A maternal health voucher scheme: what have we learned from the demand-side financing scheme in Bangladesh?

PubMed

Ahmed, Shakil; Khan, M Mahmud

2011-01-01

It is now more than 2 years since the Ministry of Health and Family Welfare of the Government of Bangladesh implemented the Maternal Health Voucher Scheme, a specialized form of demand-side financing programme. To analyse the early lessons from the scheme, information was obtained through semi-structured interviews with stakeholders at the sub-district level. The analysis identified a number of factors affecting the efficiency and performance of the scheme in the program area: delay in the release of voucher funds, selection criteria used for enrolling pregnant women in the programme, incentives created by the reimbursement system, etc. One of the objectives of the scheme was to encourage market competition among health care providers, but it failed to increase market competitiveness in the area. The resources made available through the scheme did not attract any new providers into the market and public facilities remained the only eligible provider both before and after scheme implementation. However, incentives provided through the voucher system did motivate public providers to offer a higher level of services. The beneficiaries expressed their overall satisfaction with the scheme as well. Since the local facility was not technically ready to provide all types of maternal health care services, providing vouchers may not improve access to care for many pregnant women. To improve the performance of the demand-side strategy, it has become important to adopt some supply-side interventions. In poor developing countries, a demand-side strategy may not be very effective without significant expansion of the service delivery capacity of health facilities at the sub-district level.

A secure and efficient uniqueness-and-anonymity-preserving remote user authentication scheme for connected health care.

PubMed

Das, Ashok Kumar; Goswami, Adrijit

2013-06-01

Connected health care has several applications including telecare medicine information system, personally controlled health records system, and patient monitoring. In such applications, user authentication can ensure the legality of patients. In user authentication for such applications, only the legal user/patient himself/herself is allowed to access the remote server, and no one can trace him/her according to transmitted data. Chang et al. proposed a uniqueness-and-anonymity-preserving remote user authentication scheme for connected health care (Chang et al., J Med Syst 37:9902, 2013). Their scheme uses the user's personal biometrics along with his/her password with the help of the smart card. The user's biometrics is verified using BioHashing. Their scheme is efficient due to usage of one-way hash function and exclusive-or (XOR) operations. In this paper, we show that though their scheme is very efficient, their scheme has several security weaknesses such as (1) it has design flaws in login and authentication phases, (2) it has design flaws in password change phase, (3) it fails to protect privileged insider attack, (4) it fails to protect the man-in-the middle attack, and (5) it fails to provide proper authentication. In order to remedy these security weaknesses in Chang et al.'s scheme, we propose an improvement of their scheme while retaining the original merit of their scheme. We show that our scheme is efficient as compared to Chang et al.'s scheme. Through the security analysis, we show that our scheme is secure against possible attacks. Further, we simulate our scheme for the formal security verification using the widely-accepted AVISPA (Automated Validation of Internet Security Protocols and Applications) tool to ensure that our scheme is secure against passive and active attacks. In addition, after successful authentication between the user and the server, they establish a secret session key shared between them for future secure communication.

Health Monitoring and Management for Manufacturing Workers in Adverse Working Conditions.

PubMed

Xu, Xiaoya; Zhong, Miao; Wan, Jiafu; Yi, Minglun; Gao, Tiancheng

2016-10-01

In adverse working conditions, environmental parameters such as metallic dust, noise, and environmental temperature, directly affect the health condition of manufacturing workers. It is therefore important to implement health monitoring and management based on important physiological parameters (e.g., heart rate, blood pressure, and body temperature). In recent years, new technologies, such as body area networks, cloud computing, and smart clothing, have allowed the improvement of the quality of services. In this article, we first give five-layer architecture for health monitoring and management of manufacturing workers. Then, we analyze the system implementation process, including environmental data processing, physical condition monitoring and system services and management, and present the corresponding algorithms. Finally, we carry out an evaluation and analysis from the perspective of insurance and compensation for manufacturing workers in adverse working conditions. The proposed scheme will contribute to the improvement of workplace conditions, realize health monitoring and management, and protect the interests of manufacturing workers.

Development of the Kisiizi hospital health insurance scheme: lessons learned and implications for universal health coverage.

PubMed

Baine, Sebastian Olikira; Kakama, Alex; Mugume, Moses

2018-06-15

Kisiizi Hospital Health Insurance scheme started in 1996 to; improve access to health services, and provide a stable source of funding and reduce bad debts to Kisiizi hospital. Objectives of this study were; to describe Kisiizi Hospital Health Insurance scheme and to document lessons learned and implications for universal health coverage. This was a descriptive cross-sectional study. Data from different sources were triangulated and thematically analysed. Most households (96%) were organized in Engozi societies (e-Societies), met monthly, and made financial contributions. Cultural solidarity in e-Societies provided a platform for the Kisiizi hospital health insurance scheme establishment, operation and made it compulsory for members. e-Societies disciplinary measures and fear of high out-of-pocket payment for health care enforced enrolment, retention and increased membership. Community sensitisation and community participation in setting premiums and co-payments provided for better understanding of health insurance and rendered them acceptable, affordable and equitable. Membership increased from 330 in 1996 to 38,400 families in 2017. Kisiizi hospital health insurance scheme covered only health services obtained from Kisiizi hospital. Kisiizi hospital health insurance scheme offered no exemption, credit and referral facilities. e-Societies sometimes paid premiums for members from savings and offered them loans to. Kisiizi hospital provided good quality health services, which were easily accessed by insured members. Kisiizi hospital got a stable source of funding and reduced debt burden. Kisiizi hospital health insurance scheme improved access to health services, provided a stable source of funding and reduced bad debts to the hospital. Internal and external factors to e-Society enforced enrolment and retention of members in Kisiizi hospital health insurance scheme. Good quality health services at Kisiizi hospital demonstrated value for money and offered incentives

Outcome-based health equity across different social health insurance schemes for the elderly in China.

PubMed

Liu, Xiaoting; Wong, Hung; Liu, Kai

2016-01-14

Against the achievement of nearly universal coverage for social health insurance for the elderly in China, a problem of inequity among different insurance schemes on health outcomes is still a big challenge for the health care system. Whether various health insurance schemes have divergent effects on health outcome is still a puzzle. Empirical evidence will be investigated in this study. This study employs a nationally representative survey database, the National Survey of the Aged Population in Urban/Rural China, to compare the changes of health outcomes among the elderly before and after the reform. A one-way ANOVA is utilized to detect disparities in health care expenditures and health status among different health insurance schemes. Multiple Linear Regression is applied later to examine the further effects of different insurance plans on health outcomes while controlling for other social determinants. The one-way ANOVA result illustrates that although the gaps in insurance reimbursements between the Urban Employee Basic Medical Insurance (UEBMI) and the other schemes, the New Rural Cooperative Medical Scheme (NCMS) and Urban Residents Basic Medical Insurance (URBMI) decreased, out-of-pocket spending accounts for a larger proportion of total health care expenditures, and the disparities among different insurances enlarged. Results of the Multiple Linear Regression suggest that UEBMI participants have better self-reported health status, physical functions and psychological wellbeing than URBMI and NCMS participants, and those uninsured. URBMI participants report better self-reported health than NCMS ones and uninsured people, while having worse psychological wellbeing compared with their NCMS counterparts. This research contributes to a transformation in health insurance studies from an emphasis on the opportunity-oriented health equity measured by coverage and healthcare accessibility to concern with outcome-based equity composed of health expenditure and health

A Job Classification Scheme for Health Manpower

PubMed Central

Weiss, Jeffrey H.

1968-01-01

The Census Bureau's occupational classification scheme and concept of the “health services industry” are inadequate tools for analysis of the changing job structure of health manpower. In an attempt to remedy their inadequacies, a new analytical framework—drawing upon the work of James Scoville on the job content of the U.S. economy—was devised. The first stage in formulating this new framework was to determine which jobs should be considered health jobs. The overall health care job family was designed to encompass jobs in which the primary technical focus or function is oriented toward the provision of health services. There are two dimensions to the job classification scheme presented here. The first describes each job in terms of job content; relative income data and minimum education and training requirements were employed as surrogate measures. By this means, health care jobs were grouped by three levels of job content: high, medium, and low. The other dimension describes each job in terms of its technical focus or function; by this means, health care jobs were grouped into nine job families. PMID:5673666

A Review of the National Health Insurance Scheme in Ghana: What Are the Sustainability Threats and Prospects?

PubMed

Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Arhinful, Daniel Kojo

2016-01-01

The introduction of the national health insurance scheme (NHIS) in Ghana in 2003 significantly contributed to improved health services utilization and health outcomes. However, stagnating active membership, reports of poor quality health care rendered to NHIS-insured clients and cost escalations have raised concerns on the operational and financial sustainability of the scheme. This paper reviewed peer reviewed articles and grey literature on the sustainability challenges and prospects of the NHIS in Ghana. Electronic search was done for literature published between 2003-2016 on the NHIS and its sustainability in Ghana. A total of 66 publications relevant to health insurance in Ghana and other developing countries were retrieved from Cochrane, PubMed, ScienceDirect and Googlescholar for initial screening. Out of this number, 31 eligible peer reviewed articles were selected for final review based on specific relevance to the Ghanaian context. Ability of the NHIS to continue its operations in Ghana is threatened financially and operationally by factors such as: cost escalation, possible political interference, inadequate technical capacity, spatial distribution of health facilities and health workers, inadequate monitoring mechanisms, broad benefits package, large exemption groups, inadequate client education, and limited community engagement. Moreover, poor quality care in NHIS-accredited health facilities potentially reduces clients' trust in the scheme and consequently decreases (re)enrolment rates. These sustainability challenges were reviewed and discussed in this paper. The NHIS continues to play a critical role towards attaining universal health coverage in Ghana albeit confronted by challenges that could potentially collapse the scheme. Averting this possible predicament will largely depend on concerted efforts of key stakeholders such as health insurance managers, service providers, insurance subscribers, policy makers and political actors.

Indian community health insurance schemes provide partial protection against catastrophic health expenditure.

PubMed

Devadasan, Narayanan; Criel, Bart; Van Damme, Wim; Ranson, Kent; Van der Stuyft, Patrick

2007-03-15

More than 72% of health expenditure in India is financed by individual households at the time of illness through out-of-pocket payments. This is a highly regressive way of financing health care and sometimes leads to impoverishment. Health insurance is recommended as a measure to protect households from such catastrophic health expenditure (CHE). We studied two Indian community health insurance (CHI) schemes, ACCORD and SEWA, to determine whether insured households are protected from CHE. ACCORD provides health insurance cover for the indigenous population, living in Gudalur, Tamil Nadu. SEWA provides insurance cover for self employed women in the state of Gujarat. Both cover hospitalisation expenses, but only upto a maximum limit of US$23 and US$45, respectively. We reviewed the insurance claims registers in both schemes and identified patients who were hospitalised during the period 01/04/2003 to 31/03/2004. Details of their diagnoses, places and costs of treatment and self-reported annual incomes were obtained. There is no single definition of CHE and none of these have been validated. For this research, we used the following definition; "annual hospital expenditure greater than 10% of annual income," to identify those who experienced CHE. There were a total of 683 and 3152 hospital admissions at ACCORD and SEWA, respectively. In the absence of the CHI scheme, all of the patients at ACCORD and SEWA would have had to pay OOP for their hospitalisation. With the CHI scheme, 67% and 34% of patients did not have to make any out-of-pocket (OOP) payment for their hospital expenses at ACCORD and SEWA, respectively. Both CHI schemes halved the number of households that would have experienced CHE by covering hospital costs. However, despite this, 4% and 23% of households with admissions still experienced CHE at ACCORD and SEWA, respectively. This was related to the following conditions: low annual income, benefit packages with low maximum limits, exclusion of some

[Extension of health coverage and community based health insurance schemes in Africa: Myths and realities].

PubMed

Boidin, B

2015-02-01

This article tackles the perspectives and limits of the extension of health coverage based on community based health insurance schemes in Africa. Despite their strong potential contribution to the extension of health coverage, their weaknesses challenge their ability to play an important role in this extension. Three limits are distinguished: financial fragility; insufficient adaptation to characteristics and needs of poor people; organizational and institutional failures. Therefore lessons can be learnt from the limits of the institutionalization of community based health insurance schemes. At first, community based health insurance schemes are to be considered as a transitional but insufficient solution. There is also a stronger role to be played by public actors in improving financial support, strengthening health services and coordinating coverage programs.

Establishing sustainable performance-based incentive schemes: views of rural health workers from qualitative research in three sub-Saharan African countries.

PubMed

Yé, M; Aninanya, G A; Sié, A; Kakoko, D C V; Chatio, S; Kagoné, M; Prytherch, H; Loukanova, S; Williams, J E; Sauerborn, R

2014-01-01

Performance-based incentives (PBIs) are currently receiving attention as a strategy for improving the quality of care that health providers deliver. Experiences from several African countries have shown that PBIs can trigger improvements, particularly in the area of maternal and neonatal health. The involvement of health workers in deciding how their performance should be measured is recommended. Only limited information is available about how such schemes can be made sustainable. This study explored the types of PBIs that rural health workers suggested, their ideas regarding the management and sustainability of such schemes, and their views on which indicators best lend themselves to the monitoring of performance. In this article the authors reported the findings from a cross-country survey conducted in Burkina Faso, Ghana and Tanzania. The study was exploratory with qualitative methodology. In-depth interviews were conducted with 29 maternal and neonatal healthcare providers, four district health managers and two policy makers (total 35 respondents) from one district in each of the three countries. The respondents were purposively selected from six peripheral health facilities. Care was taken to include providers who had a management role. By also including respondents from district and policy level a comparison of perspectives from different levels of the health system was facilitated. The data that was collected was coded and analysed with support of NVivo v8 software. The most frequently suggested PBIs amongst the respondents in Burkina Faso were training with per-diems, bonuses and recognition of work done. The respondents in Tanzania favoured training with per-diems, as well as payment of overtime, and timely promotion. The respondents in Ghana also called for training, including paid study leave, payment of overtime and recognition schemes for health workers or facilities. Respondents in the three countries supported the mobilisation of local resources to

A Review of the National Health Insurance Scheme in Ghana: What Are the Sustainability Threats and Prospects?

PubMed Central

Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Arhinful, Daniel Kojo

2016-01-01

Background The introduction of the national health insurance scheme (NHIS) in Ghana in 2003 significantly contributed to improved health services utilization and health outcomes. However, stagnating active membership, reports of poor quality health care rendered to NHIS-insured clients and cost escalations have raised concerns on the operational and financial sustainability of the scheme. This paper reviewed peer reviewed articles and grey literature on the sustainability challenges and prospects of the NHIS in Ghana. Methods Electronic search was done for literature published between 2003–2016 on the NHIS and its sustainability in Ghana. A total of 66 publications relevant to health insurance in Ghana and other developing countries were retrieved from Cochrane, PubMed, ScienceDirect and Googlescholar for initial screening. Out of this number, 31 eligible peer reviewed articles were selected for final review based on specific relevance to the Ghanaian context. Results Ability of the NHIS to continue its operations in Ghana is threatened financially and operationally by factors such as: cost escalation, possible political interference, inadequate technical capacity, spatial distribution of health facilities and health workers, inadequate monitoring mechanisms, broad benefits package, large exemption groups, inadequate client education, and limited community engagement. Moreover, poor quality care in NHIS-accredited health facilities potentially reduces clients’ trust in the scheme and consequently decreases (re)enrolment rates. These sustainability challenges were reviewed and discussed in this paper. Conclusions The NHIS continues to play a critical role towards attaining universal health coverage in Ghana albeit confronted by challenges that could potentially collapse the scheme. Averting this possible predicament will largely depend on concerted efforts of key stakeholders such as health insurance managers, service providers, insurance subscribers, policy

Indian community health insurance schemes provide partial protection against catastrophic health expenditure

PubMed Central

Devadasan, Narayanan; Criel, Bart; Van Damme, Wim; Ranson, Kent; Van der Stuyft, Patrick

2007-01-01

Background More than 72% of health expenditure in India is financed by individual households at the time of illness through out-of-pocket payments. This is a highly regressive way of financing health care and sometimes leads to impoverishment. Health insurance is recommended as a measure to protect households from such catastrophic health expenditure (CHE). We studied two Indian community health insurance (CHI) schemes, ACCORD and SEWA, to determine whether insured households are protected from CHE. Methods ACCORD provides health insurance cover for the indigenous population, living in Gudalur, Tamil Nadu. SEWA provides insurance cover for self employed women in the state of Gujarat. Both cover hospitalisation expenses, but only upto a maximum limit of US$23 and US$45, respectively. We reviewed the insurance claims registers in both schemes and identified patients who were hospitalised during the period 01/04/2003 to 31/03/2004. Details of their diagnoses, places and costs of treatment and self-reported annual incomes were obtained. There is no single definition of CHE and none of these have been validated. For this research, we used the following definition; "annual hospital expenditure greater than 10% of annual income," to identify those who experienced CHE. Results There were a total of 683 and 3152 hospital admissions at ACCORD and SEWA, respectively. In the absence of the CHI scheme, all of the patients at ACCORD and SEWA would have had to pay OOP for their hospitalisation. With the CHI scheme, 67% and 34% of patients did not have to make any out-of-pocket (OOP) payment for their hospital expenses at ACCORD and SEWA, respectively. Both CHI schemes halved the number of households that would have experienced CHE by covering hospital costs. However, despite this, 4% and 23% of households with admissions still experienced CHE at ACCORD and SEWA, respectively. This was related to the following conditions: low annual income, benefit packages with low maximum limits

China's Rural Cooperative Medical Scheme: a type of health insurance or a type of health cooperative?

PubMed

Wang, Fang; Liang, Yuan

2017-03-01

The Cooperative Medical Scheme (CMS) was popular in rural China in the 1960s and 1970s, having garnered praise from the World Bank and World Health Organization as an unprecedented example of a successful health care model in a low-income developing country. However, the CMS almost collapsed in the 1980s. Based on its historical origins and main activities, we think the CMS functioned as a health cooperative rather than a health insurance scheme. Perhaps, however, the importance to the CMS of cooperation between institutions has been overestimated. Overlooked, yet equally important, has been the cooperation between health workers and farmers to target health-related risk factors associated with agricultural work and ways of life. The 'cooperative' character of the CMS includes two aspects: cooperative institutions and cooperative behaviour. Although the CMS collapsed in China, similar schemes are flourishing elsewhere in the world. In the future, in-depth analysis of these schemes is required.

Health worker preferences for performance-based payment schemes in a rural health district in Burkina Faso.

PubMed

Yé, Maurice; Diboulo, Eric; Kagoné, Moubassira; Sié, Ali; Sauerborn, Rainer; Loukanova, Svetla

2016-01-01

One promising way to improve the motivation of healthcare providers and the quality of healthcare services is performance-based incentives (PBIs) also referred as performance-based financing. Our study aims to explore healthcare providers' preferences for an incentive scheme based on local resources, which aimed at improving the quality of maternal and child health care in the Nouna Health District. A qualitative and quantitative survey was carried out in 2010 involving 94 healthcare providers within 34 health facilities. In addition, in-depth interviews involving a total of 33 key informants were conducted at health facility levels. Overall, 85% of health workers were in favour of an incentive scheme based on the health district's own financial resources (95% CI: [71.91; 88.08]). Most health workers (95 and 96%) expressed a preference for financial incentives (95% CI: [66.64; 85.36]) and team-based incentives (95% CI: [67.78; 86.22]), respectively. The suggested performance indicators were those linked to antenatal care services, prevention of mother-to-child human immunodeficiency virus transmission, neonatal care, and immunization. The early involvement of health workers and other stakeholders in designing an incentive scheme proved to be valuable. It ensured their effective participation in the process and overall acceptance of the scheme at the end. This study is an important contribution towards the designing of effective PBI schemes.

Health worker preferences for performance-based payment schemes in a rural health district in Burkina Faso

PubMed Central

Yé, Maurice; Diboulo, Eric; Kagoné, Moubassira; Sié, Ali; Sauerborn, Rainer; Loukanova, Svetla

2016-01-01

Background One promising way to improve the motivation of healthcare providers and the quality of healthcare services is performance-based incentives (PBIs) also referred as performance-based financing. Our study aims to explore healthcare providers’ preferences for an incentive scheme based on local resources, which aimed at improving the quality of maternal and child health care in the Nouna Health District. Design A qualitative and quantitative survey was carried out in 2010 involving 94 healthcare providers within 34 health facilities. In addition, in-depth interviews involving a total of 33 key informants were conducted at health facility levels. Results Overall, 85% of health workers were in favour of an incentive scheme based on the health district's own financial resources (95% CI: [71.91; 88.08]). Most health workers (95 and 96%) expressed a preference for financial incentives (95% CI: [66.64; 85.36]) and team-based incentives (95% CI: [67.78; 86.22]), respectively. The suggested performance indicators were those linked to antenatal care services, prevention of mother-to-child human immunodeficiency virus transmission, neonatal care, and immunization. Conclusions The early involvement of health workers and other stakeholders in designing an incentive scheme proved to be valuable. It ensured their effective participation in the process and overall acceptance of the scheme at the end. This study is an important contribution towards the designing of effective PBI schemes. PMID:26739784

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.

Comparison of Respiratory Disease Prevalence among Voluntary Monitoring Systems for Pig Health and Welfare in the UK.

PubMed

Eze, J I; Correia-Gomes, C; Borobia-Belsué, J; Tucker, A W; Sparrow, D; Strachan, D W; Gunn, G J

2015-01-01

Surveillance of animal diseases provides information essential for the protection of animal health and ultimately public health. The voluntary pig health schemes, implemented in the United Kingdom, are integrated systems which capture information on different macroscopic disease conditions detected in slaughtered pigs. Many of these conditions have been associated with a reduction in performance traits and consequent increases in production costs. The schemes are the Wholesome Pigs Scotland in Scotland, the BPEX Pig Health Scheme in England and Wales and the Pig Regen Ltd. health and welfare checks done in Northern Ireland. This report set out to compare the prevalence of four respiratory conditions (enzootic pneumonia-like lesions, pleurisy, pleuropneumonia lesions and abscesses in the lung) assessed by these three Pig Health Schemes. The seasonal variations and year trends associated with the conditions in each scheme are presented. The paper also highlights the differences in prevalence for each condition across these schemes and areas where further research is needed. A general increase in the prevalence of enzootic pneumonia like lesions was observed in Scotland, England and Wales since 2009, while a general decrease was observed in Northern Ireland over the years of the scheme. Pleurisy prevalence has increased since 2010 in all three schemes, whilst pleuropneumonia has been decreasing. Prevalence of abscesses in the lung has decreased in England, Wales and Northern Ireland but has increased in Scotland. This analysis highlights the value of surveillance schemes based on abattoir pathology monitoring of four respiratory lesions. The outputs at scheme level have significant value as indicators of endemic and emerging disease, and for producers and herd veterinarians in planning and evaluating herd health control programs when comparing individual farm results with national averages.

Assessing responsiveness of health care services within a health insurance scheme in Nigeria: users' perspectives.

PubMed

Mohammed, Shafiu; Bermejo, Justo Lorenzo; Souares, Aurélia; Sauerborn, Rainer; Dong, Hengjin

2013-12-01

Responsiveness of health care services in low and middle income countries has been given little attention. Despite being introduced over a decade ago in many developing countries, national health insurance schemes have yet to be evaluated in terms of responsiveness of health care services. Although this responsiveness has been evaluated in many developed countries, it has rarely been done in developing countries. The concept of responsiveness is multi-dimensional and can be measured across various domains including prompt attention, dignity, communication, autonomy, choice of provider, quality of facilities, confidentiality and access to family support. This study examines the insured users' perspectives of their health care services' responsiveness. This retrospective, cross-sectional survey took place between October 2010 and March 2011. The study used a modified out-patient questionnaire from a responsiveness survey designed by the World Health Organization (WHO). Seven hundred and ninety six (796) enrolees, insured for more than one year in Kaduna State-Nigeria, were interviewed. Generalized ordered logistic regression was used to identify factors that influenced the users' perspectives on responsiveness to health services and quantify their effects. Communication (55.4%), dignity (54.1%), and quality of facilities (52.0%) were rated as "extremely important" responsiveness domains. Users were particularly contented with quality of facilities (42.8%), dignity (42.3%), and choice of provider (40.7%). Enrolees indicated lower contentment on all other domains. Type of facility, gender, referral, duration of enrolment, educational status, income level, and type of marital status were most related with responsiveness domains. Assessing the responsiveness of health care services within the NHIS is valuable in investigating the scheme's implementation. The domains of autonomy, communication and prompt attention were identified as priority areas for action to improve

Reforming Central Government Health Scheme into a 'Universal Health Coverage' model.

PubMed

Sarwal, Rakesh

2015-01-01

Universal Health Coverage (UHC) is now recognized as a goal of all health systems, irrespective of income levels. In the absence of a one-size solution, each country has to develop strategies suited to its circumstances. How does the Central Government Health Scheme (CGHS) stand up to the goals and global experience of UHC, and what can be done to make it a model? I relied on publicly available documents to identify key features of UHC, and relate it to the architecture of and practices in CGHS. Combining WHO's framework of health systems functions with log frame approach, I constructed a 'UHC status tool' of key elements and expected norms of UHC. CGHS has been performing strongly on financing function and for the range of services covered. It has performed rather poorly on all other elements of UHC. I build the argument for continued public provision of health, as opposed to insurance, on grounds of cost, public good nature of outpatient care and public health services. I suggest and strategize a sequence of reforms in CGHS anchored in health system strengthening, governance and financing, comprehensive primary care and client participation. It is both possible and desirable to transform CGHS into a UHC model within the same fiscal space. Merger of finance pools of centrally administered health schemes is suggested as a step towards UHC in India. Copyright 2015, NMJI.

A fully automated health-care monitoring at home without attachment of any biological sensors and its clinical evaluation.

