthcare facilities are connected to their headquarters and beyond, covering all aspects of primary health care, for the last four years. Without delving into the technical aspects of its software engineering processes, the progress of the implementation is reported, selection of summarized data is presented, and experience gained thus far are discussed. Four years passed and if time is any important reason to go by, then it is safe to accept that the software architecture and electronic health record structural model implemented are robust and yet extensible. Aims and duration of a pilot study should be clearly defined prior to start and managed till its completion. Resistance to change and particularly to information technology, apart from its technical aspects, is also based on human factors.