PubMed

Motoi, Kosuke; Ogawa, Mitsuhiro; Ueno, Hiroshi; Kuwae, Yutaka; Ikarashi, Akira; Yuji, Tadahiko; Higashi, Yuji; Tanaka, Shinobu; Fujimoto, Toshiro; Asanoi, Hidetsugu; Yamakoshi, Ken-ichi

2009-01-01

Daily monitoring of health condition is important for an effective scheme for early diagnosis, treatment and prevention of lifestyle-related diseases such as adiposis, diabetes, cardiovascular diseases and other diseases. Commercially available devices for health care monitoring at home are cumbersome in terms of self-attachment of biological sensors and self-operation of the devices. From this viewpoint, we have been developing a non-conscious physiological monitor installed in a bath, a lavatory, and a bed for home health care and evaluated its measurement accuracy by simultaneous recordings of a biological sensors directly attached to the body surface. In order to investigate its applicability to health condition monitoring, we have further developed a new monitoring system which can automatically monitor and store the health condition data. In this study, by evaluation on 3 patients with cardiac infarct or sleep apnea syndrome, patients' health condition such as body and excretion weight in the toilet and apnea and hypopnea during sleeping were successfully monitored, indicating that the system appears useful for monitoring the health condition during daily living.

Risk management assessment of Health Maintenance Organisations participating in the National Health Insurance Scheme

PubMed Central

Campbell, Princess Christina; Korie, Patrick Chukwuemeka; Nnaji, Feziechukwu Collins

2014-01-01

Background: The National Health Insurance Scheme (NHIS), operated majorly in Nigeria by health maintenance organisations (HMOs), took off formally in June 2005. In view of the inherent risks in the operation of any social health insurance, it is necessary to efficiently manage these risks for sustainability of the scheme. Consequently the risk-management strategies deployed by HMOs need regular assessment. This study assessed the risk management in the Nigeria social health insurance scheme among HMOs. Materials and Methods: Cross-sectional survey of 33 HMOs participating in the NHIS. Results: Utilisation of standard risk-management strategies by the HMOs was 11 (52.6%). The other risk-management strategies not utilised in the NHIS 10 (47.4%) were risk equalisation and reinsurance. As high as 11 (52.4%) of participating HMOs had a weak enrollee base (less than 30,000 and poor monthly premium and these impacted negatively on the HMOs such that a large percentage 12 (54.1%) were unable to meet up with their financial obligations. Most of the HMOs 15 (71.4%) participated in the Millennium development goal (MDG) maternal and child health insurance programme. Conclusions: Weak enrollee base and poor monthly premium predisposed the HMOs to financial risk which impacted negatively on the overall performance in service delivery in the NHIS, further worsened by the non-utilisation of risk equalisation and reinsurance as risk-management strategies in the NHIS. There is need to make the scheme compulsory and introduce risk equalisation and reinsurance. PMID:25298605

FORUM: A Suggestion for an Improved Vegetation Scheme for Local and Global Mapping and Monitoring.

PubMed

ADAMS

1999-01-01

/ Understanding of global ecological problems is at least partly dependent on clear assessments of vegetation change, and such assessment is always dependent on the use of a vegetation classification scheme. Use of satellite remotely sensed data is the only practical means of carrying out any global-scale vegetation mapping exercise, but if the resulting maps are to be useful to most ecologists and conservationists, they must be closely tied to clearly defined features of vegetation on the ground. Furthermore, much of the mapping that does take place involves more local-scale description of field sites; for purposes of cost and practicality, such studies usually do not involve remote sensing using satellites. There is a need for a single scheme that integrates the smallest to the largest scale in a way that is meaningful to most environmental scientists. Existing schemes are unsatisfactory for this task; they are ambiguous, unnecessarily complex, and their categories do not correspond to common-sense definitions. In response to these problems, a simple structural-physiognomically based scheme with 23 fundamental categories is proposed here for mapping and monitoring on any scale, from local to global. The fundamental categories each subdivide into more specific structural categories for more detailed mapping, but all the categories can be used throughout the world and at any scale, allowing intercomparison between regions. The next stage in the process will be to obtain the views of as many people working in as many different fields as possible, to see whether the proposed scheme suits their needs and how it should be modified. With a few modifications, such a scheme could easily be appended to an existing land cover classification scheme, such as the FAO system, greatly increasing the usefulness and accessability of the results of the landcover classification. KEY WORDS: Vegetation scheme; Mapping; Monitoring; Land cover

Remote coding scheme based on waveguide Bragg grating in PLC splitter chip for PON monitoring.

PubMed

Zhang, Xuan; Lu, Fengjun; Chen, Si; Zhao, Xingqun; Zhu, Min; Sun, Xiaohan

2016-03-07

A distributing arranged waveguide Bragg gratings (WBGs) in PLC splitter chip based remote coding scheme is proposed and analyzed for passive optical network (PON) monitoring, by which the management system can identify each drop fiber link through the same reflector in the terminal of each optical network unit, even though there exist several equidistant users. The corresponding coding and capacity models are respectively established and investigated so that we can obtain a minimum number of the WBGs needed under the condition of the distributed structure. Signal-to-noise ratio (SNR) model related to the number of equidistant users is also developed to extend the analyses for the overall performance of the system. Simulation results show the proposed scheme is feasible and allow the monitoring of a 64 users PON with SNR range of 7.5~10.6dB. The scheme can solve some of difficulties of construction site at the lower user cost for PON system.

Structural Health Monitoring for a Z-Type Special Vehicle

PubMed Central

Yuan, Chaolin; Ren, Liang; Li, Hongnan

2017-01-01

Nowadays there exist various kinds of special vehicles designed for some purposes, which are different from regular vehicles in overall dimension and design. In that case, accidents such as overturning will lead to large economical loss and casualties. There are still no technical specifications to follow to ensure the safe operation and driving of these special vehicles. Owing to the poor efficiency of regular maintenance, it is more feasible and effective to apply real-time monitoring during the operation and driving process. In this paper, the fiber Bragg grating (FBG) sensors are used to monitor the safety of a z-type special vehicle. Based on the structural features and force distribution, a reasonable structural health monitoring (SHM) scheme is presented. Comparing the monitoring results with the finite element simulation results guarantees the accuracy and reliability of the monitoring results. Large amounts of data are collected during the operation and driving progress to evaluate the structural safety condition and provide reference for SHM systems developed for other special vehicles. PMID:28587161

What are the emerging features of community health insurance schemes in East Africa?

PubMed Central

Basaza, Robert; Pariyo, George; Criel, Bart

2009-01-01

Background The three East African countries of Uganda, Tanzania, and Kenya are characterized by high poverty levels, population growth rates, prevalence of HIV/AIDS, under-funding of the health sector, poor access to quality health care, and small health insurance coverage. Tanzania and Kenya have user-fees whereas Uganda abolished user-fees in public-owned health units. Objective To provide comparative description of community health insurance (CHI) schemes in three East African countries of Uganda, Tanzania, and Kenya and thereafter provide a basis for future policy research for development of CHI schemes. Methods An analytical grid of 10 distinctive items pertaining to the nature of CHI schemes was developed so as to have a uniform lens of comparing country situations of CHI. Results and conclusions The majority of the schemes have been in existence for a relatively short time of less than 10 years and their number remains small. There is need for further research to identify what is the mix and weight of factors that cause people to refrain from joining schemes. Specific issues that could also be addressed in subsequent studies are whether the current schemes provide financial protection, increase access to quality of care and impact on the equity of health services financing and delivery. On the basis of this knowledge, rational policy decisions can be taken. The governments thereafter could consider an option of playing more roles in advocacy, paying for the poorest, and developing an enabling policy and legal framework. PMID:22312207

The Politico-Economic Challenges of Ghana's National Health Insurance Scheme Implementation.

PubMed

Fusheini, Adam

2016-04-27

National/social health insurance schemes have increasingly been seen in many low- and middle-income countries (LMICs) as a vehicle to universal health coverage (UHC) and a viable alternative funding mechanism for the health sector. Several countries, including Ghana, have thus introduced and implemented mandatory national health insurance schemes (NHIS) as part of reform efforts towards increasing access to health services. Ghana passed mandatory national health insurance (NHI) legislation (ACT 650) in 2003 and commenced nationwide implementation in 2004. Several peer review studies and other research reports have since assessed the performance of the scheme with positive rating while challenges also noted. This paper contributes to the literature on economic and political implementation challenges based on empirical evidence from the perspectives of the different category of actors and institutions involved in the process. Qualitative in-depth interviews were held with 33 different category of participants in four selected district mutual health insurance schemes in Southern (two) and Northern (two) Ghana. This was to ascertain their views regarding the main challenges in the implementation process. The participants were selected through purposeful sampling, stakeholder mapping, and snowballing. Data was analysed using thematic grouping procedure. Participants identified political issues of over politicisation and political interference as main challenges. The main economic issues participants identified included low premiums or contributions; broad exemptions, poor gatekeeper enforcement system; and culture of curative and hospital-centric care. The study establishes that political and economic factors have influenced the implementation process and the degree to which the policy has been implemented as intended. Thus, we conclude that there is a synergy between implementation and politics; and achieving UHC under the NHIS requires political stewardship. Political

Adverse selection in a voluntary Rural Mutual Health Care health insurance scheme in China.

PubMed

Wang, Hong; Zhang, Licheng; Yip, Winnie; Hsiao, William

2006-09-01

This study examines adverse selection in a subsidized voluntary health insurance scheme, the Rural Mutual Health Care (RMHC) scheme, in a poor rural area of China. The study was made possible by a unique longitudinal data set: the total sample includes 3492 rural residents from 1020 households. Logistic regression was employed for the data analysis. The results show that although this subsidized scheme achieved a considerable high enrollment rate of 71% of rural residents, adverse selection still exists. In general, individuals with worse health status are more likely to enroll in RMHC than individuals with better health status. Although the household is set as the enrollment unit for the RMHC for the purpose of reducing adverse selection, nearly 1/3 of enrolled households are actually only partially enrolled. Furthermore, we found that adverse selection mainly occurs in partially enrolled households. The non-enrolled individuals in partially enrolled households have the best health status, while the enrolled individuals in partially enrolled households have the worst health status. Pre-RMHC, medical expenditure for enrolled individuals in partially enrolled households was 206.6 yuan per capita per year, which is 1.7 times as much as the pre-RMHC medical expenditure for non-enrolled individuals in partially enrolled households. The study also reveals that the pre-enrolled medical expenditure per capita per year of enrolled individuals was 9.6% higher than the pre-enrolled medical expenditure of all residents, including both enrolled and non-enrolled individuals. In conclusion, although the subsidized RMHC scheme reached a very high enrollment rate and the household is set as the enrollment unit for the purpose of reducing adverse selection, adverse selection still exists, especially within partially enrolled households. Voluntary RMHC will not be financially sustainable if the adverse selection is not fully taken into account.

Determinants of enrollment of informal sector workers in cooperative based health scheme in Bangladesh.

PubMed

Sarker, Abdur Razzaque; Sultana, Marufa; Mahumud, Rashidul Alam; Ahmed, Sayem; Islam, Ziaul; Morton, Alec; Khan, Jahangir A M

2017-01-01

Providing access to affordable health care for the informal sector remains a considerable challenge for low income countries striving to make progress towards universal health coverage. The objective of the study is to identify the factors shaping the decision to enroll in a cooperative based health scheme for informal workers in Bangladesh and also help to identify the features of informal workers without health schemes and their likelihood of being insured. Data were derived from a cross-sectional in-house survey within the catchment area of a cooperative based health scheme in Bangladesh during April-June 2014, covering a total of 784 households (458 members and 326 non-members). Multivariate logistic regression model was used to identify factors associated with cooperative based health scheme and explanatory variables. This study found that a number of factors were significant determinants of health scheme participation including sex of household head, household composition, occupational category as well as involvement social financial safety net programs. Findings from this study can be suggestive for policy-makers interested in scaling up health insurance for informal workers in Bangladesh. Shared funding from this large informal sector can generate new resources for healthcare, which is in line with the healthcare financing strategy of Bangladesh as well as the recommendation of the World Health Organization for developing social health insurance as part of the path to Universal Health Coverage.

Renewing membership in three community-based health insurance schemes in rural India.

PubMed

Panda, Pradeep; Chakraborty, Arpita; Raza, Wameq; Bedi, Arjun S

2016-12-01

Low renewal rate is a key challenge facing the sustainability of community-based health insurance (CBHI) schemes. While there is a large literature on initial enrolment into such schemes, there is limited evidence on the factors that impede renewal. This article uses longitudinal data to analyse what determines renewal, both 1 year and 2 years after the introduction of three CBHI schemes, which have been operating in rural Bihar and Uttar Pradesh since 2011. We find that initial scheme uptake is ∼23-24% and that 2 years after scheme operation, only ∼20% of the initial enrolees maintain their membership. A household's socio-economic status does not seem to play a large role in impeding renewal. In some instances, a greater understanding of the scheme boosts renewal. The link between health status and use of health care in maintaining renewal is mixed. The clearest effect is that individuals living in households that have received benefits from the scheme are substantially more likely to renew their contracts. We conclude that the low retention rates may be attributed to limited benefit packages, slow claims processing times and the gap between the amounts claimed and amounts paid out by insurance. © The Author 2016. 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.

Effect of exercise referral schemes in primary care on physical activity and improving health outcomes: systematic review and meta-analysis

PubMed Central

Taylor, A H; Fox, K R; Hillsdon, M; Anokye, N; Campbell, J L; Foster, C; Green, C; Moxham, T; Mutrie, N; Searle, J; Trueman, P; Taylor, R S

2011-01-01

Objective To assess the impact of exercise referral schemes on physical activity and health outcomes. Design Systematic review and meta-analysis. Data sources Medline, Embase, PsycINFO, Cochrane Library, ISI Web of Science, SPORTDiscus, and ongoing trial registries up to October 2009. We also checked study references. Study selection Design: randomised controlled trials or non-randomised controlled (cluster or individual) studies published in peer review journals. Population: sedentary individuals with or without medical diagnosis. Exercise referral schemes defined as: clear referrals by primary care professionals to third party service providers to increase physical activity or exercise, physical activity or exercise programmes tailored to individuals, and initial assessment and monitoring throughout programmes. Comparators: usual care, no intervention, or alternative exercise referral schemes. Results Eight randomised controlled trials met the inclusion criteria, comparing exercise referral schemes with usual care (six trials), alternative physical activity intervention (two), and an exercise referral scheme plus a self determination theory intervention (one). Compared with usual care, follow-up data for exercise referral schemes showed an increased number of participants who achieved 90-150 minutes of physical activity of at least moderate intensity per week (pooled relative risk 1.16, 95% confidence intervals 1.03 to 1.30) and a reduced level of depression (pooled standardised mean difference −0.82, −1.28 to −0.35). Evidence of a between group difference in physical activity of moderate or vigorous intensity or in other health outcomes was inconsistent at follow-up. We did not find any difference in outcomes between exercise referral schemes and the other two comparator groups. None of the included trials separately reported outcomes in individuals with specific medical diagnoses.Substantial heterogeneity in the quality and nature of the exercise referral

Performance Assessment of Ga District Mutual Health Insurance Scheme, Greater Accra Region, Ghana.

PubMed

Nsiah-Boateng, Eric; Aikins, Moses

This study assessed performance of the Ga District Mutual Health Insurance Scheme over the period 2007-2009. The desk review method was used to collect secondary data on membership coverage, revenue, expenditure, and claims settlement patterns of the scheme. A household survey was also conducted in the Madina Township by using a self-administered semi-structured questionnaire to determine community coverage of the scheme. The study showed membership coverage of 21.8% and community coverage of 22.2%. The main reasons why respondents had not registered with the scheme are that contributions are high and it does not offer the services needed. Financially, the scheme depended largely on subsidies and reinsurance from the National Health Insurance Authority for 89.8% of its revenue. Approximately 92% of the total revenue was spent on medical claims, and 99% of provider claims were settled beyond the stipulated 4-week period. There is an increasing trend in medical claims expenditure and lengthy delay in claims settlements, with most of them being paid beyond the mandatory 4-week period. Introduction of cost-containment measures including co-payment and capitation payment mechanism would be necessary to reduce the escalating cost of medical claims. Adherence to the 4-week stipulated period for payment of medical claims would be important to ensure that health care providers are financially resourced to deliver continuous health services to insured members. Furthermore, resourcing the scheme would be useful for speedy vetting of claims and also, community education on the National Health Insurance Scheme to improve membership coverage and revenue from the informal sector. Copyright © 2013, International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc.

Determinants of enrollment of informal sector workers in cooperative based health scheme in Bangladesh

PubMed Central

Sarker, Abdur Razzaque; Sultana, Marufa; Mahumud, Rashidul Alam; Ahmed, Sayem; Islam, Ziaul; Morton, Alec; Khan, Jahangir A. M.

2017-01-01

Background Providing access to affordable health care for the informal sector remains a considerable challenge for low income countries striving to make progress towards universal health coverage. The objective of the study is to identify the factors shaping the decision to enroll in a cooperative based health scheme for informal workers in Bangladesh and also help to identify the features of informal workers without health schemes and their likelihood of being insured. Methods Data were derived from a cross-sectional in-house survey within the catchment area of a cooperative based health scheme in Bangladesh during April–June 2014, covering a total of 784 households (458 members and 326 non-members). Multivariate logistic regression model was used to identify factors associated with cooperative based health scheme and explanatory variables. Findings This study found that a number of factors were significant determinants of health scheme participation including sex of household head, household composition, occupational category as well as involvement social financial safety net programs. Conclusion Findings from this study can be suggestive for policy-makers interested in scaling up health insurance for informal workers in Bangladesh. Shared funding from this large informal sector can generate new resources for healthcare, which is in line with the healthcare financing strategy of Bangladesh as well as the recommendation of the World Health Organization for developing social health insurance as part of the path to Universal Health Coverage. PMID:28750052

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.

Health Care Coverage Decision Making in Low- and Middle-Income Countries: Experiences from 25 Coverage Schemes.

PubMed

Gutierrez, Hialy; Shewade, Ashwini; Dai, Minghan; Mendoza-Arana, Pedro; Gómez-Dantés, Octavio; Jain, Nishant; Khonelidze, Irma; Nabyonga-Orem, Juliet; Saleh, Karima; Teerawattananon, Yot; Nishtar, Sania; Hornberger, John

2015-08-01

Lessons learned by countries that have successfully implemented coverage schemes for health services may be valuable for other countries, especially low- and middle-income countries (LMICs), which likewise are seeking to provide/expand coverage. The research team surveyed experts in population health management from LMICs for information on characteristics of health care coverage schemes and factors that influenced decision-making processes. The level of coverage provided by the different schemes varied. Nearly all the health care coverage schemes involved various representatives and stakeholders in their decision-making processes. Maternal and child health, cardiovascular diseases, cancer, and HIV were among the highest priorities guiding coverage development decisions. Evidence used to inform coverage decisions included medical literature, regional and global epidemiology, and coverage policies of other coverage schemes. Funding was the most commonly reported reason for restricting coverage. This exploratory study provides an overview of health care coverage schemes from participating LMICs and contributes to the scarce evidence base on coverage decision making. Sharing knowledge and experiences among LMICs can support efforts to establish systems for accessible, affordable, and equitable health care.

Extending health insurance in Ghana: effects of the National Health Insurance Scheme on maternity care.

PubMed

Brugiavini, Agar; Pace, Noemi

2016-12-01

There is considerable interest in exploring the potential of social health insurance in Africa where a number of countries are currently experimenting with different approaches. Since these schemes have been introduced recently and are continuously evolving, it is important to evaluate their effectiveness in the enhancement of health care utilization and reduction of out-of-pocket expenses for potential policy suggestions. To investigate how the National Health Insurance Schemes (NHIS) in Ghana affects the utilization of maternal health care services and medical out-of-pocket expenses. We used nationally-representative household data from the Ghana Demographic and Health Survey (GDHS). We analyzed the 2014 GDHS focusing on four outcome variables, i.e. antenatal check up, delivery in a health facility, delivery assisted by a trained person and out-of-pocket expenditure. We estimated probit and bivariate probit models to take into account the issue of self selection into the health insurance schemes. The results suggest that, also taking into account the issue of self selection into the health insurance schemes, the NHIS enrollment positively affects the probability of formal antenatal check-ups before delivery, the probability of delivery in an institution and the probability of being assisted during delivery by a trained person. On the contrary, we find that, once the issue of self-selection is taken into account, the NHIS enrollment does not have a significant effect on out-of-pocket expenditure at the extensive margin. Since a greater utilization of health-care services has a strong positive effect on the current and future health status of women and their children, the health-care authorities in Ghana should make every effort to extend this coverage. In particular, since the results of the first step of the bivariate probit regressions suggest that the educational attainment of women is a strong determinant of enrollment, and those with low education and unable

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.

A Hybrid Numerical Analysis Method for Structural Health Monitoring

NASA Technical Reports Server (NTRS)

Forth, Scott C.; Staroselsky, Alexander

2001-01-01

A new hybrid surface-integral-finite-element numerical scheme has been developed to model a three-dimensional crack propagating through a thin, multi-layered coating. The finite element method was used to model the physical state of the coating (far field), and the surface integral method was used to model the fatigue crack growth. The two formulations are coupled through the need to satisfy boundary conditions on the crack surface and the external boundary. The coupling is sufficiently weak that the surface integral mesh of the crack surface and the finite element mesh of the uncracked volume can be set up independently. Thus when modeling crack growth, the finite element mesh can remain fixed for the duration of the simulation as the crack mesh is advanced. This method was implemented to evaluate the feasibility of fabricating a structural health monitoring system for real-time detection of surface cracks propagating in engine components. In this work, the authors formulate the hybrid surface-integral-finite-element method and discuss the mechanical issues of implementing a structural health monitoring system in an aircraft engine environment.

Vouchers as demand side financing instruments for health care: a review of the Bangladesh maternal voucher scheme.

PubMed

Schmidt, Jean-Olivier; Ensor, Tim; Hossain, Atia; Khan, Salam

2010-07-01

Demand side financing (DSF) mechanisms transfer purchasing power to specified groups for defined goods and services in order to increase access to specified services. This is an important innovation in health care systems where access remains poor despite substantial subsidies towards the supply side. In Bangladesh, a maternal health DSF pilot in 33 sub-districts was launched in 2007. We report the results of a rapid review of this scheme undertaken during 2008 after 1 year of its setup. Quantitative data collected by DSF committees, facilities and national information systems were assessed alongside qualitative data, i.e. key informant interviews and focus group discussions with beneficiaries and health service providers on the operation of the scheme in 6 sub-districts. The scheme provides vouchers to women distributed by health workers that entitle mainly poor women to receive skilled care at home or a facility and also provide payments for transport and food. After initial setbacks voucher distribution rose quickly. The data also suggest that the rise in facility based delivery appeared to be more rapid in DSF than in other non-DSF areas, although the methods do not allow for a strict causal attribution as there might be co-founding effects. Fears that the financial incentives for surgical delivery would lead to an over emphasis on Caesarean section appear to be unfounded although the trends need further monitoring. DSF provides substantial additional funding to facilities but remains complex to administer, requiring a parallel administrative mechanism putting additional work burden on the health workers. There is little evidence that the mechanism encourages competition due to the limited provision of health care services. The main question outstanding is whether the achievements of the DSF scheme could be achieved more efficiently by adapting the regular government funding rather than creating an entirely new mechanism. Also, improving the quality of health

Implementation of Open-Source Web Mapping Technologies to Support Monitoring of Governmental Schemes

NASA Astrophysics Data System (ADS)

Pulsani, B. R.

2015-10-01

Several schemes are undertaken by the government to uplift social and economic condition of people. The monitoring of these schemes is done through information technology where involvement of Geographic Information System (GIS) is lacking. To demonstrate the benefits of thematic mapping as a tool for assisting the officials in making decisions, a web mapping application for three government programs such as Mother and Child Tracking system (MCTS), Telangana State Housing Corporation Limited (TSHCL) and Ground Water Quality Mapping (GWQM) has been built. Indeed the three applications depicted the distribution of various parameters thematically and helped in identifying the areas with higher and weaker distributions. Based on the three applications, the study tends to find similarities of many government schemes reflecting the nature of thematic mapping and hence deduces to implement this kind of approach for other schemes as well. These applications have been developed using SharpMap Csharp library which is a free and open source mapping library for developing geospatial applications. The study highlights upon the cost benefits of SharpMap and brings out the advantage of this library over proprietary vendors and further discusses its advantages over other open source libraries as well.

An Enhanced Three-Factor User Authentication Scheme Using Elliptic Curve Cryptosystem for Wireless Sensor Networks.

PubMed

Wang, Chenyu; Xu, Guoai; Sun, Jing

2017-12-19

As an essential part of Internet of Things (IoT), wireless sensor networks (WSNs) have touched every aspect of our lives, such as health monitoring, environmental monitoring and traffic monitoring. However, due to its openness, wireless sensor networks are vulnerable to various security threats. User authentication, as the first fundamental step to protect systems from various attacks, has attracted much attention. Numerous user authentication protocols armed with formal proof are springing up. Recently, two biometric-based schemes were proposed with confidence to be resistant to the known attacks including offline dictionary attack, impersonation attack and so on. However, after a scrutinization of these two schemes, we found them not secure enough as claimed, and then demonstrated that these schemes suffer from various attacks, such as offline dictionary attack, impersonation attack, no user anonymity, no forward secrecy, etc. Furthermore, we proposed an enhanced scheme to overcome the identified weaknesses, and proved its security via Burrows-Abadi-Needham (BAN) logic and the heuristic analysis. Finally, we compared our scheme with other related schemes, and the results showed the superiority of our scheme.

An Enhanced Three-Factor User Authentication Scheme Using Elliptic Curve Cryptosystem for Wireless Sensor Networks

PubMed Central

Xu, Guoai; Sun, Jing

2017-01-01

As an essential part of Internet of Things (IoT), wireless sensor networks (WSNs) have touched every aspect of our lives, such as health monitoring, environmental monitoring and traffic monitoring. However, due to its openness, wireless sensor networks are vulnerable to various security threats. User authentication, as the first fundamental step to protect systems from various attacks, has attracted much attention. Numerous user authentication protocols armed with formal proof are springing up. Recently, two biometric-based schemes were proposed with confidence to be resistant to the known attacks including offline dictionary attack, impersonation attack and so on. However, after a scrutinization of these two schemes, we found them not secure enough as claimed, and then demonstrated that these schemes suffer from various attacks, such as offline dictionary attack, impersonation attack, no user anonymity, no forward secrecy, etc. Furthermore, we proposed an enhanced scheme to overcome the identified weaknesses, and proved its security via Burrows–Abadi–Needham (BAN) logic and the heuristic analysis. Finally, we compared our scheme with other related schemes, and the results showed the superiority of our scheme. PMID:29257066

The Politico-Economic Challenges of Ghana’s National Health Insurance Scheme Implementation

PubMed Central

Fusheini, Adam

2016-01-01

Background: National/social health insurance schemes have increasingly been seen in many low- and middle-income countries (LMICs) as a vehicle to universal health coverage (UHC) and a viable alternative funding mechanism for the health sector. Several countries, including Ghana, have thus introduced and implemented mandatory national health insurance schemes (NHIS) as part of reform efforts towards increasing access to health services. Ghana passed mandatory national health insurance (NHI) legislation (ACT 650) in 2003 and commenced nationwide implementation in 2004. Several peer review studies and other research reports have since assessed the performance of the scheme with positive rating while challenges also noted. This paper contributes to the literature on economic and political implementation challenges based on empirical evidence from the perspectives of the different category of actors and institutions involved in the process. Methods: Qualitative in-depth interviews were held with 33 different category of participants in four selected district mutual health insurance schemes in Southern (two) and Northern (two) Ghana. This was to ascertain their views regarding the main challenges in the implementation process. The participants were selected through purposeful sampling, stakeholder mapping, and snowballing. Data was analysed using thematic grouping procedure. Results: Participants identified political issues of over politicisation and political interference as main challenges. The main economic issues participants identified included low premiums or contributions; broad exemptions, poor gatekeeper enforcement system; and culture of curative and hospital-centric care. Conclusion: The study establishes that political and economic factors have influenced the implementation process and the degree to which the policy has been implemented as intended. Thus, we conclude that there is a synergy between implementation and politics; and achieving UHC under the NHIS

A hybrid feature selection and health indicator construction scheme for delay-time-based degradation modelling of rolling element bearings

NASA Astrophysics Data System (ADS)

Zhang, Bin; Deng, Congying; Zhang, Yi

2018-03-01

Rolling element bearings are mechanical components used frequently in most rotating machinery and they are also vulnerable links representing the main source of failures in such systems. Thus, health condition monitoring and fault diagnosis of rolling element bearings have long been studied to improve operational reliability and maintenance efficiency of rotatory machines. Over the past decade, prognosis that enables forewarning of failure and estimation of residual life attracted increasing attention. To accurately and efficiently predict failure of the rolling element bearing, the degradation requires to be well represented and modelled. For this purpose, degradation of the rolling element bearing is analysed with the delay-time-based model in this paper. Also, a hybrid feature selection and health indicator construction scheme is proposed for extraction of the bearing health relevant information from condition monitoring sensor data. Effectiveness of the presented approach is validated through case studies on rolling element bearing run-to-failure experiments.

Reduction of catastrophic health care expenditures by a community-based health insurance scheme in Gujarat, India: current experiences and challenges.

PubMed Central

Ranson, Michael Kent

2002-01-01

OBJECTIVE: To assess the Self Employed Women's Association's Medical Insurance Fund in Gujarat in terms of insurance coverage according to income groups, protection of claimants from costs of hospitalization, time between discharge and reimbursement, and frequency of use. METHODS: One thousand nine hundred and thirty claims submitted over six years were analysed. FINDINGS: Two hundred and fifteen (11%) of 1927 claims were rejected. The mean household income of claimants was significantly lower than that of the general population. The percentage of households below the poverty line was similar for claimants and the general population. One thousand seven hundred and twelve (1712) claims were reimbursed: 805 (47%) fully and 907 (53%) at a mean reimbursement rate of 55.6%. Reimbursement more than halved the percentage of catastrophic hospitalizations (>10% of annual household income) and hospitalizations resulting in impoverishment. The average time between discharge and reimbursement was four months. The frequency of submission of claims was low (18.0/1000 members per year: 22-37% of the estimated frequency of hospitalization). CONCLUSIONS: The findings have implications for community-based health insurance schemes in India and elsewhere. Such schemes can protect poor households against the uncertain risk of medical expenses. They can be implemented in areas where institutional capacity is too weak to organize nationwide risk-pooling. Such schemes can cover poor people, including people and households below the poverty line. A trade off exists between maintaining the scheme's financial viability and protecting members against catastrophic expenditures. To facilitate reimbursement, administration, particularly processing of claims, should happen near claimants. Fine-tuning the design of a scheme is an ongoing process - a system of monitoring and evaluation is vital. PMID:12219151

Reduction of catastrophic health care expenditures by a community-based health insurance scheme in Gujarat, India: current experiences and challenges.

PubMed

Ranson, Michael Kent

2002-01-01

To assess the Self Employed Women's Association's Medical Insurance Fund in Gujarat in terms of insurance coverage according to income groups, protection of claimants from costs of hospitalization, time between discharge and reimbursement, and frequency of use. One thousand nine hundred and thirty claims submitted over six years were analysed. Two hundred and fifteen (11%) of 1927 claims were rejected. The mean household income of claimants was significantly lower than that of the general population. The percentage of households below the poverty line was similar for claimants and the general population. One thousand seven hundred and twelve (1712) claims were reimbursed: 805 (47%) fully and 907 (53%) at a mean reimbursement rate of 55.6%. Reimbursement more than halved the percentage of catastrophic hospitalizations (>10% of annual household income) and hospitalizations resulting in impoverishment. The average time between discharge and reimbursement was four months. The frequency of submission of claims was low (18.0/1000 members per year: 22-37% of the estimated frequency of hospitalization). The findings have implications for community-based health insurance schemes in India and elsewhere. Such schemes can protect poor households against the uncertain risk of medical expenses. They can be implemented in areas where institutional capacity is too weak to organize nationwide risk-pooling. Such schemes can cover poor people, including people and households below the poverty line. A trade off exists between maintaining the scheme's financial viability and protecting members against catastrophic expenditures. To facilitate reimbursement, administration, particularly processing of claims, should happen near claimants. Fine-tuning the design of a scheme is an ongoing process - a system of monitoring and evaluation is vital.

Implementation of a compressive sampling scheme for wireless sensors to achieve energy efficiency in a structural health monitoring system

NASA Astrophysics Data System (ADS)

O'Connor, Sean M.; Lynch, Jerome P.; Gilbert, Anna C.

2013-04-01

Wireless sensors have emerged to offer low-cost sensors with impressive functionality (e.g., data acquisition, computing, and communication) and modular installations. Such advantages enable higher nodal densities than tethered systems resulting in increased spatial resolution of the monitoring system. However, high nodal density comes at a cost as huge amounts of data are generated, weighing heavy on power sources, transmission bandwidth, and data management requirements, often making data compression necessary. The traditional compression paradigm consists of high rate (>Nyquist) uniform sampling and storage of the entire target signal followed by some desired compression scheme prior to transmission. The recently proposed compressed sensing (CS) framework combines the acquisition and compression stage together, thus removing the need for storage and operation of the full target signal prior to transmission. The effectiveness of the CS approach hinges on the presence of a sparse representation of the target signal in a known basis, similarly exploited by several traditional compressive sensing applications today (e.g., imaging, MRI). Field implementations of CS schemes in wireless SHM systems have been challenging due to the lack of commercially available sensing units capable of sampling methods (e.g., random) consistent with the compressed sensing framework, often moving evaluation of CS techniques to simulation and post-processing. The research presented here describes implementation of a CS sampling scheme to the Narada wireless sensing node and the energy efficiencies observed in the deployed sensors. Of interest in this study is the compressibility of acceleration response signals collected from a multi-girder steel-concrete composite bridge. The study shows the benefit of CS in reducing data requirements while ensuring data analysis on compressed data remain accurate.

Protection of Health Imagery by Region Based Lossless Reversible Watermarking Scheme

PubMed Central

Priya, R. Lakshmi; Sadasivam, V.

2015-01-01

Providing authentication and integrity in medical images is a problem and this work proposes a new blind fragile region based lossless reversible watermarking technique to improve trustworthiness of medical images. The proposed technique embeds the watermark using a reversible least significant bit embedding scheme. The scheme combines hashing, compression, and digital signature techniques to create a content dependent watermark making use of compressed region of interest (ROI) for recovery of ROI as reported in literature. The experiments were carried out to prove the performance of the scheme and its assessment reveals that ROI is extracted in an intact manner and PSNR values obtained lead to realization that the presented scheme offers greater protection for health imageries. PMID:26649328

Secure and Efficient Two-Factor User Authentication Scheme with User Anonymity for Network Based E-Health Care Applications.

PubMed

Li, Xiong; Niu, Jianwei; Karuppiah, Marimuthu; Kumari, Saru; Wu, Fan

2016-12-01

Benefited from the development of network and communication technologies, E-health care systems and telemedicine have got the fast development. By using the E-health care systems, patient can enjoy the remote medical service provided by the medical server. Medical data are important privacy information for patient, so it is an important issue to ensure the secure of transmitted medical data through public network. Authentication scheme can thwart unauthorized users from accessing services via insecure network environments, so user authentication with privacy protection is an important mechanism for the security of E-health care systems. Recently, based on three factors (password, biometric and smart card), an user authentication scheme for E-health care systems was been proposed by Amin et al., and they claimed that their scheme can withstand most of common attacks. Unfortunate, we find that their scheme cannot achieve the untraceability feature of the patient. Besides, their scheme lacks a password check mechanism such that it is inefficient to find the unauthorized login by the mistake of input a wrong password. Due to the same reason, their scheme is vulnerable to Denial of Service (DoS) attack if the patient updates the password mistakenly by using a wrong password. In order improve the security level of authentication scheme for E-health care application, a robust user authentication scheme with privacy protection is proposed for E-health care systems. Then, security prove of our scheme are analysed. Security and performance analyses show that our scheme is more powerful and secure for E-health care systems when compared with other related schemes.

Development of a fully automated network system for long-term health-care monitoring at home.

PubMed

Motoi, K; Kubota, S; Ikarashi, A; Nogawa, M; Tanaka, S; Nemoto, T; Yamakoshi, K

2007-01-01

Daily monitoring of health condition at home is very important not only as an effective scheme for early diagnosis and treatment of cardiovascular and other diseases, but also for prevention and control of such diseases. From this point of view, we have developed a prototype room for fully automated monitoring of various vital signs. From the results of preliminary experiments using this room, it was confirmed that (1) ECG and respiration during bathing, (2) excretion weight and blood pressure, and (3) respiration and cardiac beat during sleep could be monitored with reasonable accuracy by the sensor system installed in bathtub, toilet and bed, respectively.

Management initiatives in a community-based health insurance scheme.

PubMed

Sinha, Tara; Ranson, M Kent; Chatterjee, Mirai; Mills, Anne

2007-01-01

Community-based health insurance (CBHI) schemes have developed in response to inadequacies of alternate systems for protecting the poor against health care expenditures. Some of these schemes have arisen within community-based organizations (CBOs), which have strong links with poor communities, and are therefore well situated to offer CBHI. However, the managerial capacities of many such CBOs are limited. This paper describes management initiatives undertaken in a CBHI scheme in India, in the course of an action-research project. The existing structures and systems at the CBHI had several strengths, but fell short on some counts, which became apparent in the course of planning for two interventions under the research project. Management initiatives were introduced that addressed four features of the CBHI, viz. human resources, organizational structure, implementation systems, and data management. Trained personnel were hired and given clear roles and responsibilities. Lines of reporting and accountability were spelt out, and supportive supervision was provided to team members. The data resources of the organization were strengthened for greater utilization of this information. While the changes that were introduced took some time to be accepted by team members, the commitment of the CBHI's leadership to these initiatives was critical to their success. Copyright (c) 2007 John Wiley & Sons, Ltd.

A robust uniqueness-and-anonymity-preserving remote user authentication scheme for connected health care.

PubMed

Wen, Fengtong

2013-12-01

User authentication plays an important role to protect resources or services from being accessed by unauthorized users. In a recent paper, Das et al. proposed a secure and efficient uniqueness-and-anonymity-preserving remote user authentication scheme for connected health care. This scheme uses three factors, e.g. biometrics, password, and smart card, to protect the security. It protects user privacy and is believed to have many abilities to resist a range of network attacks, even if the secret information stored in the smart card is compromised. In this paper, we analyze the security of Das et al.'s scheme, and show that the scheme is in fact insecure against the replay attack, user impersonation attacks and off-line guessing attacks. Then, we also propose a robust uniqueness-and-anonymity-preserving remote user authentication scheme for connected health care. Compared with the existing schemes, our protocol uses a different user authentication mechanism to resist replay attack. We show that our proposed scheme can provide stronger security than previous protocols. Furthermore, we demonstrate the validity of the proposed scheme through the BAN (Burrows, Abadi, and Needham) logic.

A scheme for a flexible classification of dietary and health biomarkers.

PubMed

Gao, Qian; Praticò, Giulia; Scalbert, Augustin; Vergères, Guy; Kolehmainen, Marjukka; Manach, Claudine; Brennan, Lorraine; Afman, Lydia A; Wishart, David S; Andres-Lacueva, Cristina; Garcia-Aloy, Mar; Verhagen, Hans; Feskens, Edith J M; Dragsted, Lars O

2017-01-01

Biomarkers are an efficient means to examine intakes or exposures and their biological effects and to assess system susceptibility. Aided by novel profiling technologies, the biomarker research field is undergoing rapid development and new putative biomarkers are continuously emerging in the scientific literature. However, the existing concepts for classification of biomarkers in the dietary and health area may be ambiguous, leading to uncertainty about their application. In order to better understand the potential of biomarkers and to communicate their use and application, it is imperative to have a solid scheme for biomarker classification that will provide a well-defined ontology for the field. In this manuscript, we provide an improved scheme for biomarker classification based on their intended use rather than the technology or outcomes (six subclasses are suggested: food compound intake biomarkers (FCIBs), food or food component intake biomarkers (FIBs), dietary pattern biomarkers (DPBs), food compound status biomarkers (FCSBs), effect biomarkers, physiological or health state biomarkers). The application of this scheme is described in detail for the dietary and health area and is compared with previous biomarker classification for this field of research.

Oral health in children in Denmark under different public dental health care schemes.

PubMed

Christensen, L B; Petersen, P E; Hede, B

2010-06-01

To describe and analyse oral health of children and adolescents under two types of dental health care schemes under the Public Dental Health Service in Denmark, and to analyse possible influence of socio-economic and socio-cultural factors. Data on children's oral health status was obtained from public oral health registers and were pooled with data from questionnaires sent to parents of the children and adolescents. The study comprised individuals aged 5, 12 and 15, in total 2168 persons, randomly drawn from four municipalities with dental care provided by salaried dentists in public dental clinics and three municipalities with dental care provided by dentists in private practice. 70% of the parents completed a questionnaire including questions on socio-economic and socio-cultural background, lifestyle-related factors, self assessment of parents' oral- and general health. After the data were merged, the final study population represented 60% of the original target population. The mean caries experience (DMFS+dmfs) was 2.2 and further analysis of caries experience in each age group showed no variations in relation to type of provider of dental care. However, multiple dummy regression analyses demonstrated that low education, poor general health, foreign citizenship and smoking habits of the parents were important determinants for high level of caries in their children. Occurrence of dental caries as well as changes over time in levels of dental caries of Danish children did not vary by scheme of Public Dental Health Service, i.e. whether dental health care was provided by public employed dentists or by private practitioners. However, social inequalities still relate to caries experience in children and adolescents. Adjustment of preventive oral health activities strategy seems to be needed.

The shaded side of the UHC cube: a systematic review of human resources for health management and administration in social health protection schemes.

PubMed

Obermann, Konrad; Chanturidze, Tata; Glazinski, Bernd; Dobberschuetz, Karin; Steinhauer, Heiko; Schmidt, Jean-Olivier

2018-02-20

Managers and administrators in charge of social protection and health financing, service purchasing and provision play a crucial role in harnessing the potential advantage of prudent organization, management and purchasing of health services, thereby supporting the attainment of Universal Health Coverage. However, very little is known about the needed quantity and quality of such staff, in particular when it comes to those institutions managing mandatory health insurance schemes and purchasing services. As many health care systems in low- and middle-income countries move towards independent institutions (both purchasers and providers) there is a clear need to have good data on staff and administrative cost in different social health protection schemes as a basis for investing in the development of a cadre of health managers and administrators for such schemes. We report on a systematic literature review of human resources in health management and administration in social protection schemes and suggest some aspects in moving research, practical applications and the policy debate forward.

Payment for Health Care and Perception of the National Health Insurance Scheme in a Rural Area in Southwest Nigeria

PubMed Central

Adewole, David A.; Adebayo, Ayodeji M.; Udeh, Emeka I.; Shaahu, Vivian N.; Dairo, Magbagbeola D.

2015-01-01

Health insurance coverage of the informal sector is a challenge in Nigeria. This study assessed the methods of payment for health care and awareness about the National Health Insurance Scheme (NHIS) among members of selected households in a rural area in the southwest of Nigeria. Using a multistage sampling technique, a semi-structured, pretested interviewer-administered questionnaire was used to collect data from 345 households. The majority of the people still pay for health care by out-of-pocket (OOP) method. Awareness about the NHIS in Nigeria was poor, but attitude to it was encouraging; and from the responses obtained, the people implied that they were willing to enroll in the scheme if the opportunity is offered. However, lack of trust in government social policies, religious belief, and poverty were some of the factors that might impede the implementation and expansion of the NHIS in the informal sector. Stakeholders should promote socioculturally appropriate awareness program about the NHIS and its benefits. Factors that might present challenges to the scheme should be adequately addressed by the government and other stakeholders associated with prepayment schemes in Nigeria. PMID:26195464

Payment for Health Care and Perception of the National Health Insurance Scheme in a Rural Area in Southwest Nigeria.

PubMed

Adewole, David A; Adebayo, Ayodeji M; Udeh, Emeka I; Shaahu, Vivian N; Dairo, Magbagbeola D

2015-09-01

Health insurance coverage of the informal sector is a challenge in Nigeria. This study assessed the methods of payment for health care and awareness about the National Health Insurance Scheme (NHIS) among members of selected households in a rural area in the southwest of Nigeria. Using a multistage sampling technique, a semi-structured, pretested interviewer-administered questionnaire was used to collect data from 345 households. The majority of the people still pay for health care by out-of-pocket (OOP) method. Awareness about the NHIS in Nigeria was poor, but attitude to it was encouraging; and from the responses obtained, the people implied that they were willing to enroll in the scheme if the opportunity is offered. However, lack of trust in government social policies, religious belief, and poverty were some of the factors that might impede the implementation and expansion of the NHIS in the informal sector. Stakeholders should promote socioculturally appropriate awareness program about the NHIS and its benefits. Factors that might present challenges to the scheme should be adequately addressed by the government and other stakeholders associated with prepayment schemes in Nigeria. © The American Society of Tropical Medicine and Hygiene.

Improvement of a uniqueness-and-anonymity-preserving user authentication scheme for connected health care.

PubMed

Xie, Qi; Liu, Wenhao; Wang, Shengbao; Han, Lidong; Hu, Bin; Wu, Ting

2014-09-01

Patient's privacy-preserving, security and mutual authentication between patient and the medical server are the important mechanism in connected health care applications, such as telecare medical information systems and personally controlled health records systems. In 2013, Wen showed that Das et al.'s scheme is vulnerable to the replay attack, user impersonation attacks and off-line guessing attacks, and then proposed an improved scheme using biometrics, password and smart card to overcome these weaknesses. However, we show that Wen's scheme is still vulnerable to off-line password guessing attacks, does not provide user's anonymity and perfect forward secrecy. Further, we propose an improved scheme to fix these weaknesses, and use the applied pi calculus based formal verification tool ProVerif to prove the security and authentication.

Comparison of medicines management strategies in insurance schemes in middle-income countries: four case studies.

PubMed

Kaplan, Warren A; Ashigbie, Paul G; Brooks, Mohamad I; Wirtz, Veronika J

2017-01-01

Many middle-income countries are scaling up health insurance schemes to provide financial protection and access to affordable medicines to poor and uninsured populations. Although there is a wealth of evidence on how high income countries with mature insurance schemes manage cost-effective use of medicines, there is limited evidence on the strategies used in middle-income countries. This paper compares the medicines management strategies that four insurance schemes in middle-income countries use to improve access and cost-effective use of medicines among beneficiaries. We compare key strategies promoting cost-effective medicines use in the New Rural Cooperative Medical Scheme (NCMS) in China, National Health Insurance Scheme in Ghana, Jamkesmas in Indonesia and Seguro Popular in Mexico. Through the peer-reviewed and grey literature as of late 2013, we identified strategies that met our inclusion criteria as well as any evidence showing if, and/or how, these strategies affected medicines management. Stakeholders involved and affected by medicines coverage policies in these insurance schemes were asked to provide relevant documents describing the medicines related aspects of these insurance programs. We also asked them specifically to identify publications discussing the unintended consequences of the strategies implemented. Use of formularies, bulk procurement, standard treatment guidelines and separation of prescribing and dispensing were present in all four schemes. Also, increased transparency through publication of tender agreements and procurement prices was introduced in all four. Common strategies shared by three out of four schemes were medicine price negotiation or rebates, generic reference pricing, fixed salaries for prescribers, accredited preferred provider network, disease management programs, and monitoring of medicines purchases. Cost-sharing and payment for performance was rarely used. There was a lack of performance monitoring strategies in all

Autonomous health management for PMSM rail vehicles through demagnetization monitoring and prognosis control.

PubMed

Niu, Gang; Jiang, Junjie; Youn, Byeng D; Pecht, Michael

2018-01-01

Autonomous vehicles are playing an increasingly importance in support of a wide variety of critical events. This paper presents a novel autonomous health management scheme on rail vehicles driven by permanent magnet synchronous motors (PMSMs). Firstly, the PMSMs are modeled based on first principle to deduce the initial profile of pneumatic braking (p-braking) force, then which is utilized for real-time demagnetization monitoring and degradation prognosis through similarity-based theory and generate prognosis-enhanced p-braking force strategy for final optimal control. A case study is conducted to demonstrate the feasibility and benefit of using the real-time prognostics and health management (PHM) information in vehicle 'drive-brake' control automatically. The results show that accurate demagnetization monitoring, degradation prognosis, and real-time capability for control optimization can be obtained, which can effectively relieve brake shoe wear. Copyright © 2018 ISA. Published by Elsevier Ltd. All rights reserved.

Linking payment to health outcomes: a taxonomy and examination of performance-based reimbursement schemes between healthcare payers and manufacturers.

PubMed

Carlson, Josh J; Sullivan, Sean D; Garrison, Louis P; Neumann, Peter J; Veenstra, David L

2010-08-01

To identify, categorize and examine performance-based health outcomes reimbursement schemes for medical technology. We performed a review of performance-based health outcomes reimbursement schemes over the past 10 years (7/98-010/09) using publicly available databases, web and grey literature searches, and input from healthcare reimbursement experts. We developed a taxonomy of scheme types by inductively organizing the schemes identified according to the timing, execution, and health outcomes measured in the schemes. Our search yielded 34 coverage with evidence development schemes, 10 conditional treatment continuation schemes, and 14 performance-linked reimbursement schemes. The majority of schemes are in Europe and Australia, with an increasing number in Canada and the U.S. These schemes have the potential to alter the reimbursement and pricing landscape for medical technology, but significant challenges, including high transaction costs and insufficient information systems, may limit their long-term impact. Future studies regarding experiences and outcomes of implemented schemes are necessary. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Disparity in reimbursement for tuberculosis care among different health insurance schemes: evidence from three counties in central China.

PubMed

Pan, Yao; Chen, Shanquan; Chen, Manli; Zhang, Pei; Long, Qian; Xiang, Li; Lucas, Henry

2016-01-27

Health inequity is an important issue all around the world. The Chinese basic medical security system comprises three major insurance schemes, namely the Urban Employee Basic Medical Insurance (UEBMI), the Urban Resident Basic Medical Insurance (URBMI), and the New Cooperative Medical Scheme (NCMS). Little research has been conducted to look into the disparity in payments among the health insurance schemes in China. In this study, we aimed to evaluate the disparity in reimbursements for tuberculosis (TB) care among the abovementioned health insurance schemes. This study uses a World Health Organization (WHO) framework to analyze the disparities and equity relating to the three dimensions of health insurance: population coverage, the range of services covered, and the extent to which costs are covered. Each of the health insurance scheme's policies were categorized and analyzed. An analysis of the claims database of all hospitalizations reimbursed from 2010 to 2012 in three counties of Yichang city (YC), which included 1506 discharges, was conducted to identify the differences in reimbursement rates and out-of-pocket (OOP) expenses among the health insurance schemes. Tuberculosis patients had various inpatient expenses depending on which scheme they were covered by (TB patients covered by the NCMS have less inpatient expenses than those who were covered by the URBMI, who have less inpatient expenses than those covered by the UEBMI). We found a significant horizontal inequity of healthcare utilization among the lower socioeconomic groups. In terms of financial inequity, TB patients who earned less paid more. The NCMS provides modest financial protection, based on income. Overall, TB patients from lower socioeconomic groups were the most vulnerable. There are large disparities in reimbursement for TB care among the three health insurance schemes and this, in turn, hampers TB control. Reducing the gap in health outcomes between the three health insurance schemes in

[Intelligent watch system for health monitoring based on Bluetooth low energy technology].

PubMed

Wang, Ji; Guo, Hailiang; Ren, Xiaoli

2017-08-01

According to the development status of wearable technology and the demand of intelligent health monitoring, we studied the multi-function integrated smart watches solution and its key technology. First of all, the sensor technology with high integration density, Bluetooth low energy (BLE) and mobile communication technology were integrated and used in develop practice. Secondly, for the hardware design of the system in this paper, we chose the scheme with high integration density and cost-effective computer modules and chips. Thirdly, we used real-time operating system FreeRTOS to develop the friendly graphical interface interacting with touch screen. At last, the high-performance application software which connected with BLE hardware wirelessly and synchronized data was developed based on android system. The function of this system included real-time calendar clock, telephone message, address book management, step-counting, heart rate and sleep quality monitoring and so on. Experiments showed that the collecting data accuracy of various sensors, system data transmission capacity, the overall power consumption satisfy the production standard. Moreover, the system run stably with low power consumption, which could realize intelligent health monitoring effectively.

National health insurance scheme: How receptive are the private healthcare practitioners in a local government area of Lagos state.

PubMed

Christina, Campbell Princess; Latifat, Taiwo Toyin; Collins, Nnaji Feziechukwu; Olatunbosun, Abolarin Thaddeus

2014-11-01

National Health Insurance Scheme (NHIS) is one of the health financing options adopted by Nigeria for improved healthcare access especially to the low income earners. One of the key operators of the scheme is the health care providers, thus their uptake of the scheme is fundamental to the survival of the scheme. The study reviewed the uptake of the NHIS by private health care providers in a Local Government Area in Lagos State. To assess the uptake of the NHIS by private healthcare practitioners. This descriptive cross-sectional study recruited 180 private healthcare providers selected by multistage sampling technique with a response rate of 88.9%. Awareness, knowledge and uptake of NHIS were 156 (97.5%), 110 (66.8%) and 97 (60.6%), respectively. Half of the respondents 82 (51.3%) were dissatisfied with the operations of the scheme. Major reasons were failure of entitlement payment by Health Maintenance Organisations 13 (81.3%) and their incurring losses in participating in the scheme 8(50%). There was a significant association between awareness, level of education, knowledge of NHIS and registration into scheme by the respondents P-value < 0.05. Awareness and knowledge of NHIS were commendable among the private health care providers. Six out of 10 had registered with the NHIS but half of the respondents 82 (51.3%) were dissatisfied with the scheme and 83 (57.2%) regretted participating in the scheme. There is need to improve payment modalities and ensure strict adherence to laid down policies.

Ability to Pay for Future National Health Financing Scheme among Malaysian Households.

PubMed

Aizuddin, Azimatun Noor; Aljunid, Syed Mohamed

Malaysia is no exception to the challenging health care financing phenomenon of globalization. The objective of the present study was to assess the ability to pay among Malaysian households as preparation for a future national health financing scheme. This was a cross-sectional study involving representative samples of 774 households in Peninsular Malaysia. A majority of households were found to have the ability to pay for their health care. Household expenditure on health care per month was between MYR1 and MYR2000 with a mean (standard deviation [SD]) of 73.54 (142.66), or in a percentage of per-month income between 0.05% and 50% with mean (SD) 2.74 (5.20). The final analysis indicated that ability to pay was significantly higher among younger and higher-income households. Sociodemographic and socioeconomic statuses are important eligibility factors to be considered in planning the proposed national health care financing scheme to shield the needed group from catastrophic health expenditures. Copyright © 2017 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.

Who benefits from the Obio Community Health Insurance Scheme in Rivers State, Nigeria? A benefit incidence analysis.

PubMed

Vaughan, Kelsey; Akwataghibe, Ngozi; Fakunle, Babatunde; Wolmarans, Liezel

2016-11-01

A key aspect of monitoring and evaluating health programs is ensuring that benefits are reaching their target population. We conducted a benefit incidence analysis (BIA) of a Shell-sponsored community health insurance scheme in Nigeria to determine the extent to which the target group (the poor) was benefitting. We examined a sample of 616 patients' hospital attendance, financial and administrative records from 2012-2013. We estimated annual utilization rates and average unit costs for inpatient and outpatient services. We multiplied the two to produce a total cost per patient, then deducted annual out-of-pocket expenditures to estimate the total community-based health insurance scheme benefit per person. Benefits were multiplied by the total number of persons in each socioeconomic group to aggregate benefits. We used concentration curves and dominance tests to determine statistical significance at 5% and 10% levels of significance. Collectively, the poorest 20% of the population received 12% of benefits while the richest quintile received the largest share (23%). Inpatient and outpatient benefits are weakly regressive (pro-rich), statistically significant at a 10% level of significance. Although the poor were found to benefit, this BIA revealed a tendency towards pro-rich distributions. Removing co-payments for the poorest, reducing long wait and visit times and using community volunteers to help increase access to health services may improve benefits for the poor. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

An Internet of Things based physiological signal monitoring and receiving system for virtual enhanced health care network.

PubMed

Rajan, J Pandia; Rajan, S Edward

2018-01-01

Wireless physiological signal monitoring system designing with secured data communication in the health care system is an important and dynamic process. We propose a signal monitoring system using NI myRIO connected with the wireless body sensor network through multi-channel signal acquisition method. Based on the server side validation of the signal, the data connected to the local server is updated in the cloud. The Internet of Things (IoT) architecture is used to get the mobility and fast access of patient data to healthcare service providers. This research work proposes a novel architecture for wireless physiological signal monitoring system using ubiquitous healthcare services by virtual Internet of Things. We showed an improvement in method of access and real time dynamic monitoring of physiological signal of this remote monitoring system using virtual Internet of thing approach. This remote monitoring and access system is evaluated in conventional value. This proposed system is envisioned to modern smart health care system by high utility and user friendly in clinical applications. We claim that the proposed scheme significantly improves the accuracy of the remote monitoring system compared to the other wireless communication methods in clinical system.

Exploiting geo-distributed clouds for a e-health monitoring system with minimum service delay and privacy preservation.

PubMed

Shen, Qinghua; Liang, Xiaohui; Shen, Xuemin; Lin, Xiaodong; Luo, Henry Y

2014-03-01

In this paper, we propose an e-health monitoring system with minimum service delay and privacy preservation by exploiting geo-distributed clouds. In the system, the resource allocation scheme enables the distributed cloud servers to cooperatively assign the servers to the requested users under the load balance condition. Thus, the service delay for users is minimized. In addition, a traffic-shaping algorithm is proposed. The traffic-shaping algorithm converts the user health data traffic to the nonhealth data traffic such that the capability of traffic analysis attacks is largely reduced. Through the numerical analysis, we show the efficiency of the proposed traffic-shaping algorithm in terms of service delay and privacy preservation. Furthermore, through the simulations, we demonstrate that the proposed resource allocation scheme significantly reduces the service delay compared to two other alternatives using jointly the short queue and distributed control law.

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.

Offending outcomes of a mental health youth diversion pilot scheme in England.

PubMed

Haines, Alina; Lane, Steven; McGuire, James; Perkins, Elizabeth; Whittington, Richard

2015-04-01

A youth justice diversion scheme designed to enhance health provision for young people with mental health and developmental problems as soon as they enter the youth justice system has been piloted in six areas of England. As part of a wider evaluation of the first youth justice diversion scheme outside the USA, our aim here was to examine re-offending. We sought to test the hypothesis that a specialised service for young people with mental health difficulties would be associated with reductions in re-offending. In addition, we examined factors associated with the re-offending that occurred. Two hundred and eight young offenders with access to the diversion scheme and 200 without were compared in four geographical area pairings to allow for socio-demographic contextual differences. Officially recorded re-offending was ascertained for 15-30 months after study entry. We also tested characteristics associated with re-offending among everyone entering the diversion scheme (n = 870). There was no statistically significant difference in re-offending rates between the diversion and comparison samples, but those with access to diversion had significantly longer periods of desistance from offending than those who did not. In multivariate analysis, the only significant characteristic associated with re-offending was history of previous offending. Prevention of re-offending is only one of the potentially beneficial outcomes of diversion of young people who are vulnerable because of mental health problems, but it is an important one. The advantage of longer survival without prevention of re-offending suggests that future research should explore critical timings for these young people. The equivocal nature of the findings suggests that a randomised controlled trial would be justified. Copyright © 2014 John Wiley & Sons, Ltd.

A user anonymity preserving three-factor authentication scheme for telecare medicine information systems.

PubMed

Tan, Zuowen

2014-03-01

The telecare medicine information system enables the patients gain health monitoring at home and access medical services over internet or mobile networks. In recent years, the schemes based on cryptography have been proposed to address the security and privacy issues in the telecare medicine information systems. However, many schemes are insecure or they have low efficiency. Recently, Awasthi and Srivastava proposed a three-factor authentication scheme for telecare medicine information systems. In this paper, we show that their scheme is vulnerable to the reflection attacks. Furthermore, it fails to provide three-factor security and the user anonymity. We propose a new three-factor authentication scheme for the telecare medicine information systems. Detailed analysis demonstrates that the proposed scheme provides mutual authentication, server not knowing password and freedom of password, biometric update and three-factor security. Moreover, the new scheme provides the user anonymity. As compared with the previous three-factor authentication schemes, the proposed scheme is more secure and practical.

Stakeholders Perspectives on the Success Drivers in Ghana's National Health Insurance Scheme - Identifying Policy Translation Issues.

PubMed

Fusheini, Adam; Marnoch, Gordon; Gray, Ann Marie

2016-10-01

Ghana's National Health Insurance Scheme (NHIS), established by an Act of Parliament (Act 650), in 2003 and since replaced by Act 852 of 2012 remains, in African terms, unprecedented in terms of growth and coverage. As a result, the scheme has received praise for its associated legal reforms, clinical audit mechanisms and for serving as a hub for knowledge sharing and learning within the context of South-South cooperation. The scheme continues to shape national health insurance thinking in Africa. While the success, especially in coverage and financial access has been highlighted by many authors, insufficient attention has been paid to critical and context-specific factors. This paper seeks to fill that gap. Based on an empirical qualitative case study of stakeholders' views on challenges and success factors in four mutual schemes (district offices) located in two regions of Ghana, the study uses the concept of policy translation to assess whether the Ghana scheme could provide useful lessons to other African and developing countries in their quest to implement social/NHISs. In the study, interviewees referred to both 'hard and soft' elements as driving the "success" of the Ghana scheme. The main 'hard elements' include bureaucratic and legal enforcement capacities; IT; financing; governance, administration and management; regulating membership of the scheme; and service provision and coverage capabilities. The 'soft' elements identified relate to: the background/context of the health insurance scheme; innovative ways of funding the NHIS, the hybrid nature of the Ghana scheme; political will, commitment by government, stakeholders and public cooperation; social structure of Ghana (solidarity); and ownership and participation. Other developing countries can expect to translate rather than re-assemble a national health insurance programme in an incomplete and highly modified form over a period of years, amounting to a process best conceived as germination as opposed

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

PubMed

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

2015-01-01

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

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

PubMed Central

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

2015-01-01

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

Catastrophic Health Expenditure and Rural Household Impoverishment in China: What Role Does the New Cooperative Health Insurance Scheme Play?

PubMed Central

Wu, Qunhong; Liu, Chaojie; Jiao, Mingli; Liu, Guoxiang; Hao, Yanhua; Ning, Ning

2014-01-01

Objective To determine whether the New Cooperative Medical Insurance Scheme (NCMS) is associated with decreased levels of catastrophic health expenditure and reduced impoverishment due to medical expenses in rural households of China. Methods An analysis of a national representative sample of 38,945 rural households (129,635 people) from the 2008 National Health Service Survey was performed. Logistic regression models used binary indicator of catastrophic health expenditure as dependent variable, with household consumption, demographic characteristics, health insurance schemes, and chronic illness as independent variables. Results Higher percentage of households experiencing catastrophic health expenditure and medical impoverishment correlates to increased health care need. While the higher socio-economic status households had similar levels of catastrophic health expenditure as compared with the lowest. Households covered by the NCMS had similar levels of catastrophic health expenditure and medical impoverishment as those without health insurance. Conclusion Despite over 95% of coverage, the NCMS has failed to prevent catastrophic health expenditure and medical impoverishment. An upgrade of benefit packages is needed, and effective cost control mechanisms on the provider side needs to be considered. PMID:24714605

Reconsideration of the scheme of the international classification of functioning, disability and health: incentives from the Netherlands for a global debate.

PubMed

Heerkens, Yvonne F; de Weerd, Marjolein; Huber, Machteld; de Brouwer, Carin P M; van der Veen, Sabina; Perenboom, Rom J M; van Gool, Coen H; Ten Napel, Huib; van Bon-Martens, Marja; Stallinga, Hillegonda A; van Meeteren, Nico L U

2018-03-01

The ICF (International Classification of Functioning, Disability and Health) framework (used worldwide to describe 'functioning' and 'disability'), including the ICF scheme (visualization of functioning as result of interaction with health condition and contextual factors), needs reconsideration. The purpose of this article is to discuss alternative ICF schemes. Reconsideration of ICF via literature review and discussions with 23 Dutch ICF experts. Twenty-six experts were invited to rank the three resulting alternative schemes. The literature review provided five themes: 1) societal developments; 2) health and research influences; 3) conceptualization of health; 4) models/frameworks of health and disability; and 5) ICF-criticism (e.g. position of 'health condition' at the top and role of 'contextual factors'). Experts concluded that the ICF scheme gives the impression that the medical perspective is dominant instead of the biopsychosocial perspective. Three alternative ICF schemes were ranked by 16 (62%) experts, resulting in one preferred scheme. There is a need for a new ICF scheme, better reflecting the ICF framework, for further (inter)national consideration. These Dutch schemes should be reviewed on a global scale, to develop a scheme that is more consistent with current and foreseen developments and changing ideas on health. Implications for Rehabilitation We propose policy makers on community, regional and (inter)national level to consider the use of the alternative schemes of the International Classification of Functioning, Disability and Health within their plans to promote functioning and health of their citizens and researchers and teachers to incorporate the alternative schemes into their research and education to emphasize the biopsychosocial paradigm. We propose to set up an international Delphi procedure involving citizens (including patients), experts in healthcare, occupational care, research, education and policy, and planning to get consensus on

Community-based health insurance programmes and the national health insurance scheme of Nigeria: challenges to uptake and integration

PubMed Central

2014-01-01

Background Nigeria has included a regulated community-based health insurance (CBHI) model within its National Health Insurance Scheme (NHIS). Uptake to date has been disappointing, however. The aim of this study is to review the present status of CBHI in SSA in general to highlight the issues that affect its successful integration within the NHIS of Nigeria and more widely in developing countries. Methods A literature survey using PubMed and EconLit was carried out to identify and review studies that report factors affecting implementation of CBHI in SSA with a focus on Nigeria. Results CBHI schemes with a variety of designs have been introduced across SSA but with generally disappointing results so far. Two exceptions are Ghana and Rwanda, both of which have introduced schemes with effective government control and support coupled with intensive implementation programmes. Poor support for CBHI is repeatedly linked elsewhere with failure to engage and account for the ‘real world’ needs of beneficiaries, lack of clear legislative and regulatory frameworks, inadequate financial support, and unrealistic enrolment requirements. Nigeria’s CBHI-type schemes for the informal sectors of its NHIS have been set up under an appropriate legislative framework, but work is needed to eliminate regressive financing, to involve scheme members in the setting up and management of programmes, to inform and educate more effectively, to eliminate lack of confidence in the schemes, and to address inequity in provision. Targeted subsidies should also be considered. Conclusions Disappointing uptake of CBHI-type NHIS elements in Nigeria can be addressed through closer integration of informal and formal programmes under the NHIS umbrella, with increasing involvement of beneficiaries in scheme design and management, improved communication and education, and targeted financial assistance. PMID:24559409

Hybrid monitoring scheme for end-to-end performance enhancement of multicast-based real-time media

NASA Astrophysics Data System (ADS)

Park, Ju-Won; Kim, JongWon

2004-10-01

As real-time media applications based on IP multicast networks spread widely, end-to-end QoS (quality of service) provisioning for these applications have become very important. To guarantee the end-to-end QoS of multi-party media applications, it is essential to monitor the time-varying status of both network metrics (i.e., delay, jitter and loss) and system metrics (i.e., CPU and memory utilization). In this paper, targeting the multicast-enabled AG (Access Grid) a next-generation group collaboration tool based on multi-party media services, the applicability of hybrid monitoring scheme that combines active and passive monitoring is investigated. The active monitoring measures network-layer metrics (i.e., network condition) with probe packets while the passive monitoring checks both application-layer metrics (i.e., user traffic condition by analyzing RTCP packets) and system metrics. By comparing these hybrid results, we attempt to pinpoint the causes of performance degradation and explore corresponding reactions to improve the end-to-end performance. The experimental results show that the proposed hybrid monitoring can provide useful information to coordinate the performance improvement of multi-party real-time media applications.

Ultrasensitive and Highly Stable Resistive Pressure Sensors with Biomaterial-Incorporated Interfacial Layers for Wearable Health-Monitoring and Human-Machine Interfaces.

PubMed

Chang, Hochan; Kim, Sungwoong; Jin, Sumin; Lee, Seung-Woo; Yang, Gil-Tae; Lee, Ki-Young; Yi, Hyunjung

2018-01-10

Flexible piezoresistive sensors have huge potential for health monitoring, human-machine interfaces, prosthetic limbs, and intelligent robotics. A variety of nanomaterials and structural schemes have been proposed for realizing ultrasensitive flexible piezoresistive sensors. However, despite the success of recent efforts, high sensitivity within narrower pressure ranges and/or the challenging adhesion and stability issues still potentially limit their broad applications. Herein, we introduce a biomaterial-based scheme for the development of flexible pressure sensors that are ultrasensitive (resistance change by 5 orders) over a broad pressure range of 0.1-100 kPa, promptly responsive (20 ms), and yet highly stable. We show that employing biomaterial-incorporated conductive networks of single-walled carbon nanotubes as interfacial layers of contact-based resistive pressure sensors significantly enhances piezoresistive response via effective modulation of the interlayer resistance and provides stable interfaces for the pressure sensors. The developed flexible sensor is capable of real-time monitoring of wrist pulse waves under external medium pressure levels and providing pressure profiles applied by a thumb and a forefinger during object manipulation at a low voltage (1 V) and power consumption (<12 μW). This work provides a new insight into the material candidates and approaches for the development of wearable health-monitoring and human-machine interfaces.

Remote Health Monitoring Outcome Success Prediction Using Baseline and First Month Intervention Data.

PubMed

Alshurafa, Nabil; Sideris, Costas; Pourhomayoun, Mohammad; Kalantarian, Haik; Sarrafzadeh, Majid; Eastwood, Jo-Ann

2017-03-01

Remote health monitoring (RHM) systems are becoming more widely adopted by clinicians and hospitals to remotely monitor and communicate with patients while optimizing clinician time, decreasing hospital costs, and improving quality of care. In the Women's heart health study (WHHS), we developed Wanda-cardiovascular disease (CVD), where participants received healthy lifestyle education followed by six months of technology support and reinforcement. Wanda-CVD is a smartphone-based RHM system designed to assist participants in reducing identified CVD risk factors through wireless coaching using feedback and prompts as social support. Many participants benefitted from this RHM system. In response to the variance in participants' success, we developed a framework to identify classification schemes that predicted successful and unsuccessful participants. We analyzed both contextual baseline features and data from the first month of intervention such as activity, blood pressure, and questionnaire responses transmitted through the smartphone. A prediction tool can aid clinicians and scientists in identifying participants who may optimally benefit from the RHM system. Targeting therapies could potentially save healthcare costs, clinician, and participant time and resources. Our classification scheme yields RHM outcome success predictions with an F-measure of 91.9%, and identifies behaviors during the first month of intervention that help determine outcome success. We also show an improvement in prediction by using intervention-based smartphone data. Results from the WHHS study demonstrates that factors such as the variation in first month intervention response to the consumption of nuts, beans, and seeds in the diet help predict patient RHM protocol outcome success in a group of young Black women ages 25-45.

Cryptanalysis and Enhancement of Anonymity Preserving Remote User Mutual Authentication and Session Key Agreement Scheme for E-Health Care Systems.

PubMed

Amin, Ruhul; Islam, S K Hafizul; Biswas, G P; Khan, Muhammad Khurram; Li, Xiong

2015-11-01

The E-health care systems employ IT infrastructure for maximizing health care resources utilization as well as providing flexible opportunities to the remote patient. Therefore, transmission of medical data over any public networks is necessary in health care system. Note that patient authentication including secure data transmission in e-health care system is critical issue. Although several user authentication schemes for accessing remote services are available, their security analysis show that none of them are free from relevant security attacks. We reviewed Das et al.'s scheme and demonstrated their scheme lacks proper protection against several security attacks such as user anonymity, off-line password guessing attack, smart card theft attack, user impersonation attack, server impersonation attack, session key discloser attack. In order to overcome the mentioned security pitfalls, this paper proposes an anonymity preserving remote patient authentication scheme usable in E-health care systems. We then validated the security of the proposed scheme using BAN logic that ensures secure mutual authentication and session key agreement. We also presented the experimental results of the proposed scheme using AVISPA software and the results ensure that our scheme is secure under OFMC and CL-AtSe models. Moreover, resilience of relevant security attacks has been proved through both formal and informal security analysis. The performance analysis and comparison with other schemes are also made, and it has been found that the proposed scheme overcomes the security drawbacks of the Das et al.'s scheme and additionally achieves extra security requirements.

Factors That Influence Enrolment and Retention in Ghana' National Health Insurance Scheme.

PubMed

Kotoh, Agnes Millicent; Aryeetey, Genevieve Cecilia; Van der Geest, Sjaak

2017-10-17

The government of Ghana introduced the National Health Insurance Scheme (NHIS) in 2004 with the goal of achieving universal coverage within 5 years. Evidence, however, shows that expanding NHIS coverage and especially retaining members have remained a challenge. A multilevel perspective was employed as a conceptual framework and methodological tool to examine why enrolment and retention in the NHIS remains low. A household survey was conducted after 20 months educational and promotional activities aimed at improving enrolment and retention rates in 15 communities in the Central and Eastern Regions (ERs) of Ghana. Observation, indepth interviews and informal conversations were used to collect qualitative data. Forty key informants (community members, health providers and district health insurance schemes' [DHISs] staff) purposely selected from two casestudy communities in the Central Region (CR) were interviewed. Several community members, health providers and DHISs' staff were also engaged in informal conversations in the other five communities in the region. Also, four staff of the Ministry of Health (MoH), Ghana Health Service (GHS) and National Health Insurance Authority (NHIA) were engaged in in-depth interviews. Descriptive statistics was used to analyse quantitative data. Qualitative data was analysed using thematic content analysis. The results show that factors that influence enrolment and retention in the NHIS are multi-dimensional and cut across all stakeholders. People enrolled and renewed their membership because of NHIS' benefits and health providers' positive behaviour. Barriers to enrolment and retention included: poverty, traditional risk-sharing arrangements influence people to enrol or renew their membership only when they need healthcare, dissatisfaction about health providers' behaviour and service delivery challenges. Given the multi-dimensional nature of barriers to enrolment and retention, we suggest that the NHIA should engage DHISs, health

Wearable Health Monitoring Systems

NASA Technical Reports Server (NTRS)

Bell, John

2015-01-01

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

Propulsion Health Monitoring of a Turbine Engine Disk Using Spin Test Data

NASA Technical Reports Server (NTRS)

Abdul-Aziz, Ali; Woike, Mark R.; Oza, Nikunj; Matthews, Bryan; Baaklini, George Y.

2010-01-01

This paper considers data collected from an experimental study using high frequency capacitive sensor technology to capture blade tip clearance and tip timing measurements in a rotating turbine engine-like-disk-to predict the disk faults and assess its structural integrity. The experimental results collected at a range of rotational speeds from tests conducted at the NASA Glenn Research Center s Rotordynamics Laboratory are evaluated using multiple data-driven anomaly detection techniques to identify abnormalities in the disk. Further, this study presents a select evaluation of an online health monitoring scheme of a rotating disk using high caliber sensors and test the capability of the in-house spin system.

Health Monitoring System for Car Seat

NASA Technical Reports Server (NTRS)

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

2004-01-01

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

Impact of Publicly Financed Health Insurance Schemes on Healthcare Utilization and Financial Risk Protection in India: A Systematic Review.

PubMed

Prinja, Shankar; Chauhan, Akashdeep Singh; Karan, Anup; Kaur, Gunjeet; Kumar, Rajesh

2017-01-01

Several publicly financed health insurance schemes have been launched in India with the aim of providing universalizing health coverage (UHC). In this paper, we report the impact of publicly financed health insurance schemes on health service utilization, out-of-pocket (OOP) expenditure, financial risk protection and health status. Empirical research studies focussing on the impact or evaluation of publicly financed health insurance schemes in India were searched on PubMed, Google scholar, Ovid, Scopus, Embase and relevant websites. The studies were selected based on two stage screening PRISMA guidelines in which two researchers independently assessed the suitability and quality of the studies. The studies included in the review were divided into two groups i.e., with and without a comparison group. To assess the impact on utilization, OOP expenditure and health indicators, only the studies with a comparison group were reviewed. Out of 1265 articles screened after initial search, 43 studies were found eligible and reviewed in full text, finally yielding 14 studies which had a comparator group in their evaluation design. All the studies (n-7) focussing on utilization showed a positive effect in terms of increase in the consumption of health services with introduction of health insurance. About 70% studies (n-5) studies with a strong design and assessing financial risk protection showed no impact in reduction of OOP expenditures, while remaining 30% of evaluations (n-2), which particularly evaluated state sponsored health insurance schemes, reported a decline in OOP expenditure among the enrolled households. One study which evaluated impact on health outcome showed reduction in mortality among enrolled as compared to non-enrolled households, from conditions covered by the insurance scheme. While utilization of healthcare did improve among those enrolled in the scheme, there is no clear evidence yet to suggest that these have resulted in reduced OOP expenditures or

Impact of Publicly Financed Health Insurance Schemes on Healthcare Utilization and Financial Risk Protection in India: A Systematic Review

PubMed Central

Chauhan, Akashdeep Singh; Karan, Anup; Kaur, Gunjeet; Kumar, Rajesh

2017-01-01

Several publicly financed health insurance schemes have been launched in India with the aim of providing universalizing health coverage (UHC). In this paper, we report the impact of publicly financed health insurance schemes on health service utilization, out-of-pocket (OOP) expenditure, financial risk protection and health status. Empirical research studies focussing on the impact or evaluation of publicly financed health insurance schemes in India were searched on PubMed, Google scholar, Ovid, Scopus, Embase and relevant websites. The studies were selected based on two stage screening PRISMA guidelines in which two researchers independently assessed the suitability and quality of the studies. The studies included in the review were divided into two groups i.e., with and without a comparison group. To assess the impact on utilization, OOP expenditure and health indicators, only the studies with a comparison group were reviewed. Out of 1265 articles screened after initial search, 43 studies were found eligible and reviewed in full text, finally yielding 14 studies which had a comparator group in their evaluation design. All the studies (n-7) focussing on utilization showed a positive effect in terms of increase in the consumption of health services with introduction of health insurance. About 70% studies (n-5) studies with a strong design and assessing financial risk protection showed no impact in reduction of OOP expenditures, while remaining 30% of evaluations (n-2), which particularly evaluated state sponsored health insurance schemes, reported a decline in OOP expenditure among the enrolled households. One study which evaluated impact on health outcome showed reduction in mortality among enrolled as compared to non-enrolled households, from conditions covered by the insurance scheme. While utilization of healthcare did improve among those enrolled in the scheme, there is no clear evidence yet to suggest that these have resulted in reduced OOP expenditures or

Stakeholders Perspectives on the Success Drivers in Ghana’s National Health Insurance Scheme – Identifying Policy Translation Issues

PubMed Central

Fusheini, Adam; Marnoch, Gordon; Gray, Ann Marie

2017-01-01

Background: Ghana’s National Health Insurance Scheme (NHIS), established by an Act of Parliament (Act 650), in 2003 and since replaced by Act 852 of 2012 remains, in African terms, unprecedented in terms of growth and coverage. As a result, the scheme has received praise for its associated legal reforms, clinical audit mechanisms and for serving as a hub for knowledge sharing and learning within the context of South-South cooperation. The scheme continues to shape national health insurance thinking in Africa. While the success, especially in coverage and financial access has been highlighted by many authors, insufficient attention has been paid to critical and context-specific factors. This paper seeks to fill that gap. Methods: Based on an empirical qualitative case study of stakeholders’ views on challenges and success factors in four mutual schemes (district offices) located in two regions of Ghana, the study uses the concept of policy translation to assess whether the Ghana scheme could provide useful lessons to other African and developing countries in their quest to implement social/NHISs. Results: In the study, interviewees referred to both ‘hard and soft’ elements as driving the "success" of the Ghana scheme. The main ‘hard elements’ include bureaucratic and legal enforcement capacities; IT; financing; governance, administration and management; regulating membership of the scheme; and service provision and coverage capabilities. The ‘soft’ elements identified relate to: the background/context of the health insurance scheme; innovative ways of funding the NHIS, the hybrid nature of the Ghana scheme; political will, commitment by government, stakeholders and public cooperation; social structure of Ghana (solidarity); and ownership and participation. Conclusion: Other developing countries can expect to translate rather than re-assemble a national health insurance programme in an incomplete and highly modified form over a period of years

Lunar Health Monitor (LHM)

NASA Technical Reports Server (NTRS)

Lisy, Frederick J.

2015-01-01

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

Health Monitoring System for Composite Structures

NASA Technical Reports Server (NTRS)

Tang, S. S.; Riccardella, P. C.; Andrews, R. J.; Grady, J. E.; Mucciaradi, A. N.

1996-01-01

An automated system was developed to monitor the health status of composites. It uses the vibration characteristics of composites to identify a component's damage condition. The vibration responses are characterized by a set of signal features defined in the time, frequency and spatial domains. The identification of these changes in the vibration characteristics corresponding to different health conditions was performed using pattern recognition principles. This allows efficient data reduction and interpretation of vast amounts of information. Test components were manufactured from isogrid panels to evaluate performance of the monitoring system. The components were damaged by impact to simulate different health conditions. Free vibration response was induced by a tap test on the test components. The monitoring system was trained using these free vibration responses to identify three different health conditions. They are undamaged vs. damaged, damage location and damage zone size. High reliability in identifying the correct component health condition was achieved by the monitoring system.

Strategic purchasing and health system efficiency: A comparison of two financing schemes in Thailand.

PubMed

Patcharanarumol, Walaiporn; Panichkriangkrai, Warisa; Sommanuttaweechai, Angkana; Hanson, Kara; Wanwong, Yaowaluk; Tangcharoensathien, Viroj

2018-01-01

Strategic purchasing is an essential health financing function. This paper compares the strategic purchasing practices of Thailand's two tax-financed health insurance schemes, the Universal Coverage Scheme (UCS) and the Civil Servant Medical Benefit Scheme (CSMBS), and identifies factors contributing to successful universal health coverage outcomes by analysing the relationships between the purchaser and government, providers and members. The study uses a cross-sectional mixed-methods design, including document review and interviews with 56 key informants. The Comptroller General Department (CGD) of Ministry of Finance manages CSMBS as one among civil servant welfare programmes. Their purchasing is passive. Fee for service payment for outpatient care has resulted in rapid cost escalation and overspending of their annual budget. In contrast, National Health Security Office (NHSO) manages purchasing for UCS, which undertakes a range of strategic purchasing actions, including applying closed ended provider payment, promoting primary healthcare's gate keeping functions, exercising collective purchasing power and engaging views of members in decision making process. This difference in purchasing arrangements resulted in expenditure per CSMBS member being 4 times higher than UCS in 2014. The governance of the purchaser organization, the design of the purchasing arrangements including incentives and use of information, and the institutional capacities to implement purchasing functions are essential for effective strategic purchasing which can improve health system efficiency as a whole.

Strategic purchasing and health system efficiency: A comparison of two financing schemes in Thailand

PubMed Central

2018-01-01

Strategic purchasing is an essential health financing function. This paper compares the strategic purchasing practices of Thailand’s two tax-financed health insurance schemes, the Universal Coverage Scheme (UCS) and the Civil Servant Medical Benefit Scheme (CSMBS), and identifies factors contributing to successful universal health coverage outcomes by analysing the relationships between the purchaser and government, providers and members. The study uses a cross-sectional mixed-methods design, including document review and interviews with 56 key informants. The Comptroller General Department (CGD) of Ministry of Finance manages CSMBS as one among civil servant welfare programmes. Their purchasing is passive. Fee for service payment for outpatient care has resulted in rapid cost escalation and overspending of their annual budget. In contrast, National Health Security Office (NHSO) manages purchasing for UCS, which undertakes a range of strategic purchasing actions, including applying closed ended provider payment, promoting primary healthcare’s gate keeping functions, exercising collective purchasing power and engaging views of members in decision making process. This difference in purchasing arrangements resulted in expenditure per CSMBS member being 4 times higher than UCS in 2014. The governance of the purchaser organization, the design of the purchasing arrangements including incentives and use of information, and the institutional capacities to implement purchasing functions are essential for effective strategic purchasing which can improve health system efficiency as a whole. PMID:29608610

Challenges of medicines management in the public and private sector under Ghana's National Health Insurance Scheme - A qualitative study.

PubMed

Ashigbie, Paul G; Azameti, Devine; Wirtz, Veronika J

2016-01-01

largely positive impact on access to medicines. However, concerns remain about equity in access to medicines and the differences in quality of pharmaceutical care delivered by private and public providers. Routine monitoring of medicines use during the implementation of health insurance schemes is important to identify and address the potential consequences of medicines policies and practices under the scheme.

An exploration of moral hazard behaviors under the national health insurance scheme in Northern Ghana: a qualitative study.

PubMed

Debpuur, Cornelius; Dalaba, Maxwell Ayindenaba; Chatio, Samuel; Adjuik, Martin; Akweongo, Patricia

2015-10-15

The government of Ghana introduced the National Health Insurance Scheme (NHIS) in 2003 through an Act of Parliament (Act 650) as a strategy to improve financial access to quality basic health care services. Although attendance at health facilities has increased since the introduction of the NHIS, there have been media reports of widespread abuse of the NHIS by scheme operators, service providers and insured persons. The aim of the study was to document behaviors and practices of service providers and clients of the NHIS in the Kassena-Nankana District (KND) of Ghana that constitute moral hazards (abuse of the scheme) and identify strategies to minimize such behaviors. Qualitative methods through 14 Focused Group Discussions (FGDs) and 5 individual in-depth interviews were conducted between December 2009 and January 2010. Thematic analysis was performed with the aid of QSR NVivo 8 software. Analysis of FGDs and in-depth interviews showed that community members, health providers and NHIS officers are aware of various behaviors and practices that constitute abuse of the scheme. Behaviors such as frequent and 'frivolous' visits to health facilities, impersonation, feigning sickness to collect drugs for non-insured persons, over charging for services provided to clients, charging clients for services not provided and over prescription were identified. Suggestions on how to minimize abuse of the NHIS offered by respondents included: reduction of premiums and registration fees, premium payments by installment, improvement in the picture quality of the membership cards, critical examination and verification of membership cards at health facilities, some ceiling on the number of times one can seek health care within a specified time period, and general education to change behaviors that abuse the scheme. Attention should be focused on addressing the identified moral hazard behaviors and pursue cost containment strategies to ensure the smooth operation of the scheme and

National health inequality monitoring: current challenges and opportunities.

PubMed

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

National health inequality monitoring needs considerably more investment to realize equity-oriented health improvements in countries, including advancement towards the Sustainable Development Goals. Following an overview of national health inequality monitoring and the associated resource requirements, we highlight challenges that countries may encounter when setting up, expanding or strengthening national health inequality monitoring systems, and discuss opportunities and key initiatives that aim to address these challenges. We provide specific proposals on what is needed to ensure that national health inequality monitoring systems are harnessed to guide the reduction of health inequalities.

Inter-sectoral costs and benefits of mental health prevention: towards a new classification scheme.

PubMed

Drost, Ruben M W A; Paulus, Aggie T G; Ruwaard, Dirk; Evers, Silvia M A A

2013-12-01

Many preventive interventions for mental disorders have costs and benefits that spill over to sectors outside the healthcare sector. Little is known about these "inter-sectoral costs and benefits" (ICBs) of prevention. However, to achieve an efficient allocation of scarce resources, insights on ICBs are indispensable. The main aim was to identify the ICBs related to the prevention of mental disorders and provide a sector-specific classification scheme for these ICBs. Using PubMed, a literature search was conducted for ICBs of mental disorders and related (psycho)social effects. A policy perspective was used to build the scheme's structure, which was adapted to the outcomes of the literature search. In order to validate the scheme's international applicability inside and outside the mental health domain, semi-structured interviews were conducted with (inter)national experts in the broad fields of health promotion and disease prevention. The searched-for items appeared in a total of 52 studies. The ICBs found were classified in one of four sectors: "Education", "Labor and Social Security", "Household and Leisure" or "Criminal Justice System". Psycho(social) effects were placed in a separate section under "Individual and Family". Based on interviews, the scheme remained unadjusted, apart from adding a population-based dimension. This is the first study which offers a sector-specific classification of ICBs. Given the explorative nature of the study, no guidelines on sector-specific classification of ICBs were available. Nevertheless, the classification scheme was acknowledged by an international audience and could therefore provide added value to researchers and policymakers in the field of mental health economics and prevention. The identification and classification of ICBs offers decision makers supporting information on how to optimally allocate scarce resources with respect to preventive interventions for mental disorders. By exploring a new area of research, which

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.

Progress and challenges of the rural cooperative medical scheme in China

PubMed Central

Xu, Ke

2014-01-01

Abstract Problem During China’s transition to a market economy in the 1980s and 1990s, the rural population faced substantial barriers to accessing health care and encountered heavier financial burdens than urban residents in paying for necessary health services. Approach In 2003, China started to implement a rural cooperative medical scheme (RCMS), mainly through government subsidies. The scheme operates at the county level and offers a modest benefit package. Local setting In spite of rapid economic growth since the early 1980s, income disparities in China have increased, particularly between rural and urban populations. In response, the government has put greater emphasis on social development, including health system development. Examples are the prioritization of improved access to health services and the reduction of the burden of payment for necessary services. Relevant changes After 10 years of implementation, the RCMS now provides coverage to the entire rural population and has substantially improved access to health care. Yet despite a drop in out-of-pocket payments as a proportion of total health expenditure, paying for necessary services continues to cause financial hardship for many rural residents. Lessons learnt In its first decade, the RCMS made progress through political mobilization, government subsidies, the readiness of the health-care delivery system, and the availability of a monitoring and evaluation system. Further improving the RCMS will require a focus on cost containment, quality improvement and making the scheme portable. PMID:24940019

Socioeconomic and programmatic determinants of renewal of membership in a voluntary micro health insurance scheme: evidence from Chakaria, Bangladesh.

PubMed

Iqbal, Mohammad; Chowdhury, Asiful Haidar; Mahmood, Shehrin Shaila; Mia, Mohammad Nahid; Hanifi, S M A; Bhuiya, Abbas

2017-01-01

Out-of-pocket (OOP) healthcare expenditure is a major obstacle for achieving universal health coverage in low-income countries including Bangladesh. Sixty-three percent of the USD 27 annual per-capita healthcare expenditure in Bangladesh comes from individuals' pockets. Although health insurance is a financial tool for reducing OOP, use of such tools in Bangladesh has been limited to some small-scale voluntary micro health insurance (MHI) schemes run by non-governmental organizations (NGO). The MHI, however, can orient people on health insurance concept and provide learning for product development, implementation, barriers to enrolment, membership renewal, and other operational challenges and solutions. Keeping this in mind, icddr,b in 2012 initiated a pilot MHI, Amader Shasthya, in Chakaria, Bangladesh. This paper explores the determinants of membership renewal in this scheme, which is a perpetual challenge for MHI. Identify socioeconomic and programmatic determinants and their effects on membership renewal in a voluntary MHI scheme. Data came from the online management information system of the scheme and Health and Demographic Surveillance System of Chakaria, covering the period February 2012-May 2015. Association between renewal and independent variables was examined using cross-tabular and logistic regression analyses. Nearly 20% of households in the catchment area ever enroled in the scheme, and 38% renewed membership over the initial 3 years of operation. Frequency of consultation with healthcare providers, benefits received, proximity of member's residence to health facility, socioeconomic status, educational level, and age of the household head showed significant positive association with renewal of membership. Villagers' enrolment in the scheme indicated that even in poor economic and literacy conditions people can be motivated to enrol in insurance schemes. Degree of service utilization and benefits received can greatly enhance the probability of

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

PubMed

Rienhoff, Otto

2013-01-01

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

Design, implementation, and evaluation of a community financing scheme for hospital care in developing countries: a pre-paid health plan in the Bwamanda health zone, Zaire.

PubMed

Moens, F

1990-01-01

Unless scarce resources can be mobilized and used efficiently, health for all by the year 2000 will remain a vain attempt. Innovative financing schemes exploring increased cost recovery from the users of the health system are explored throughout the world. In Bwamanda, Zaire, a community financing scheme for hospital care was developed through the application of operations research. A preference heuristic with considerable involvement of health providers and the community was used to identify the type of financing scheme and resulted in a pre-paid health plan, while a mathematical model was developed to determine the premiums to charge. The implementation of the health plant is briefly described. An evaluation of the effects of the pre-paid plan on the accessibility and equity of health care, as well as on the financial sustainability of the hospital, is presented and discussed: a steadily increasing membership of the health plan illustrates its appropriateness, while a doubling of the cost recovery of the hospital's operating costs after two years seems promising; the hospitalization rate of members of the health plan was significantly higher than for non-members. These findings suggest that a health zone may be an appropriate level for the organization of a regional pre-paid health plan. Problems of equity, full cost recovery, and replicability of the financing scheme are discussed.

Toward flexible and wearable human-interactive health-monitoring devices.

PubMed

Takei, Kuniharu; Honda, Wataru; Harada, Shingo; Arie, Takayuki; Akita, Seiji

2015-03-11

This Progress Report introduces flexible wearable health-monitoring devices that interact with a person by detecting from and stimulating the body. Interactive health-monitoring devices should be highly flexible and attach to the body without awareness like a bandage. This type of wearable health-monitoring device will realize a new class of electronics, which will be applicable not only to health monitoring, but also to other electrical devices. However, to realize wearable health-monitoring devices, many obstacles must be overcome to economically form the active electrical components on a flexible substrate using macroscale fabrication processes. In particular, health-monitoring sensors and curing functions need to be integrated. Here recent developments and advancements toward flexible health-monitoring devices are presented, including conceptual designs of human-interactive devices. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Social capital and active membership in the Ghana National Health Insurance Scheme - a mixed method study.

PubMed

Fenenga, Christine J; Nketiah-Amponsah, Edward; Ogink, Alice; Arhinful, Daniel K; Poortinga, Wouter; Hutter, Inge

2015-11-02

People's decision to enroll in a health insurance scheme is determined by socio-cultural and socio-economic factors. On request of the National health Insurance Authority (NHIA) in Ghana, our study explores the influence of social relationships on people's perceptions, behavior and decision making to enroll in the National Health Insurance Scheme. This social scheme, initiated in 2003, aims to realize accessible quality healthcare services for the entire population of Ghana. We look at relationships of trust and reciprocity between individuals in the communities (so called horizontal social capital) and between individuals and formal health institutions (called vertical social capital) in order to determine whether these two forms of social capital inhibit or facilitate enrolment of clients in the scheme. Results can support the NHIA in exploiting social capital to reach their objective and strengthen their policy and practice. We conducted 20 individual- and seven key-informant interviews, 22 focus group discussions, two stakeholder meetings and a household survey, using a random sample of 1903 households from the catchment area of 64 primary healthcare facilities. The study took place in Greater Accra Region and Western Regions in Ghana between June 2011 and March 2012. While social developments and increased heterogeneity seem to reduce community solidarity in Ghana, social networks remain common in Ghana and are valued for their multiple benefits (i.e. reciprocal trust and support, information sharing, motivation, risk sharing). Trusting relations with healthcare and insurance providers are, according healthcare clients, based on providers' clear communication, attitude, devotion, encouragement and reliability of services. Active membership of the NHIS is positive associated with community trust, trust in healthcare providers and trust in the NHIS (p-values are .009, .000 and .000 respectively). Social capital can motivate clients to enroll in health insurance

Novel cloud and SOA-based framework for e-health monitoring using wireless biosensors.

PubMed

Benharref, Abdelghani; Serhani, Mohamed Adel

2014-01-01

Various and independent studies are showing that an exponential increase of chronic diseases (CDs) is exhausting governmental and private healthcare systems to an extent that some countries allocate half of their budget to healthcare systems. To benefit from the IT development, e-health monitoring and prevention approaches revealed to be among top promising solutions. In fact, well-implemented monitoring and prevention schemes have reported a decent reduction of CDs risk and have narrowed their effects, on both patients' health conditions and on government budget spent on healthcare. In this paper, we propose a framework to collect patients' data in real time, perform appropriate nonintrusive monitoring, and propose medical and/or life style engagements, whenever needed and appropriate. The framework, which relies on service-oriented architecture (SOA) and the Cloud, allows a seamless integration of different technologies, applications, and services. It also integrates mobile technologies to smoothly collect and communicate vital data from a patient's wearable biosensors while considering the mobile devices' limited capabilities and power drainage in addition to intermittent network disconnections. Then, data are stored in the Cloud and made available via SOA to allow easy access by physicians, paramedics, or any other authorized entity. A case study has been developed to evaluate the usability of the framework, and the preliminary results that have been analyzed are showing very promising results.

Hybrid Modeling Improves Health and Performance Monitoring

NASA Technical Reports Server (NTRS)

2007-01-01

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

Sensor data monitoring and decision level fusion scheme for early fire detection

NASA Astrophysics Data System (ADS)

Rizogiannis, Constantinos; Thanos, Konstantinos Georgios; Astyakopoulos, Alkiviadis; Kyriazanos, Dimitris M.; Thomopoulos, Stelios C. A.

2017-05-01

The aim of this paper is to present the sensor monitoring and decision level fusion scheme for early fire detection which has been developed in the context of the AF3 Advanced Forest Fire Fighting European FP7 research project, adopted specifically in the OCULUS-Fire control and command system and tested during a firefighting field test in Greece with prescribed real fire, generating early-warning detection alerts and notifications. For this purpose and in order to improve the reliability of the fire detection system, a two-level fusion scheme is developed exploiting a variety of observation solutions from air e.g. UAV infrared cameras, ground e.g. meteorological and atmospheric sensors and ancillary sources e.g. public information channels, citizens smartphone applications and social media. In the first level, a change point detection technique is applied to detect changes in the mean value of each measured parameter by the ground sensors such as temperature, humidity and CO2 and then the Rate-of-Rise of each changed parameter is calculated. In the second level the fire event Basic Probability Assignment (BPA) function is determined for each ground sensor using Fuzzy-logic theory and then the corresponding mass values are combined in a decision level fusion process using Evidential Reasoning theory to estimate the final fire event probability.

Effectiveness of compressed sensing and transmission in wireless sensor networks for structural health monitoring

NASA Astrophysics Data System (ADS)

Fujiwara, Takahiro; Uchiito, Haruki; Tokairin, Tomoya; Kawai, Hiroyuki

2017-04-01

Regarding Structural Health Monitoring (SHM) for seismic acceleration, Wireless Sensor Networks (WSN) is a promising tool for low-cost monitoring. Compressed sensing and transmission schemes have been drawing attention to achieve effective data collection in WSN. Especially, SHM systems installing massive nodes of WSN require efficient data transmission due to restricted communications capability. The dominant frequency band of seismic acceleration is occupied within 100 Hz or less. In addition, the response motions on upper floors of a structure are activated at a natural frequency, resulting in induced shaking at the specified narrow band. Focusing on the vibration characteristics of structures, we introduce data compression techniques for seismic acceleration monitoring in order to reduce the amount of transmission data. We carry out a compressed sensing and transmission scheme by band pass filtering for seismic acceleration data. The algorithm executes the discrete Fourier transform for the frequency domain and band path filtering for the compressed transmission. Assuming that the compressed data is transmitted through computer networks, restoration of the data is performed by the inverse Fourier transform in the receiving node. This paper discusses the evaluation of the compressed sensing for seismic acceleration by way of an average error. The results present the average error was 0.06 or less for the horizontal acceleration, in conditions where the acceleration was compressed into 1/32. Especially, the average error on the 4th floor achieved a small error of 0.02. Those results indicate that compressed sensing and transmission technique is effective to reduce the amount of data with maintaining the small average error.

A systematic approach for the accurate non-invasive estimation of blood glucose utilizing a novel light-tissue interaction adaptive modelling scheme

NASA Astrophysics Data System (ADS)

Rybynok, V. O.; Kyriacou, P. A.

2007-10-01

Diabetes is one of the biggest health challenges of the 21st century. The obesity epidemic, sedentary lifestyles and an ageing population mean prevalence of the condition is currently doubling every generation. Diabetes is associated with serious chronic ill health, disability and premature mortality. Long-term complications including heart disease, stroke, blindness, kidney disease and amputations, make the greatest contribution to the costs of diabetes care. Many of these long-term effects could be avoided with earlier, more effective monitoring and treatment. Currently, blood glucose can only be monitored through the use of invasive techniques. To date there is no widely accepted and readily available non-invasive monitoring technique to measure blood glucose despite the many attempts. This paper challenges one of the most difficult non-invasive monitoring techniques, that of blood glucose, and proposes a new novel approach that will enable the accurate, and calibration free estimation of glucose concentration in blood. This approach is based on spectroscopic techniques and a new adaptive modelling scheme. The theoretical implementation and the effectiveness of the adaptive modelling scheme for this application has been described and a detailed mathematical evaluation has been employed to prove that such a scheme has the capability of extracting accurately the concentration of glucose from a complex biological media.

Inductive System Health Monitoring

NASA Technical Reports Server (NTRS)

Iverson, David L.

2004-01-01

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

Spatial Analysis for Monitoring Forest Health

Treesearch

Francis A. Roesch

1994-01-01

A plan for the spatial analysis for the sample design for the detection monitoring phase in the joint USDA Forest Service/EPA Forest Health Monitoring Program (FHM) in the United States is discussed. The spatial analysis procedure is intended to more quickly identify changes in forest health by providing increased sensitivity to localized changes. The procedure is...

Perspectives of frontline health workers on Ghana's National Health Insurance Scheme before and after community engagement interventions.

PubMed

Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Spieker, Nicole; Arhinful, Daniel Kojo; Rinke de Wit, Tobias F

2016-05-28

Barely a decade after introduction of Ghana's National Health Insurance Scheme (NHIS), significant successes have been recorded in universal access to basic healthcare services. However, sustainability of the scheme is increasingly threatened by concerns on quality of health service delivery in NHIS-accredited health facilities coupled with stakeholders' discontentment with the operational and administrative challenges confronting the NHIS. The study sought to ascertain whether or not Systematic Community Engagement (SCE) interventions have a significant effect on frontline health workers' perspectives on the NHIS and its impact on quality health service delivery. The study is a randomized cluster trial involving clinical and non-clinical frontline health workers (n = 234) interviewed at baseline and follow-up in the Greater Accra and Western regions of Ghana. Individual respondents were chosen from within each intervention and control groupings. Difference-in-difference estimations and propensity score matching were performed to determine impact of SCE on staff perceptions of the NHIS. The main outcome measure of interest was staff perception of the NHIS based on eight (8) factor-analyzed quality service parameters. Staff interviewed in intervention facilities appeared to perceive the NHIS more positively in terms of its impact on "availability and quality of drugs (p < 0.05)" and "workload on health staff/infrastructure" than those interviewed in control facilities (p < 0.1). Delayed reimbursement of service providers remained a key concern to over 70 % of respondents in control and intervention health facilities. Community engagement in quality service assessment is a potential useful strategy towards empowering communities while promoting frontline health workers' interest, goodwill and active participation in Ghana's NHIS.

[Current state and prospects of military personnel health monitoring].

PubMed

Rezvantsev, M V; Kuznetsov, S M; Ivanov, V V; Zakurdaev, V V

2014-01-01

The current article is dedicated to some features of the Russian Federation Armed Forces military personnel health monitoring such as legal and informational provision, methodological basis of functioning, historical aspect of formation and development of the social and hygienic monitoring in the Russian Federation Armed Forces. The term "military personnel health monitoring" is defined as an analytical system of constant and long-term observation, analysis, assessment, studying of factors determined the military personnel health, these factors correlations, health risk factors management in order to minimize them. The current state of the military personnel health monitoring allows coming to the conclusion that the military health system does have forces and resources for state policy of establishing the population health monitoring system implementation. The following directions of the militarily personnel health monitoring improvement are proposed: the Russian Federation Armed Forces medical service record and report system reorganization bringing it closer to the civilian one, implementation of the integrated approach to the medical service informatisation, namely, military personnel health status and medical service resources monitoring. The leading means in this direction are development and introduction of a military serviceman individual health status monitoring system on the basis of a serviceman electronic medical record card. Also it is proposed the current Russian Federation Armed Forces social and hygienic monitoring improvement at the expense of informational interaction between the two subsystems on the basis of unified military medical service space.

Small Autonomous Aircraft Servo Health Monitoring

NASA Technical Reports Server (NTRS)

Quintero, Steven

2008-01-01

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

Privacy by design in personal health monitoring.

PubMed

Nordgren, Anders

2015-06-01

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

Insured persons dilemma about other family members: a perspective on the national health insurance scheme in Nigeria.

PubMed

Umar, Nasir; Mohammed, Shafiu

2011-09-05

The need for health care reforms and alternative financing mechanism in many low and middle-income countries has been advocated. This led to the introduction of the national health insurance scheme (NHIS) in Nigeria, at first with the enrollment of formal sector employees. A qualitative study was conducted to assess enrollee's perception on the quality of health care before and after enrollment. Initial results revealed that respondents (heads of households) have generally viewed the NHIS favorably, but consistently expressed dissatisfaction over the terms of coverage. Specifically, because the NHIS enrollment covers only the primary insured person, their spouse and only up to four biological children (child defined as <18 years of age), in a setting where extended family is common. Dissatisfaction of enrollees could affect their willingness to participate in the insurance scheme, which may potentially affect the success and future extension of the scheme.

A quantitative study on factors influencing enrolment of dairy farmers in a community health insurance scheme.

PubMed

Greef, Tineke de Groot-de; Monareng, Lydia V; Roos, Janetta H

2016-12-09

Access to affordable and effective health care is a challenge in low- and middle- income countries. Out-of-pocket expenditure for health care is a major cause of impoverishment. One way to facilitate access and overcome catastrophic expenditure is through a health insurance mechanism, whereby risks are shared and financial inputs pooled by way of contributions. This study examined factors that influenced the enrolment status of dairy farmers in Western Kenya to a community health insurance (CHI) scheme. Quantitative, cross-sectional research was used to describe factors influencing the enrolment in the CHI scheme. Quota and convenience sampling was used, recruiting a sample of 135 farmers who supply milk to a dairy cooperation. Data were collected using a structured interview schedule and analysed using Stata SE, Data Analysis and Statistical Software, Version 12. Factors influencing non-enrolment were identified as affordability (40%; n = 47), unfamiliarity with the management of the scheme (37%; n = 44) and a lack of understanding about the scheme (41%; n = 48). An exploratory factor analysis was used to reduce the variables to two factors: information provision and understanding community health insurance (CHI). Logistic regression identified factors associated with enrolment in the Tanykina Community Healthcare Plan (TCHP). Supplies of less than six litres of milk per day (OR: 0.22; 95% CI: 0.06-0.84) and information provision (OR: 8.77; 95% CI: 2.25-34.16) were significantly associated with enrolment in the TCHP. Nearly 30% (29.6%; n = 40) of the respondents remarked that TCHP is expensive and 17% (n = 23) asked for more education on CHI and TCHP in an open-ended question. Recommendations related to marketing strategies, financial approach, information provision and further research were outlined to be made to the management of the TCHP as well as to those involved in public health.

Forest health monitoring: 2008 national technical report

Treesearch

Kevin M. Potter; Barbara L. Conkling

2012-01-01

The Forest Health Monitoring (FHM) Program’s annual national technical report has three objectives: (1) to present forest health status and trends from a national or a multi-State regional perspective using a variety of sources, (2) to introduce new techniques for analyzing forest health data, and (3) to report results of recently completed evaluation monitoring...

Design of wearable health monitoring device

NASA Astrophysics Data System (ADS)

Devara, Kresna; Ramadhanty, Savira; Abuzairi, Tomy

2018-02-01

Wearable smart health monitoring devices have attracted considerable attention in both research community and industry. Some of the causes are the increasing healthcare costs, along with the growing technology. To address this demand, in this paper, design and evaluation of wearable health monitoring device integrated with smartphone were presented. This device was designed for patients in need of constant health monitoring. The performance of the proposed design has been tested by conducting measurement once in 2 minutes for 10 minutes to obtain heart rate and body temperature data. The comparation between data measured by the proposed device and that measured by the reference device yields only an average error of 1.45% for heart rate and 1.04% for body temperature.

Physical health monitoring in mental health settings: a study exploring mental health nurses' views of their role.

PubMed

Mwebe, Herbert

2017-10-01

To explore nurses' views of their role in the screening and monitoring of the physical care needs of people with serious mental illness in a mental health service provider. There is increasing awareness through research that people with serious mental illness disproportionately experience and die early from physical health conditions. Mental health nurses are best placed as front-line workers to offer screening, monitoring and interventions; however, their views on physical care interventions are not studied often. Qualitative exploratory study. The study was carried out in a mental health inpatient centre in England. Volunteer sampling was adopted for the study with a total target sample of (n = 20) nurses from three inpatient wards. Semistructured interviews were conducted with (n = 10) registered mental health nurses who had consented to take part in the study. Inductive data analysis and theme development were guided by a thematic analytic framework. Participants shared a clear commitment regarding their role regarding physical health screening and monitoring in mental health settings. Four themes emerged as follows: features of current practice and physical health monitoring; perceived barriers to physical health monitoring; education and training needs; and strategies to improve physical health monitoring. Nurses were unequivocal in their resolve to ensure good standard physical health monitoring and screening interventions in practice. However, identified obstacles have to be addressed to ensure that physical health screening and monitoring is integrated adequately in everyday clinical activities. Achieving this would require improvements in nurses' training, and an integrated multiservice and team-working approach. Attending to the physical health needs of people with serious mental illness has been associated with multiple improvements in both mental and physical health; nurses have a vital role to play in identifying and addressing causes of poor

Novel health monitoring method using an RGB camera.

PubMed

Hassan, M A; Malik, A S; Fofi, D; Saad, N; Meriaudeau, F

2017-11-01

In this paper we present a novel health monitoring method by estimating the heart rate and respiratory rate using an RGB camera. The heart rate and the respiratory rate are estimated from the photoplethysmography (PPG) and the respiratory motion. The method mainly operates by using the green spectrum of the RGB camera to generate a multivariate PPG signal to perform multivariate de-noising on the video signal to extract the resultant PPG signal. A periodicity based voting scheme (PVS) was used to measure the heart rate and respiratory rate from the estimated PPG signal. We evaluated our proposed method with a state of the art heart rate measuring method for two scenarios using the MAHNOB-HCI database and a self collected naturalistic environment database. The methods were furthermore evaluated for various scenarios at naturalistic environments such as a motion variance session and a skin tone variance session. Our proposed method operated robustly during the experiments and outperformed the state of the art heart rate measuring methods by compensating the effects of the naturalistic environment.

Performance evaluation of a health insurance in Nigeria using optimal resource use: health care providers perspectives

PubMed Central

2014-01-01

Background Performance measures are often neglected during the transition period of national health insurance scheme implementation in many low and middle income countries. These measurements evaluate the extent to which various aspects of the schemes meet their key objectives. This study assesses the implementation of a health insurance scheme using optimal resource use domains and examines possible factors that influence each domain, according to providers’ perspectives. Methods A retrospective, cross-sectional survey was done between August and December 2010 in Kaduna state, and 466 health care provider personnel were interviewed. Optimal-resource-use was defined in four domains: provider payment mechanism (capitation and fee-for-service payment methods), benefit package, administrative efficiency, and active monitoring mechanism. Logistic regression analysis was used to identify provider factors that may influence each domain. Results In the provider payment mechanism domain, capitation payment method (95%) performed better than fee-for-service payment method (62%). Benefit package domain performed strongly (97%), while active monitoring mechanism performed weakly (37%). In the administrative efficiency domain, both promptness of referral system (80%) and prompt arrival of funds (93%) performed well. At the individual level, providers with fewer enrolees encountered difficulties with reimbursement. Other factors significantly influenced each of the optimal-resource-use domains. Conclusions Fee-for-service payment method and claims review, in the provider payment and active monitoring mechanisms, respectively, performed weakly according to the providers’ (at individual-level) perspectives. A short-fall on the supply-side of health insurance could lead to a direct or indirect adverse effect on the demand-side of the scheme. Capitation payment per enrolees should be revised to conform to economic circumstances. Performance indicators and providers�

Health Monitoring System Technology Assessments: Cost Benefits Analysis

NASA Technical Reports Server (NTRS)

Kent, Renee M.; Murphy, Dennis A.

2000-01-01

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

Smart health monitoring systems: an overview of design and modeling.

PubMed

Baig, Mirza Mansoor; Gholamhosseini, Hamid

2013-04-01

Health monitoring systems have rapidly evolved during the past two decades and have the potential to change the way health care is currently delivered. Although smart health monitoring systems automate patient monitoring tasks and, thereby improve the patient workflow management, their efficiency in clinical settings is still debatable. This paper presents a review of smart health monitoring systems and an overview of their design and modeling. Furthermore, a critical analysis of the efficiency, clinical acceptability, strategies and recommendations on improving current health monitoring systems will be presented. The main aim is to review current state of the art monitoring systems and to perform extensive and an in-depth analysis of the findings in the area of smart health monitoring systems. In order to achieve this, over fifty different monitoring systems have been selected, categorized, classified and compared. Finally, major advances in the system design level have been discussed, current issues facing health care providers, as well as the potential challenges to health monitoring field will be identified and compared to other similar systems.

Health disparities monitoring in the U.S.: lessons for monitoring efforts in Israel and other countries.

PubMed

Abu-Saad, Kathleen; Avni, Shlomit; Kalter-Leibovici, Ofra

2018-02-28

Health disparities are a persistent problem in many high-income countries. Health policymakers recognize the need to develop systematic methods for documenting and tracking these disparities in order to reduce them. The experience of the U.S., which has a well-established health disparities monitoring infrastructure, provides useful insights for other countries. This article provides an in-depth review of health disparities monitoring in the U.S. Lessons of potential relevance for other countries include: 1) the integration of health disparities monitoring in population health surveillance, 2) the role of political commitment, 3) use of monitoring as a feedback loop to inform future directions, 4) use of monitoring to identify data gaps, 5) development of extensive cross-departmental cooperation, and 6) exploitation of digital tools for monitoring and reporting. Using Israel as a case in point, we provide a brief overview of the healthcare and health disparities landscape in Israel, and examine how the lessons from the U.S. experience might be applied in the Israeli context. The U.S. model of health disparities monitoring provides useful lessons for other countries with respect to documentation of health disparities and tracking of progress made towards their elimination. Given the persistence of health disparities both in the U.S. and Israel, there is a need for monitoring systems to expand beyond individual- and healthcare system-level factors, to incorporate social and environmental determinants of health as health indicators/outcomes.

Who uses outpatient healthcare services under Ghana's health protection scheme and why?

PubMed

Fenny, Ama P; Asante, Felix A; Arhinful, Daniel K; Kusi, Anthony; Parmar, Divya; Williams, Gemma

2016-05-10

The National Health Insurance Scheme (NHIS) was launched in Ghana in 2003 with the main objective of increasing utilisation to healthcare by making healthcare more affordable. Previous studies on the NHIS have repeatedly highlighted that cost of premiums is one of the major barriers for enrollment. However, despite introducing premium exemptions for pregnant women, older people, children and indigents, many Ghanaians are still not active members of the NHIS. In this paper we investigate why there is limited success of the NHIS in improving access to healthcare in Ghana and whether social exclusion could be one of the limiting barriers. The study explores this by looking at the Social, Political, Economic and Cultural (SPEC) dimensions of social exclusion. Using logistic regression, the study investigates the determinants of health service utilisation using SPEC variables including other variables. Data was collected from 4050 representative households in five districts in Ghana covering the 3 ecological zones (coastal, forest and savannah) in Ghana. Among 16,200 individuals who responded to the survey, 54 % were insured. Out of the 1349 who sought health care, 64 % were insured and 65 % of them had basic education and 60 % were women. The results from the logistic regressions show health insurance status, education and gender to be the three main determinants of health care utilisation. Overall, a large proportion of the insured who reported ill, sought care from formal health care providers compared to those who had never insured in the scheme. The paper demonstrates that the NHIS presents a workable policy tool for increasing access to healthcare through an emphasis on social health protection. However, affordability is not the only barrier for access to health services. Geographical, social, cultural, informational, political, and other barriers also come into play.

Factors That Influence Enrolment and Retention in Ghana’ National Health Insurance Scheme

PubMed Central

Millicent Kotoh, Agnes; Aryeetey, Genevieve Cecilia; der Geest, Sjaak Van

2018-01-01

Background: The government of Ghana introduced the National Health Insurance Scheme (NHIS) in 2004 with the goal of achieving universal coverage within 5 years. Evidence, however, shows that expanding NHIS coverage and especially retaining members have remained a challenge. A multilevel perspective was employed as a conceptual framework and methodological tool to examine why enrolment and retention in the NHIS remains low. Methods: A household survey was conducted after 20 months educational and promotional activities aimed at improving enrolment and retention rates in 15 communities in the Central and Eastern Regions (ERs) of Ghana. Observation, indepth interviews and informal conversations were used to collect qualitative data. Forty key informants (community members, health providers and district health insurance schemes’ [DHISs] staff) purposely selected from two casestudy communities in the Central Region (CR) were interviewed. Several community members, health providers and DHISs’ staff were also engaged in informal conversations in the other five communities in the region. Also, four staff of the Ministry of Health (MoH), Ghana Health Service (GHS) and National Health Insurance Authority (NHIA) were engaged in in-depth interviews. Descriptive statistics was used to analyse quantitative data. Qualitative data was analysed using thematic content analysis. Results: The results show that factors that influence enrolment and retention in the NHIS are multi-dimensional and cut across all stakeholders. People enrolled and renewed their membership because of NHIS’ benefits and health providers’ positive behaviour. Barriers to enrolment and retention included: poverty, traditional risk-sharing arrangements influence people to enrol or renew their membership only when they need healthcare, dissatisfaction about health providers’ behaviour and service delivery challenges. Conclusion: Given the multi-dimensional nature of barriers to enrolment and retention

Provider payment in community-based health insurance schemes in developing countries: a systematic review

PubMed Central

Robyn, Paul Jacob; Sauerborn, Rainer; Bärnighausen, Till

2013-01-01

Objectives Community-based health insurance (CBI) is a common mechanism to generate financial resources for health care in developing countries. We review for the first time provider payment methods used in CBI in developing countries and their impact on CBI performance. Methods We conducted a systematic review of the literature on provider payment methods used by CBI in developing countries published up to January 2010. Results Information on provider payment was available for a total of 32 CBI schemes in 34 reviewed publications: 17 schemes in South Asia, 10 in sub-Saharan Africa, 4 in East Asia and 1 in Latin America. Various types of provider payment were applied by the CBI schemes: 17 used fee-for-service, 12 used salaries, 9 applied a coverage ceiling, 7 used capitation and 6 applied a co-insurance. The evidence suggests that provider payment impacts CBI performance through provider participation and support for CBI, population enrolment and patient satisfaction with CBI, quantity and quality of services provided and provider and patient retention. Lack of provider participation in designing and choosing a CBI payment method can lead to reduced provider support for the scheme. Conclusion CBI schemes in developing countries have used a wide range of provider payment methods. The existing evidence suggests that payment methods are a key determinant of CBI performance and sustainability, but the strength of this evidence is limited since it is largely based on observational studies rather than on trials or on quasi-experimental research. According to the evidence, provider payment can affect provider participation, satisfaction and retention in CBI; the quantity and quality of services provided to CBI patients; patient demand of CBI services; and population enrollment, risk pooling and financial sustainability of CBI. CBI schemes should carefully consider how their current payment methods influence their performance, how changes in the methods could improve

Provider payment in community-based health insurance schemes in developing countries: a systematic review.

PubMed

Robyn, Paul Jacob; Sauerborn, Rainer; Bärnighausen, Till

2013-03-01

Community-based health insurance (CBI) is a common mechanism to generate financial resources for health care in developing countries. We review for the first time provider payment methods used in CBI in developing countries and their impact on CBI performance. We conducted a systematic review of the literature on provider payment methods used by CBI in developing countries published up to January 2010. Information on provider payment was available for a total of 32 CBI schemes in 34 reviewed publications: 17 schemes in South Asia, 10 in sub-Saharan Africa, 4 in East Asia and 1 in Latin America. Various types of provider payment were applied by the CBI schemes: 17 used fee-for-service, 12 used salaries, 9 applied a coverage ceiling, 7 used capitation and 6 applied a co-insurance. The evidence suggests that provider payment impacts CBI performance through provider participation and support for CBI, population enrolment and patient satisfaction with CBI, quantity and quality of services provided and provider and patient retention. Lack of provider participation in designing and choosing a CBI payment method can lead to reduced provider support for the scheme. CBI schemes in developing countries have used a wide range of provider payment methods. The existing evidence suggests that payment methods are a key determinant of CBI performance and sustainability, but the strength of this evidence is limited since it is largely based on observational studies rather than on trials or on quasi-experimental research. According to the evidence, provider payment can affect provider participation, satisfaction and retention in CBI; the quantity and quality of services provided to CBI patients; patient demand of CBI services; and population enrollment, risk pooling and financial sustainability of CBI. CBI schemes should carefully consider how their current payment methods influence their performance, how changes in the methods could improve performance, and how such effects could be

Space Shuttle Main Engine: Advanced Health Monitoring System

NASA Technical Reports Server (NTRS)

Singer, Chirs

1999-01-01

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

Remote personal health monitoring with radio waves

NASA Astrophysics Data System (ADS)

Nguyen, Andrew

2008-03-01

We present several techniques utilizing radio-frequency identification (RFID) technology for personal health monitoring. One technique involves using RFID sensors external to the human body, while another technique uses both internal and external RFID sensors. Simultaneous monitoring of many patients in a hospital setting can also be done using networks of RFID sensors. All the monitoring are done wirelessly, either continuously or periodically in any interval, in which the sensors collect information on human parts such as the lungs or heart and transmit this information to a router, PC or PDA device connected to the internet, from which patient's condition can be diagnosed and viewed by authorized medical professionals in remote locations. Instantaneous information allows medical professionals to intervene properly and timely to prevent possible catastrophic effects to patients. The continuously monitored information provides medical professionals more complete and long-term studies of patients. All of these result in not only enhancement of the health treatment quality but also significant reduction of medical expenditure. These techniques demonstrate that health monitoring of patients can be done wirelessly at any time and any place without interfering with the patients' normal activities. Implementing the RFID technology would not only help reduce the enormous and significantly growing medical costs in the U.S.A., but also help improve the health treatment capability as well as enhance the understanding of long-term personal health and illness.

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.

Distributed FBG sensors apply in spacecraft health monitoring

NASA Astrophysics Data System (ADS)

Huang, Xiujun; Zhang, Cuicui; Shi, Dele; Shen, Jingshi

2017-10-01

At present, Spacecraft manufacturing face with high adventure for its complicate structure, serious space environment and not maintained on orbit. When something wrong with spacecraft, monitoring its health state, supply health data in real time would assure quickly locate error and save more time to rescue it. For FBG sensor can distributed test several parameters such as temperature, strain, vibration and easily construct net. At same time, it has more advantages such as ant-radiate, anti-jamming, rodent-resistant and with long lifetime, which more fit for applying in space. In this paper, a spacecraft health monitor system based on FBG sensors is present, Firstly, spacecraft health monitor system and its development are introduced. Then a four channels FBG demodulator is design. At last, Temperature and strain detecting experiment is done. The result shows that the demodulator fully satisfied the need of spacecraft health monitor system.

The Overview of the Health Monitoring Management System

NASA Astrophysics Data System (ADS)

Zhong-Ji, Tan; Zhiqiang, Zhang; Yan-Bin, Shi

The health monitoring management system has prominent function to improve the security and dependability of the aircraft, can also shortens the maintain cycle by a large margin, improves the sortie rate at the same time. This paper has explained the concept, the development in domestic and international and the key technology of the health monitoring management system of aircraft; Construct the structure of the aircraft health monitoring management system, and has carried on analysis and research to its implementation method.

Health Monitor for Multitasking, Safety-Critical, Real-Time Software

NASA Technical Reports Server (NTRS)

Zoerner, Roger

2011-01-01

Health Manager can detect Bad Health prior to a failure occurring by periodically monitoring the application software by looking for code corruption errors, and sanity-checking each critical data value prior to use. A processor s memory can fail and corrupt the software, or the software can accidentally write to the wrong address and overwrite the executing software. This innovation will continuously calculate a checksum of the software load to detect corrupted code. This will allow a system to detect a failure before it happens. This innovation monitors each software task (thread) so that if any task reports "bad health," or does not report to the Health Manager, the system is declared bad. The Health Manager reports overall system health to the outside world by outputting a square wave signal. If the square wave stops, this indicates that system health is bad or hung and cannot report. Either way, "bad health" can be detected, whether caused by an error, corrupted data, or a hung processor. A separate Health Monitor Task is started and run periodically in a loop that starts and stops pending on a semaphore. Each monitored task registers with the Health Manager, which maintains a count for the task. The registering task must indicate if it will run more or less often than the Health Manager. If the task runs more often than the Health Manager, the monitored task calls a health function that increments the count and verifies it did not go over max-count. When the periodic Health Manager runs, it verifies that the count did not go over the max-count and zeroes it. If the task runs less often than the Health Manager, the periodic Health Manager will increment the count. The monitored task zeroes the count, and both the Health Manager and monitored task verify that the count did not go over the max-count.

Working practices and incomes of health workers: evidence from an evaluation of a delivery fee exemption scheme in Ghana

PubMed Central

Witter, Sophie; Kusi, Anthony; Aikins, Moses

2007-01-01

Background This article describes a survey of health workers and traditional birth attendants (TBAs) which was carried out in 2005 in two regions of Ghana. The objective of the survey was to ascertain the impact of the introduction of a delivery fee exemption scheme on both health workers and those providers who were excluded from the scheme (TBAs). This formed part of an overall evaluation of the delivery fee exemption scheme. The results shed light not only on the scheme itself but also on the general productivity of a range of health workers in Ghana. Methods A structured questionnaire was developed, covering individual and household characteristics, working hours and practices, sources of income, and views of the exemptions scheme and general motivation. After field testing, this was administered to 374 respondents in 12 districts of Central and Volta regions. The respondents included doctors, medical assistants (MAs), public and private midwives, nurses, community health nurses (CHNs), and traditional birth attendants, both trained and untrained. Results Health workers were well informed about the delivery fee exemptions scheme and their responses on its impact suggest a realistic view that it was a good scheme, but one that faces serious challenges regarding financial sustainability. Concerning its impact on their morale and working conditions, the responses were broadly neutral. Most public sector workers have seen an increased workload, but counterbalanced by increased pay. TBAs have suffered, in terms of client numbers and income, while the picture for private midwives is mixed. The survey also sheds light on pay and productivity. The respondents report long working hours, with a mean of 54 hours per week for community nurses and up to 129 hours per week for MAs. Weekly reported client loads in the public sector range from a mean of 86 for nurses to 269 for doctors. Over the past two years, reported working hours have been increasing, but so have pay and

Wearable Sensors for Remote Health Monitoring.

PubMed

Majumder, Sumit; Mondal, Tapas; Deen, M Jamal

2017-01-12

Life expectancy in most countries has been increasing continually over the several few decades thanks to significant improvements in medicine, public health, as well as personal and environmental hygiene. However, increased life expectancy combined with falling birth rates are expected to engender a large aging demographic in the near future that would impose significant  burdens on the socio-economic structure of these countries. Therefore, it is essential to develop cost-effective, easy-to-use systems for the sake of elderly healthcare and well-being. Remote health monitoring, based on non-invasive and wearable sensors, actuators and modern communication and information technologies offers an efficient and cost-effective solution that allows the elderly to continue to live in their comfortable home environment instead of expensive healthcare facilities. These systems will also allow healthcare personnel to monitor important physiological signs of their patients in real time, assess health conditions and provide feedback from distant facilities. In this paper, we have presented and compared several low-cost and non-invasive health and activity monitoring systems that were reported in recent years. A survey on textile-based sensors that can potentially be used in wearable systems is also presented. Finally, compatibility of several communication technologies as well as future perspectives and research challenges in remote monitoring systems will be discussed.

Wearable Sensors for Remote Health Monitoring

PubMed Central

Majumder, Sumit; Mondal, Tapas; Deen, M. Jamal

2017-01-01

Life expectancy in most countries has been increasing continually over the several few decades thanks to significant improvements in medicine, public health, as well as personal and environmental hygiene. However, increased life expectancy combined with falling birth rates are expected to engender a large aging demographic in the near future that would impose significant  burdens on the socio-economic structure of these countries. Therefore, it is essential to develop cost-effective, easy-to-use systems for the sake of elderly healthcare and well-being. Remote health monitoring, based on non-invasive and wearable sensors, actuators and modern communication and information technologies offers an efficient and cost-effective solution that allows the elderly to continue to live in their comfortable home environment instead of expensive healthcare facilities. These systems will also allow healthcare personnel to monitor important physiological signs of their patients in real time, assess health conditions and provide feedback from distant facilities. In this paper, we have presented and compared several low-cost and non-invasive health and activity monitoring systems that were reported in recent years. A survey on textile-based sensors that can potentially be used in wearable systems is also presented. Finally, compatibility of several communication technologies as well as future perspectives and research challenges in remote monitoring systems will be discussed. PMID:28085085

Players and processes behind the national health insurance scheme: a case study of Uganda.

PubMed

Basaza, Robert K; O'Connell, Thomas S; Chapčáková, Ivana

2013-09-22

Uganda is the last East African country to adopt a National Health Insurance Scheme (NHIS). To lessen the inequitable burden of healthcare spending, health financing reform has focused on the establishment of national health insurance. The objective of this research is to depict how stakeholders and their power and interests have shaped the process of agenda setting and policy formulation for Uganda's proposed NHIS. The study provides a contextual analysis of the development of NHIS policy within the context of national policies and processes. The methodology is a single case study of agenda setting and policy formulation related to the proposed NHIS in Uganda. It involves an analysis of the real-life context, the content of proposals, the process, and a retrospective stakeholder analysis in terms of policy development. Data collection comprised a literature review of published documents, technical reports, policy briefs, and memos obtained from Uganda's Ministry of Health and other unpublished sources. Formal discussions were held with ministry staff involved in the design of the scheme and some members of the task force to obtain clarification, verify events, and gain additional information. The process of developing the NHIS has been an incremental one, characterised by small-scale, gradual changes and repeated adjustments through various stakeholder engagements during the three phases of development: from 1995 to 1999; 2000 to 2005; and 2006 to 2011. Despite political will in the government, progress with the NHIS has been slow, and it has yet to be implemented. Stakeholders, notably the private sector, played an important role in influencing the pace of the development process and the currently proposed design of the scheme. This study underscores the importance of stakeholder analysis in major health reforms. Early use of stakeholder analysis combined with an ongoing review and revision of NHIS policy proposals during stakeholder discussions would be an

Individualized Behavioral Health Monitoring Tool

NASA Technical Reports Server (NTRS)

Mollicone, Daniel

2015-01-01

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

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.

Wearable sensors for human health monitoring

NASA Astrophysics Data System (ADS)

Asada, H. Harry; Reisner, Andrew

2006-03-01

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

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

PubMed

Ahnn, Jong Hoon; Potkonjak, Miodrag

2013-10-01

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

Gaussian mixture modeling of acoustic emissions for structural health monitoring of reinforced concrete structures

NASA Astrophysics Data System (ADS)

Farhidzadeh, Alireza; Dehghan-Niri, Ehsan; Salamone, Salvatore

2013-04-01

Reinforced Concrete (RC) has been widely used in construction of infrastructures for many decades. The cracking behavior in concrete is crucial due to the harmful effects on structural performance such as serviceability and durability requirements. In general, in loading such structures until failure, tensile cracks develop at the initial stages of loading, while shear cracks dominate later. Therefore, monitoring the cracking modes is of paramount importance as it can lead to the prediction of the structural performance. In the past two decades, significant efforts have been made toward the development of automated structural health monitoring (SHM) systems. Among them, a technique that shows promises for monitoring RC structures is the acoustic emission (AE). This paper introduces a novel probabilistic approach based on Gaussian Mixture Modeling (GMM) to classify AE signals related to each crack mode. The system provides an early warning by recognizing nucleation of numerous critical shear cracks. The algorithm is validated through an experimental study on a full-scale reinforced concrete shear wall subjected to a reversed cyclic loading. A modified conventional classification scheme and a new criterion for crack classification are also proposed.

The National Health Insurance Scheme (NHIS): a survey of knowledge and opinions of Nigerian dentists' in Lagos.

PubMed

Adeniyi, A A; Onajole, A T

2010-03-01

This study was designed to assess the knowledge and perceptions of Nigerian dentists to the National Health Insurance scheme (NHIS). A cross-sectional descriptive survey was conducted amongst 250 dentists employed in private and public dental clinics in Lagos State, Nigeria. The survey instrument was a self-administered questionnaire designed to assess their knowledge and attitudes towards the scheme. Data analysis was done using the Epi-Info statistical software (version 6.04). Statistical tools used included measures of central tendency, frequency distribution and chi-square test. A total of 216 dentists (response rate of 82.4%) participated in this study. Most 132 (61.1%) of the respondents had a fair knowledge of the NHIS, while 22 (10.2%) and 62 (28.7%) had poor and good knowledge respectively. Majority (70.4%) viewed the NHIS as a good idea that will succeed if properly implemented. Most (76.6%) respondents also believed that the scheme will improve access to oral health services, affordability of services (71.4%), availability of the services (68.3%) and recognition of dentistry as a profession (62.4%). Most of the respondents (66.2%) considered oral health care as not properly positioned in the NHIS and 154 respondents (74.4%) found the current position of oral health on the NHIS unacceptable. A good number of the respondents (77.3%) would like dentistry to operate at the primary care level on the NHIS. Majority of the dentists involved in this study had some knowledge of the NHIS and were generally positively disposed towards the scheme and viewed it as a good idea.

On-Line Modal State Monitoring of Slowly Time-Varying Structures

NASA Technical Reports Server (NTRS)

Johnson, Erik A.; Bergman, Lawrence A.; Voulgaris, Petros G.

1997-01-01

Monitoring the dynamic response of structures is often performed for a variety of reasons. These reasons include condition-based maintenance, health monitoring, performance improvements, and control. In many cases the data analysis that is performed is part of a repetitive decision-making process, and in these cases the development of effective on-line monitoring schemes help to speed the decision-making process and reduce the risk of erroneous decisions. This report investigates the use of spatial modal filters for tracking the dynamics of slowly time-varying linear structures. The report includes an overview of modal filter theory followed by an overview of several structural system identification methods. Included in this discussion and comparison are H-infinity, eigensystem realization, and several time-domain least squares approaches. Finally, a two-stage adaptive on-line monitoring scheme is developed and evaluated.

Equity of the premium of the Ghanaian national health insurance scheme and the implications for achieving universal coverage

PubMed Central

2013-01-01

The Ghanaian National Health Insurance Scheme (NHIS) was introduced to provide access to adequate health care regardless of ability to pay. By law the NHIS is mandatory but because the informal sector has to make premium payment before they are enrolled, the authorities are unable to enforce mandatory nature of the scheme. The ultimate goal of the Scheme then is to provide all residents with access to adequate health care at affordable cost. In other words, the Scheme intends to achieve universal coverage. An important factor for the achievement of universal coverage is that revenue collection be equitable. The purpose of this study is to examine the vertical and horizontal equity of the premium collection of the Scheme. The Kakwani index method as well as graphical analysis was used to study the vertical equity. Horizontal inequity was measured through the effect of the premium on redistribution of ability to pay of members. The extent to which the premium could cause catastrophic expenditure was also examined. The results showed that revenue collection was both vertically and horizontally inequitable. The horizontal inequity had a greater effect on redistribution of ability to pay than vertical inequity. The computation of catastrophic expenditure showed that a small minority of the poor were likely to incur catastrophic expenditure from paying the premium a situation that could impede the achievement of universal coverage. The study provides recommendations to improve the inequitable system of premium payment to help achieve universal coverage. PMID:23294982

Can health insurance protect against out-of-pocket and catastrophic expenditures and also support poverty reduction? Evidence from Ghana's National Health Insurance Scheme.

PubMed

Aryeetey, Genevieve Cecilia; Westeneng, Judith; Spaan, Ernst; Jehu-Appiah, Caroline; Agyepong, Irene Akua; Baltussen, Rob

2016-07-22

Ghana since 2004, begun implementation of a National Health Insurance Scheme (NHIS) to minimize financial barriers to health care at point of use of service. Usually health insurance is expected to offer financial protection to households. This study aims to analyze the effect health insurance on household out-of-pocket expenditure (OOPE), catastrophic expenditure (CE) and poverty. We conducted two repeated household surveys in two regions of Ghana in 2009 and 2011. We first analyzed the effect of OOPE on poverty by estimating poverty headcount before and after OOPE were incurred. We also employed probit models and use of instrumental variables to analyze the effect of health insurance on OOPE, CE and poverty. Our findings showed that between 7-18 % of insured households incurred CE as a result of OOPE whereas this was between 29-36 % for uninsured households. In addition, between 3-5 % of both insured and uninsured households fell into poverty due to OOPE. Our regression analyses revealed that health insurance enrolment reduced OOPE by 86 % and protected households against CE and poverty by 3.0 % and 7.5 % respectively. This study provides evidence that high OOPE leads to CE and poverty in Ghana but enrolment into the NHIS reduces OOPE, provides financial protection against CE and reduces poverty. These findings support the pro-poor policy objective of Ghana's National Health Insurance Scheme and holds relevance to other low and middle income countries implementing or aiming to implement insurance schemes.

Beyond health aid: would an international equalization scheme for universal health coverage serve the international collective interest?

PubMed Central

2014-01-01

It has been argued that the international community is moving ‘beyond aid’. International co-financing in the international collective interest is expected to replace altruistically motivated foreign aid. The World Health Organization promotes ‘universal health coverage’ as the overarching health goal for the next phase of the Millennium Development Goals. In order to provide a basic level of health care coverage, at least some countries will need foreign aid for decades to come. If international co-financing of global public goods is replacing foreign aid, is universal health coverage a hopeless endeavor? Or would universal health coverage somehow serve the international collective interest? Using the Sustainable Development Solutions Network proposal to finance universal health coverage as a test case, we examined the hypothesis that national social policies face the threat of a ‘race to the bottom’ due to global economic integration and that this threat could be mitigated through international social protection policies that include international cross-subsidies – a kind of ‘equalization’ at the international level. The evidence for the race to the bottom theory is inconclusive. We seem to be witnessing a ‘convergence to the middle’. However, the ‘middle’ where ‘convergence’ of national social policies is likely to occur may not be high enough to keep income inequality in check. The implementation of the international equalization scheme proposed by the Sustainable Development Solutions Network would allow to ensure universal health coverage at a cost of US$55 in low income countries-the minimum cost estimated by the World Health Organization. The domestic efforts expected from low and middle countries are far more substantial than the international co-financing efforts expected from high income countries. This would contribute to ‘convergence’ of national social policies at a higher level. We therefore submit that the proposed

Design of smart neonatal health monitoring system using SMCC.

PubMed

De, Debashis; Mukherjee, Anwesha; Sau, Arkaprabha; Bhakta, Ishita

2017-02-01

Automated health monitoring and alert system development is a demanding research area today. Most of the currently available monitoring and controlling medical devices are wired which limits freeness of working environment. Wireless sensor network (WSN) is a better alternative in such an environment. Neonatal intensive care unit is used to take care of sick and premature neonates. Hypothermia is an independent risk factor for neonatal mortality and morbidity. To prevent it an automated monitoring system is required. In this Letter, an automated neonatal health monitoring system is designed using sensor mobile cloud computing (SMCC). SMCC is based on WSN and MCC. In the authors' system temperature sensor, acceleration sensor and heart rate measurement sensor are used to monitor body temperature, acceleration due to body movement and heart rate of neonates. The sensor data are stored inside the cloud. The health person continuously monitors and accesses these data through the mobile device using an Android Application for neonatal monitoring. When an abnormal situation arises, an alert is generated in the mobile device of the health person. By alerting health professional using such an automated system, early care is provided to the affected babies and the probability of recovery is increased.

Factors influencing the transferability of occupational safety and health economic incentive schemes between different countries.

PubMed

Elsler, Dietmar; Eeckelaert, Lieven

2010-06-01

This article looks at the factors that influence the transferability of different types of occupational safety and health (OSH) economic incentives from one country to another. To review the legal, political, and cultural framework conditions for economic incentive schemes in the European Union (EU), the European Agency for Safety and Health at Work (EU-OSHA) surveyed EU member states about the state of such schemes in their countries. In addition to the survey responses, relevant information on existing schemes and their national context within the 27 EU member states was gathered through reports, articles, and databases. Following this, countries were clustered according to cross-cultural differences. Despite the apparent variations in Europe's social security systems, there is a high degree of similarity between the countries regarding the basic criteria of design of the system. In addition, different kinds of incentives are used in different member states regardless of the social insurance system. When it comes to insurance incentive schemes, the fundamental difference between countries is whether the workers' compensation scheme is based on a competitive market between private insurance companies or a kind of monopoly structure, where the employers do not have the choice between several insurance companies. A clear majority of 19 of the 27 EU member states have a monopoly system. Subsidy systems, tax incentives, and insurance-based "experience rating" are theoretically -possible in all EU countries. In competitive insurance markets, effort-based incentives are more difficult to achieve. A possible solution could be the introduction of long-term contracts or the creation of a common prevention fund, financed equally by all insurers.

Forest Health Monitoring in Maryland 1996-1999

Treesearch

Northeastern Research Station

2003-01-01

The National Forest Health Monitoring (FHM) program monitors the long-term status, changes and trends in the health of forest ecosystems and is conducted in cooperation with individual states. In Maryland, 40 FHM plots were established in 1991. Beginning in 1998, 95 plots were added. Each plot is a series of four fixed-area circular plots. Most tree measurements are...

CCS_WHMS: A Congestion Control Scheme for Wearable Health Management System.

PubMed

Kafi, Mohamed Amine; Ben Othman, Jalel; Bagaa, Miloud; Badache, Nadjib

2015-12-01

Wearable computing is becoming a more and more attracting field in the last years thanks to the miniaturisation of electronic devices. Wearable healthcare monitoring systems (WHMS) as an important client of wearable computing technology has gained a lot. Indeed, the wearable sensors and their surrounding healthcare applications bring a lot of benefits to patients, elderly people and medical staff, so facilitating their daily life quality. But from a research point of view, there is still work to accomplish in order to overcome the gap between hardware and software parts. In this paper, we target the problem of congestion control when all these healthcare sensed data have to reach the destination in a reliable manner that avoids repetitive transmission which wastes precious energy or leads to loss of important information in emergency cases, too. We propose a congestion control scheme CCS_WHMS that ensures efficient and fair data delivery while used in the body wearable system part or in the multi-hop inter bodies wearable ones to get the destination. As the congestion detection paradigm is very important in the control process, we do experimental tests to compare between state of the art congestion detection methods, using MICAz motes, in order to choose the appropriate one for our scheme.

Investigating the Willingness to Pay for a Contributory National Health Insurance Scheme in Saudi Arabia: A Cross-sectional Stated Preference Approach.

PubMed

Al-Hanawi, Mohammed Khaled; Vaidya, Kirit; Alsharqi, Omar; Onwujekwe, Obinna

2018-04-01

The Saudi Healthcare System is universal, financed entirely from government revenue principally derived from oil, and is 'free at the point of delivery' (non-contributory). However, this system is unlikely to be sustainable in the medium to long term. This study investigates the feasibility and acceptability of healthcare financing reform by examining households' willingness to pay (WTP) for a contributory national health insurance scheme. Using the contingent valuation method, a pre-tested interviewer-administered questionnaire was used to collect data from 1187 heads of household in Jeddah province over a 5-month period. Multi-stage sampling was employed to select the study sample. Using a double-bounded dichotomous choice with the follow-up elicitation method, respondents were asked to state their WTP for a hypothetical contributory national health insurance scheme. Tobit regression analysis was used to examine the factors associated with WTP and assess the construct validity of elicited WTP. Over two-thirds (69.6%) indicated that they were willing to participate in and pay for a contributory national health insurance scheme. The mean WTP was 50 Saudi Riyal (US$13.33) per household member per month. Tobit regression analysis showed that household size, satisfaction with the quality of public healthcare services, perceptions about financing healthcare, education and income were the main determinants of WTP. This study demonstrates a theoretically valid WTP for a contributory national health insurance scheme by Saudi people. The research shows that willingness to participate in and pay for a contributory national health insurance scheme depends on participant characteristics. Identifying and understanding the main influencing factors associated with WTP are important to help facilitate establishing and implementing the national health insurance scheme. The results could assist policy-makers to develop and set insurance premiums, thus providing an additional source

Robust Strategy for Rocket Engine Health Monitoring

NASA Technical Reports Server (NTRS)

Santi, L. Michael

2001-01-01

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

Flexible Sensing Electronics for Wearable/Attachable Health Monitoring.

PubMed

Wang, Xuewen; Liu, Zheng; Zhang, Ting

2017-07-01

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

Wearable sensors for health monitoring

NASA Astrophysics Data System (ADS)

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

2015-02-01

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

The social security scheme in Thailand: what lessons can be drawn?

PubMed

Tangcharoensathien, V; Supachutikul, A; Lertiendumrong, J

1999-04-01

The Social Security Scheme was launched in 1990, covering formal sector private employees for non-work related sickness, maternity and invalidity including cash benefits and funeral grants. The scheme is financed by tripartite contributions from government, employers and employees, each of 1.5% of payroll (total of 4.5%). The scheme decided to pay health care providers, whether public or private, on a flat rate capitation basis to cover both ambulatory and inpatient care. Registration of the insured with a contractor hospital was a necessary consequence of the chosen capitation payment system. The aim of this paper is to review the operation of the scheme, and to explore the implications of capitation payment and registration for utilisation levels and provider behaviour. A key weakness of the scheme's design is suggested to be the initial decision to give employers not employees the responsibility for choosing the registered hospitals. This was done for administrative reasons, but it contributed to low levels of use of the contractor hospitals. In addition, low levels of use were also probably the result of the potential for cream skimming, cost shifting from inpatient to ambulatory care and under-provision of patient care, though since monitoring mechanisms by the Social Security Office were weak, these effects are difficult to detect conclusively. Mechanisms to improve utilisation levels were gradually introduced, such as employee choice of registered hospitals and the formation of sub-contractor networks to improve access to care. A beneficial effect of the capitation payment system was that the Social Security Fund generated substantial reserves and expenditures on sickness benefits were well stabilised. The paper ends by recommending that future policy amendments should be guided by research and empirical findings and that tougher monitoring and enforcement of quality of care standards are required.

Acceptance by laypersons and medical professionals of the personalized eHealth platform, eHealthMonitor.

PubMed

Griebel, Lena; Kolominsky-Rabas, Peter; Schaller, Sandra; Siudyka, Jakub; Sierpinski, Radoslaw; Papapavlou, Dimitrios; Simeonidou, Aliki; Prokosch, Hans-Ulrich; Sedlmayr, Martin

2017-09-01

Often, eHealth services are not accepted because of factors such as eHealth literacy or trust. Within this study, eHealthMonitor was evaluated in three European countries (Germany, Greece, and Poland) by medical professionals and laypersons with respect to numerous acceptance factors. Questionnaires were created on the basis of factors from literature and with the help of scales which have already been validated. A qualitative survey was conducted in Germany, Poland, and Greece. The eHealth literacy of all participants was medium/high. Laypersons mostly agreed that they could easily become skillful with eHealthMonitor and that other people thought that they should use eHealthMonitor. Amongst medical professionals, a large number were afraid that eHealthMonitor could violate their privacy or the privacy of their patients. Overall, the participants thought that eHealthMonitor was a good concept and that they would use it. The main hindrances to the use of eHealthMonitor were found in trust issues including data privacy. In the future, more research on the linkage of all measured factors is needed, for example, to address the question of whether highly educated people tend to mistrust eHealth information more than people with lower levels of education.

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

Monitoring nanotechnology using patent classifications: an overview and comparison of nanotechnology classification schemes

NASA Astrophysics Data System (ADS)

Jürgens, Björn; Herrero-Solana, Victor

2017-04-01

Patents are an essential information source used to monitor, track, and analyze nanotechnology. When it comes to search nanotechnology-related patents, a keyword search is often incomplete and struggles to cover such an interdisciplinary discipline. Patent classification schemes can reveal far better results since they are assigned by experts who classify the patent documents according to their technology. In this paper, we present the most important classifications to search nanotechnology patents and analyze how nanotechnology is covered in the main patent classification systems used in search systems nowadays: the International Patent Classification (IPC), the United States Patent Classification (USPC), and the Cooperative Patent Classification (CPC). We conclude that nanotechnology has a significantly better patent coverage in the CPC since considerable more nanotechnology documents were retrieved than by using other classifications, and thus, recommend its use for all professionals involved in nanotechnology patent searches.

Design of smart neonatal health monitoring system using SMCC

PubMed Central

Mukherjee, Anwesha; Bhakta, Ishita

2016-01-01

Automated health monitoring and alert system development is a demanding research area today. Most of the currently available monitoring and controlling medical devices are wired which limits freeness of working environment. Wireless sensor network (WSN) is a better alternative in such an environment. Neonatal intensive care unit is used to take care of sick and premature neonates. Hypothermia is an independent risk factor for neonatal mortality and morbidity. To prevent it an automated monitoring system is required. In this Letter, an automated neonatal health monitoring system is designed using sensor mobile cloud computing (SMCC). SMCC is based on WSN and MCC. In the authors’ system temperature sensor, acceleration sensor and heart rate measurement sensor are used to monitor body temperature, acceleration due to body movement and heart rate of neonates. The sensor data are stored inside the cloud. The health person continuously monitors and accesses these data through the mobile device using an Android Application for neonatal monitoring. When an abnormal situation arises, an alert is generated in the mobile device of the health person. By alerting health professional using such an automated system, early care is provided to the affected babies and the probability of recovery is increased. PMID:28261491

Sensor validation and fusion for gas turbine vibration monitoring

NASA Astrophysics Data System (ADS)

Yan, Weizhong; Goebel, Kai F.

2003-08-01

Vibration monitoring is an important practice throughout regular operation of gas turbine power systems and, even more so, during characterization tests. Vibration monitoring relies on accurate and reliable sensor readings. To obtain accurate readings, sensors are placed such that the signal is maximized. In the case of characterization tests, strain gauges are placed at the location of vibration modes on blades inside the gas turbine. Due to the prevailing harsh environment, these sensors have a limited life and decaying accuracy, both of which impair vibration assessment. At the same time bandwidth limitations may restrict data transmission, which in turn limits the number of sensors that can be used for assessment. Knowing the sensor status (normal or faulty), and more importantly, knowing the true vibration level of the system all the time is essential for successful gas turbine vibration monitoring. This paper investigates a dynamic sensor validation and system health reasoning scheme that addresses the issues outlined above by considering only the information required to reliably assess system health status. In particular, if abnormal system health is suspected or if the primary sensor is determined to be faulted, information from available "sibling" sensors is dynamically integrated. A confidence expresses the complex interactions of sensor health and system health, their reliabilities, conflicting information, and what the health assessment is. Effectiveness of the scheme in achieving accurate and reliable vibration evaluation is then demonstrated using a combination of simulated data and a small sample of a real-world application data where the vibration of compressor blades during a real time characterization test of a new gas turbine power system is monitored.

Patient monitoring in mobile health: opportunities and challenges.

PubMed

Mohammadzadeh, Niloofar; Safdari, Reza

2014-01-01

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

Expanding health insurance scheme in the informal sector in Nigeria: awareness as a potential demand-side tool

PubMed Central

Adewole, David Ayobami; Akanbi, Saidat Abisola; Osungbade, Kayode Omoniyi; Bello, Segun

2017-01-01

Introduction The implementation and expansion of a health insurance scheme in the informal sector, particularly in developing countries, is a challenge. With the aid of an innovative Information-Education and Communication model, titled 'Understanding the concept of health insurance: An innovative social marketing tool', an assessment of the awareness and perception of the scheme among market women was carried out. Methods This is a cross-sectional descriptive survey, carried out among market women in Ibadan, Nigeria. In a multi-stage sampling technique, a total of 351 women were interviewed using an interviewer-administered, semi-structured questionnaire. The data was analysed using SPSS version 16. Chi-square test was used to test associations between selected variables of interest. Logistic regression model was used to determine predictors of awareness of the National Health Insurance Scheme (NHIS). A model controlling for participants' enrolment status was built and Adjusted Odds Ratio (AOR) reported. Level of statistical significance was set at p < 0.05. Results A total of 344 market women aged 18 years and above participated in the study, a response rate of 98.0%. Respondents' educational status was the only predictor significantly associated with awareness of the NHIS. Respondents with post-primary education had 10 times the odds of being aware of the NHIS than respondents with no education or only primary education (Adjusted Odds Ratio = 10.3; 95% CI = 4.1-26.0). Conclusion Innovative models to enable potential beneficiaries, especially among the informal sector, to better comprehend and accept the concept of prepayment methods of financing healthcare costs is important in efforts to implement and expand a social health insurance scheme. PMID:28819474

Private healthcare provider experiences with social health insurance schemes: Findings from a qualitative study in Ghana and Kenya

PubMed Central

Sieverding, Maia; Onyango, Cynthia

2018-01-01

Background Incorporating private healthcare providers into social health insurance schemes is an important means towards achieving universal health coverage in low and middle income countries. However, little research has been conducted about why private providers choose to participate in social health insurance systems in such contexts, or their experiences with these systems. We explored private providers’ perceptions of and experiences with participation in two different social health insurance schemes in Sub-Saharan Africa—the National Health Insurance Scheme (NHIS) in Ghana and the National Hospital Insurance Fund (NHIF) in Kenya. Methods In-depth interviews were held with providers working at 79 facilities of varying sizes in three regions of Kenya (N = 52) and three regions of Ghana (N = 27). Most providers were members of a social franchise network. Interviews covered providers’ reasons for (non) enrollment in the health insurance system, their experiences with the accreditation process, and benefits and challenges with the system. Interviews were coded in Atlas.ti using an open coding approach and analyzed thematically. Results Most providers in Ghana were NHIS-accredited and perceived accreditation to be essential to their businesses, despite challenges they encountered due to long delays in claims reimbursement. In Kenya, fewer than half of providers were NHIF-accredited and several said that their clientele were not NHIF enrolled. Understanding of how the NHIF functioned was generally low. The lengthy and cumbersome accreditation process also emerged as a major barrier to providers’ participation in the NHIF in Kenya, but the NHIS accreditation process was not a major concern for providers in Ghana. Conclusions In expanding social health insurance, coordinated efforts are needed to increase coverage rates among underserved populations while also accrediting the private providers who serve those populations. Market pressure was a key force

Private healthcare provider experiences with social health insurance schemes: Findings from a qualitative study in Ghana and Kenya.

PubMed

Sieverding, Maia; Onyango, Cynthia; Suchman, Lauren

2018-01-01

Incorporating private healthcare providers into social health insurance schemes is an important means towards achieving universal health coverage in low and middle income countries. However, little research has been conducted about why private providers choose to participate in social health insurance systems in such contexts, or their experiences with these systems. We explored private providers' perceptions of and experiences with participation in two different social health insurance schemes in Sub-Saharan Africa-the National Health Insurance Scheme (NHIS) in Ghana and the National Hospital Insurance Fund (NHIF) in Kenya. In-depth interviews were held with providers working at 79 facilities of varying sizes in three regions of Kenya (N = 52) and three regions of Ghana (N = 27). Most providers were members of a social franchise network. Interviews covered providers' reasons for (non) enrollment in the health insurance system, their experiences with the accreditation process, and benefits and challenges with the system. Interviews were coded in Atlas.ti using an open coding approach and analyzed thematically. Most providers in Ghana were NHIS-accredited and perceived accreditation to be essential to their businesses, despite challenges they encountered due to long delays in claims reimbursement. In Kenya, fewer than half of providers were NHIF-accredited and several said that their clientele were not NHIF enrolled. Understanding of how the NHIF functioned was generally low. The lengthy and cumbersome accreditation process also emerged as a major barrier to providers' participation in the NHIF in Kenya, but the NHIS accreditation process was not a major concern for providers in Ghana. In expanding social health insurance, coordinated efforts are needed to increase coverage rates among underserved populations while also accrediting the private providers who serve those populations. Market pressure was a key force driving providers to gain and maintain accreditation

A Comprehensive Observational Coding Scheme for Analyzing Instrumental, Affective, and Relational Communication in Health Care Contexts

PubMed Central

SIMINOFF, LAURA A.; STEP, MARY M.

2011-01-01

Many observational coding schemes have been offered to measure communication in health care settings. These schemes fall short of capturing multiple functions of communication among providers, patients, and other participants. After a brief review of observational communication coding, the authors present a comprehensive scheme for coding communication that is (a) grounded in communication theory, (b) accounts for instrumental and relational communication, and (c) captures important contextual features with tailored coding templates: the Siminoff Communication Content & Affect Program (SCCAP). To test SCCAP reliability and validity, the authors coded data from two communication studies. The SCCAP provided reliable measurement of communication variables including tailored content areas and observer ratings of speaker immediacy, affiliation, confirmation, and disconfirmation behaviors. PMID:21213170

A new scheme for biomonitoring heavy metal concentrations in semi-natural wetlands.

PubMed

Batzias, A F; Siontorou, C G

2008-10-30

This work introduces a semi-natural wetland biomonitoring framework for heavy metal concentrations based on a robust dynamic integration between biological assemblages and relevant biosensors. The cooperative/synergistic scheme developed minimizes uncertainty and monitoring costs and increases reliability of pollution control and abatement. Attention is given to establishing a fully functioning and reliable network approach for monitoring inflows and achieving dose-response relations and calibration of biomonitoring species. The biomonitoring network initially consists of both, biosensors and species, as a validation phase in each wetland of the surveillance area; once the species monitoring efficiency is verified by the biosensors, the biosensor network moves to the next wetland and so on, following a circular pattern until all area wetlands have a fully functional natural monitoring scheme. By means of species recalibration with periodic revisiting of the biosensors, the scheme progressively reaches a quasi steady-state (including seasonality), thus ensuring reliability and robustness. This framework, currently pilot-tested in Voiotia, Greece, for assessing chromium levels, has been built to cover short-, medium- and long-term monitoring requirements. The results gathered so far, support the employment of the proposed scheme in heavy metal monitoring, and, further, arise the need for volunteer involvement to achieve long-term viability.

Health State Utilities Associated with Glucose Monitoring Devices.

PubMed

Matza, Louis S; Stewart, Katie D; Davies, Evan W; Hellmund, Richard; Polonsky, William H; Kerr, David

2017-03-01

Glucose monitoring is important for patients with diabetes treated with insulin. Conventional glucose monitoring requires a blood sample, typically obtained by pricking the finger. A new sensor-based system called "flash glucose monitoring" monitors glucose levels with a sensor worn on the arm, without requiring blood samples. To estimate the utility difference between these two glucose monitoring approaches for use in cost-utility models. In time trade-off interviews, general population participants in the United Kingdom (London and Edinburgh) valued health states that were drafted and refined on the basis of literature, clinician input, and a pilot study. The health states had identical descriptions of diabetes and insulin treatment, differing only in glucose monitoring approach. A total of 209 participants completed the interviews (51.7% women; mean age = 42.1 years). Mean utilities were 0.851 ± 0.140 for conventional monitoring and 0.882 ± 0.121 for flash monitoring (significant difference between the mean utilities; t = 8.3; P < 0.0001). Of the 209 participants, 78 (37.3%) had a higher utility for flash monitoring, 2 (1.0%) had a higher utility for conventional monitoring, and 129 (61.7%) had the same utility for both health states. The flash glucose monitoring system was associated with a significantly greater utility than the conventional monitoring system. This difference may be useful in cost-utility models comparing the value of glucose monitoring devices for patients with diabetes. This study adds to the literature on treatment process utilities, suggesting that time trade-off methods may be used to quantify preferences among medical devices. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Introduction to:Forest health monitoring program

Treesearch

Mark J. Ambrose

2009-01-01

This annual technical report is a product of the Forest Health Monitoring (FHM) Program. The report provides information about a variety of issues relating to forest health at a national scale. FHM national reports have the dual focus of presenting analyses of the latest available data and showcasing innovative techniques for analyzing forest health data. The report is...

Players and processes behind the national health insurance scheme: a case study of Uganda

PubMed Central

2013-01-01

Background Uganda is the last East African country to adopt a National Health Insurance Scheme (NHIS). To lessen the inequitable burden of healthcare spending, health financing reform has focused on the establishment of national health insurance. The objective of this research is to depict how stakeholders and their power and interests have shaped the process of agenda setting and policy formulation for Uganda’s proposed NHIS. The study provides a contextual analysis of the development of NHIS policy within the context of national policies and processes. Methods The methodology is a single case study of agenda setting and policy formulation related to the proposed NHIS in Uganda. It involves an analysis of the real-life context, the content of proposals, the process, and a retrospective stakeholder analysis in terms of policy development. Data collection comprised a literature review of published documents, technical reports, policy briefs, and memos obtained from Uganda’s Ministry of Health and other unpublished sources. Formal discussions were held with ministry staff involved in the design of the scheme and some members of the task force to obtain clarification, verify events, and gain additional information. Results The process of developing the NHIS has been an incremental one, characterised by small-scale, gradual changes and repeated adjustments through various stakeholder engagements during the three phases of development: from 1995 to 1999; 2000 to 2005; and 2006 to 2011. Despite political will in the government, progress with the NHIS has been slow, and it has yet to be implemented. Stakeholders, notably the private sector, played an important role in influencing the pace of the development process and the currently proposed design of the scheme. Conclusions This study underscores the importance of stakeholder analysis in major health reforms. Early use of stakeholder analysis combined with an ongoing review and revision of NHIS policy proposals

Financial viability of district mutual health insurance schemes of lawra and sissala East districts, upper west region, ghana.

PubMed

Yevutsey, S K; Aikins, M

2010-12-01

The National Health Insurance Act, passed in 2003 mandates the National Health Insurance Authority to, in conjunction with the district assemblies establish district mutual health insurance scheme (DMHIS) governed by semi-autonomous boards in all ten regions. Since its implementation, unsubstantiated reports indicate increasing health care and administrative costs of the various DMHIS across the country without any corresponding increase in the premium level. We sought to assess the financial viability of the DMHIS in Lawra (LDMHIS) and Sissala East (SEDMHIS) districts, Upper West Region of Ghana. Cost analysis of revenue and expenditure of LDMHIS and SEDMHIS from 2004 to 2007 was used to estimate the revenue, expenditure, administrative cost, expense, claims and combined ratios. The scheme's major sources of revenue were funds from NHIA on behalf of exempted group and the formal sector employees and premium collected from the informal sector. Other sources of revenue were significant at the beginning and became almost negligible at the end of 2007. At the end of 2005, administrative cost was higher than medical claims. By the end of 2007, it has reduced to 34.3% and 15.7% of the total expenditure of the SEDMHIS and LDMHIS respectively. The combined ratios decreased from 2.27 and 1.17 in 2005 to 0.74 and 0.95 in 2007 for SEDMHIS and LDMHIS respectively. Continuous NHIA support, increasing coverage of the scheme and a corresponding reduction in administrative cost would increase revenue. If this is sustained, the schemes could be financially viable in the long term.

Flexible Structural-Health-Monitoring Sheets

NASA Technical Reports Server (NTRS)

Qing, Xinlin; Kuo, Fuo

2008-01-01

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

Health financing reform in Uganda: How equitable is the proposed National Health Insurance scheme?

PubMed

Orem, Juliet Nabyonga; Zikusooka, Charlotte Muheki

2010-10-13

Uganda is proposing introduction of the National Health Insurance scheme (NHIS) in a phased manner with the view to obtaining additional funding for the health sector and promoting financial risk protection. In this paper, we have assessed the proposed NHIS from an equity perspective, exploring the extent to which NHIS would improve existing disparities in the health sector. We reviewed the proposed design and other relevant documents that enhanced our understanding of contextual issues. We used the Kutzin and fair financing frameworks to critically assess the impact of NHIS on overall equity in financing in Uganda. The introduction of NHIS is being proposed against the backdrop of inequalities in the distribution of health system inputs between rural and urban areas, different levels of care and geographic areas. In this assessment, we find that gradual implementation of NHIS will result in low coverage initially, which might pose a challenge for effective management of the scheme. The process for accreditation of service providers during the first phase is not explicit on how it will ensure that a two-tier service provision arrangement does not emerge to cater for different types of patients. If the proposed fee-for-service mechanism of reimbursing providers is pursued, utilisation patterns will determine how resources are allocated. This implies that equity in resource allocation will be determined by the distribution of accredited providers, and checks put in place to prohibit frivolous use. The current design does not explicitly mention how these two issues will be tackled. Lastly, there is no clarity on how the NHIS will fit into, and integrate within existing financing mechanisms. Under the current NHIS design, the initial low coverage in the first years will inhibit optimal achievement of the important equity characteristics of pooling, cross-subsidisation and financial protection. Depending on the distribution of accredited providers and utilisation

Action Monitoring for Equity and Gender in Health

PubMed Central

Bhuiya, Abbas; Hanifi, S.M.A.; Mahmood, Shehrin Shaila

2008-01-01

Equity and gender, despite being universal concerns for all health programmes in Bangladesh, are often missing in many of the health agenda. The health programmes fail to address these important dimensions unless these are specifically included in the planning stage of a programme and are continually monitored for progress. This paper presents the situation of equity in health in Bangladesh, innovations in monitoring equity in the use of health services in general and by the poor in particular, and impact of targeted non-health interventions on health outcomes of the poor. It was argued that an equitable use of health services might also result in enhanced overall coverage of the services. The findings show that government services at the upazila level are used by the poor proportionately more than they are in the community, while at the private facilities, the situation is reverse. Commonly-used monitoring tools, at times, are not very useful for the programme managers to know how well they are doing in reaching the poor. Use of benefit-incidence ratio may provide a quick feedback to the health facility managers about their extent of serving the poor. Similarly, Lot Quality Assurance Sampling can be an easy-to-use tool for monitoring coverage at the community level requiring a very small sample size. Although health problems are biomedical phenomena, their solutions may include actions beyond the biomedical framework. Studies have shown that non-health interventions targeted towards the poor improve the use of health services and reduce mortality among children in poor households. The study on equity and health deals with various interlocking issues, and the examples and views presented in this paper intend to introduce their importance in designing and managing health and development programmes. PMID:18831232

Action monitoring for equity and gender in health.

PubMed

Bhuiya, Abbas; Hanifi, S M A; Mahmood, Shehrin Shaila

2008-09-01

Equity and gender, despite being universal concerns for all health programmes in Bangladesh, are often missing in many of the health agenda. The health programmes fail to address these important dimensions unless these are specifically included in the planning stage of a programme and are continually monitored for progress. This paper presents the situation of equity in health in Bangladesh, innovations in monitoring equity in the use of health services in general and by the poor in particular, and impact of targeted non-health interventions on health outcomes of the poor. It was argued that an equitable use of health services might also result in enhanced overall coverage of the services. The findings show that government services at the upazila level are used by the poor proportionately more than they are in the community, while at the private facilities, the situation is reverse. Commonly-used monitoring tools, at times, are not very useful for the programme managers to know how well they are doing in reaching the poor. Use of benefit-incidence ratio may provide a quick feedback to the health facility managers about their extent of serving the poor. Similarly, Lot Quality Assurance Sampling can be an easy-to-use tool for monitoring coverage at the community level requiring a very small sample size. Although health problems are biomedical phenomena, their solutions may include actions beyond the biomedical framework. Studies have shown that non-health interventions targeted towards the poor improve the use of health services and reduce mortality among children in poor households. The study on equity and health deals with various interlocking issues, and the examples and views presented in this paper intend to introduce their importance in designing and managing health and development programmes.

International health research monitoring: exploring a scientific and a cooperative approach using participatory action research

PubMed Central

Chantler, Tracey; Cheah, Phaik Yeong; Miiro, George; Hantrakum, Viriya; Nanvubya, Annet; Ayuo, Elizabeth; Kivaya, Esther; Kidola, Jeremiah; Kaleebu, Pontiano; Parker, Michael; Njuguna, Patricia; Ashley, Elizabeth; Guerin, Philippe J; Lang, Trudie

2014-01-01

Objectives To evaluate and determine the value of monitoring models developed by the Mahidol Oxford Tropical Research Unit and the East African Consortium for Clinical Research, consider how this can be measured and explore monitors’ and investigators’ experiences of and views about the nature, purpose and practice of monitoring. Research design A case study approach was used within the context of participatory action research because one of the aims was to guide and improve practice. 34 interviews, five focus groups and observations of monitoring practice were conducted. Setting and participants Fieldwork occurred in the places where the monitoring models are coordinated and applied in Thailand, Cambodia, Uganda and Kenya. Participants included those coordinating the monitoring schemes, monitors, senior investigators and research staff. Analysis Transcribed textual data from field notes, interviews and focus groups was imported into a qualitative data software program (NVIVO V. 10) and analysed inductively and thematically by a qualitative researcher. The initial coding framework was reviewed internally and two main categories emerged from the subsequent interrogation of the data. Results The categories that were identified related to the conceptual framing and nature of monitoring, and the practice of monitoring, including relational factors. Particular emphasis was given to the value of a scientific and cooperative style of monitoring as a means of enhancing data quality, trust and transparency. In terms of practice the primary purpose of monitoring was defined as improving the conduct of health research and increasing the capacity of researchers and trial sites. Conclusions The models studied utilise internal and network wide expertise to improve the ethics and quality of clinical research. They demonstrate how monitoring can be a scientific and constructive exercise rather than a threatening process. The value of cooperative relations needs to be given

Impact of Thailand universal coverage scheme on the country's health information systems and health information technology.

PubMed

Kijsanayotin, Boonchai

2013-01-01

Thailand achieved universal healthcare coverage with the implementation of the Universal Coverage Scheme (UCS) in 2001. This study employed qualitative method to explore the impact of the UCS on the country's health information systems (HIS) and health information technology (HIT) development. The results show that health insurance beneficiary registration system helps improve providers' service workflow and country vital statistics. Implementation of casemix financing tool, Thai Diagnosis-Related Groups, has stimulated health providers' HIS and HIT capacity building, data and medical record quality and the adoption of national administrative data standards. The system called "Disease Management Information Systems" aiming at reimbursement for select diseases increased the fragmentation of HIS and increase burden on data management to providers. The financial incentive of outpatient data quality improvement project enhance providers' HIS and HIT investment and also induce data fraudulence tendency. Implementation of UCS has largely brought favorable impact on the country HIS and HIT development. However, the unfavorable effects are also evident.

Evaluation of health benefit using BenMAP-CE with an integrated scheme of model and monitor data during Guangzhou Asian Games.

PubMed

Ding, Dian; Zhu, Yun; Jang, Carey; Lin, Che-Jen; Wang, Shuxiao; Fu, Joshua; Gao, Jian; Deng, Shuang; Xie, Junping; Qiu, Xuezhen

2016-04-01

Guangzhou is the capital and largest city (land area: 7287 km(2)) of Guangdong province in South China. The air quality in Guangzhou typically worsens in November due to unfavorable meteorological conditions for pollutant dispersion. During the Guangzhou Asian Games in November 2010, the Guangzhou government carried out a number of emission control measures that significantly improved the air quality. In this paper, we estimated the acute health outcome changes related to the air quality improvement during the 2010 Guangzhou Asian Games using a next-generation, fully-integrated assessment system for air quality and health benefits. This advanced system generates air quality data by fusing model and monitoring data instead of using monitoring data alone, which provides more reliable results. The air quality estimates retain the spatial distribution of model results while calibrating the value with observations. The results show that the mean PM2.5 concentration in November 2010 decreased by 3.5 μg/m(3) compared to that in 2009 due to the emission control measures. From the analysis, we estimate that the air quality improvement avoided 106 premature deaths, 1869 cases of hospital admission, and 20,026 cases of outpatient visits. The overall cost benefit of the improved air quality is estimated to be 165 million CNY, with the avoided premature death contributing 90% of this figure. The research demonstrates that BenMAP-CE is capable of assessing the health and cost benefits of air pollution control for sound policy making. Copyright © 2015. Published by Elsevier B.V.

A new strategy toward Internet of Things: structural health monitoring using a combined fiber optic and acoustic emission wireless sensor platform

NASA Astrophysics Data System (ADS)

Nguyen, A. D.; Page, C.; Wilson, C. L.

2016-04-01

This paper investigates a new low-power structural health monitoring (SHM) strategy where fiber Bragg grating (FBG) rosettes can be used to continuously monitor for changes in a host structure's principal strain direction, suggesting damage and thus enabling the immediate triggering of a higher power acoustic emissions (AE) sensor to provide for better characterization of the damage. Unlike traditional "always on" AE platforms, this strategy has the potential for low power, while the wireless communication between different sensor types supports the Internet of Things (IoT) approach. A combination of fiber-optic sensor rosettes for strain monitoring and a fiber-optic sensor for acoustic emissions monitoring was attached to a sample and used to monitor crack initiation. The results suggest that passive principal strain direction monitoring could be used as a damage initiation trigger for other active sensing elements such as acoustic emissions. In future work, additional AE sensors can be added to provide for damage location; and a strategy where these sensors can be powered on periodically to further establish reliability while preserving an energy efficient scheme can be incorporated.

Social health insurance contributes to universal coverage in South Africa, but generates inequities: survey among members of a government employee insurance scheme.

PubMed

Goudge, Jane; Alaba, Olufunke A; Govender, Veloshnee; Harris, Bronwyn; Nxumalo, Nonhlanhla; Chersich, Matthew F

2018-01-04

Many low- and middle-income countries are reforming their health financing mechanisms as part of broader strategies to achieve universal health coverage (UHC). Voluntary social health insurance, despite evidence of resulting inequities, is attractive to policy makers as it generates additional funds for health, and provides access to a greater range of benefits for the formally employed. The South African government introduced a voluntary health insurance scheme (GEMS) for government employees in 2005 with the aim of improving access to care and extending health coverage. In this paper we ask whether the new scheme has assisted in efforts to move towards UHC. Using a cross-sectional survey across four of South Africa's nine provinces, we interviewed 1329 government employees, from the education and health sectors. Data were collected on socio-demographics, insurance coverage, health status and utilisation of health care. Multivariate logistic regression was used to determine if service utilisation was associated with insurance status. A quarter of respondents remained uninsured, even higher among 20-29 year olds (46%) and lower-skilled employees (58%). In multivariate analysis, the odds of an outpatient visit and hospital admission for the uninsured was 0.3 fold that of the insured. Cross-subsidisation within the scheme has provided lower-paid civil servants with improved access to outpatient care at private facilities and chronic medication, where their outpatient (0.54 visits/month) and inpatient utilisation (10.1%/year) approximates that of the overall population (29.4/month and 12.2% respectively). The scheme, however, generated inequities in utilisation among its members due to its differential benefit packages, with, for example, those with the most benefits having 1.0 outpatient visits/month compared to 0.6/month with lowest benefits. By introducing the scheme, the government chose to prioritise access to private sector care for government employees, over

Should Governments engage health insurance intermediaries? A comparison of benefits with and without insurance intermediary in a large tax funded community health insurance scheme in the Indian state of Andhra Pradesh.

PubMed

Nagulapalli, Srikant; Rokkam, Sudarsana Rao

2015-09-10

A peculiar phenomenon of engaging insurance intermediaries for government funded health insurance schemes for the poor, not usually found globally, is gaining ground in India. Rajiv Aarogyasri Scheme launched in the Indian state of Andhra Pradesh, is first largest tax funded community health insurance scheme in the country covering more than 20 million poor families. Aarogyasri Health Care Trust (trust), the scheme administrator, transfers funds to hospitals through two routes one, directly and the other through an insurance intermediary. The objective of this paper is to find out if engaging an insurance intermediary has any effect on cost efficiency of the insurance scheme. We used payment data of RAS for the period 2007-12, to find out the influence of insurance intermediary on the two variables, benefit cost ratio defined as benefit payment divided by premium payment, and claim denial ratio defined as benefit payment divided by treatment cost. Relationship between scheme expenditure and number of beds empanelled under the scheme is examined. OLS regression is used to perform all analyses. We found that adding an additional layer of insurance intermediary between the trust and hospitals reduced the benefit cost ratio under the scheme by 12.2% (p-value = 0.06). Every addition of 100 beds under the scheme increases the scheme payments by US$ 0.75 million (p-value < 0.001). The gap in claim denial ratio between insurance and trust modes narrowed down from 2.84% in government hospitals to 0.41% in private hospitals (p-value < 0.001). The scheme is a classic case of Roemer's principle in operation. Introduction of insurance intermediary has the twin effects of reduction in benefit payments to beneficiaries, and chocking fund flow to government hospitals. The idea of engaging insurance intermediary should be abandoned.

Health care utilisation under the 30-Baht Scheme among the urban poor in Mitrapap slum, Khon Kaen, Thailand: a cross-sectional study

PubMed Central

Coronini-Cronberg, Sophie; Laohasiriwong, Wongsa; Gericke, Christian A

2007-01-01

Background In 2001, the Government of Thailand introduced a universal coverage scheme with the aim of ensuring equitable health care access for even the poorest citizens. For a flat user fee of 30 Baht per consultation, or for free for those falling into exemption categories, every scheme participant may access registered health services. The exemption categories include children under 12 years of age, senior citizens aged 60 years and over, the very poor, and volunteer health workers. The functioning of these exemption mechanisms and the effect of the scheme on health service utilisation among the poor is controversial. Methods This cross-sectional study investigated the prevalence of 30-Baht Scheme registration and subsequent self-reported health service utilisation among an urban poor population in the Teparuk community within the Mitrapap slum in Khon Kaen city, northeastern Thailand. Furthermore, the effectiveness of the exemption mechanisms in reaching the very poor and the elderly was examined. Factors for users' choice of health facilities were identified. Results Overall, the proportion of the Teparuk community enrolled with the 30-Baht Scheme was high at 86%, with over one quarter of these exempted from paying the consultation fee. User fee exemption was significantly more frequent among households with an above-poverty-line income (64.7%) compared to those below the poverty line (35.3%), χ2 (df) = 5.251 (1); p-value = 0.018. In addition, one third of respondents over 60 years of age were found to be still paying user fees. Self-reported use of registered medical facilities in case of illness was stated to be predominantly due to the service being available through the scheme, with service quality not a chief consideration. Overall consumer satisfaction was high, especially among those not required to pay the 30 Baht user fee. Conclusion Whilst the 30-Baht Scheme seems to cover most of the poor population of Mitrapap slum in Khon Kaen, the user fee

Recommendations for Health Monitoring and Reporting for Zebrafish Research Facilities

PubMed Central

Crim, Marcus J.; Lieggi, Christine

2016-01-01

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

Continuous wireless pressure monitoring and mapping with ultra-small passive sensors for health monitoring and critical care

NASA Astrophysics Data System (ADS)

Chen, Lisa Y.; Tee, Benjamin C.-K.; Chortos, Alex L.; Schwartz, Gregor; Tse, Victor; J. Lipomi, Darren; Wong, H.-S. Philip; McConnell, Michael V.; Bao, Zhenan

2014-10-01

Continuous monitoring of internal physiological parameters is essential for critical care patients, but currently can only be practically achieved via tethered solutions. Here we report a wireless, real-time pressure monitoring system with passive, flexible, millimetre-scale sensors, scaled down to unprecedented dimensions of 1 × 1 × 0.1 cubic millimeters. This level of dimensional scaling is enabled by novel sensor design and detection schemes, which overcome the operating frequency limits of traditional strategies and exhibit insensitivity to lossy tissue environments. We demonstrate the use of this system to capture human pulse waveforms wirelessly in real time as well as to monitor in vivo intracranial pressure continuously in proof-of-concept mice studies using sensors down to 2.5 × 2.5 × 0.1 cubic millimeters. We further introduce printable wireless sensor arrays and show their use in real-time spatial pressure mapping. Looking forward, this technology has broader applications in continuous wireless monitoring of multiple physiological parameters for biomedical research and patient care.

Continuous wireless pressure monitoring and mapping with ultra-small passive sensors for health monitoring and critical care.

PubMed

Chen, Lisa Y; Tee, Benjamin C-K; Chortos, Alex L; Schwartz, Gregor; Tse, Victor; Lipomi, Darren J; Wong, H-S Philip; McConnell, Michael V; Bao, Zhenan

2014-10-06

Continuous monitoring of internal physiological parameters is essential for critical care patients, but currently can only be practically achieved via tethered solutions. Here we report a wireless, real-time pressure monitoring system with passive, flexible, millimetre-scale sensors, scaled down to unprecedented dimensions of 1 × 1 × 0.1 cubic millimeters. This level of dimensional scaling is enabled by novel sensor design and detection schemes, which overcome the operating frequency limits of traditional strategies and exhibit insensitivity to lossy tissue environments. We demonstrate the use of this system to capture human pulse waveforms wirelessly in real time as well as to monitor in vivo intracranial pressure continuously in proof-of-concept mice studies using sensors down to 2.5 × 2.5 × 0.1 cubic millimeters. We further introduce printable wireless sensor arrays and show their use in real-time spatial pressure mapping. Looking forward, this technology has broader applications in continuous wireless monitoring of multiple physiological parameters for biomedical research and patient care.

Maintaining the Health of Software Monitors

NASA Technical Reports Server (NTRS)

Person, Suzette; Rungta, Neha

2013-01-01

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

Forest health monitoring: National status, trends, and analysis 2012

Treesearch

Kevin M. Potter; Barbara L. Conkling

2014-01-01

The annual national report of the Forest Health Monitoring Program of the Forest Service, U.S. Department of Agriculture, presents forest health status and trends from a national or multi-State regional perspective using a variety of sources, introduces new techniques for analyzing forest health data, and summarizes results of recently completed Evaluation Monitoring...

Forest health monitoring: national status, trends, and analysis 2011

Treesearch

Kevin M. Potter; Barbara L. Conkling

2013-01-01

The annual national report of the Forest Health Monitoring Program of the Forest Service, U.S. Department of Agriculture, presents forest health status and trends from a national or multi-State regional perspective using a variety of sources, introduces new techniques for analyzing forest health data, and summarizes results of recently completed Evaluation Monitoring...

Forest Health Monitoring: national status, trends, and analysis 2010

Treesearch

Kevin M. Potter; Barbara L. Conkling

2013-01-01

The annual national report of the Forest Health Monitoring Program of the Forest Service, U.S. Department of Agriculture, presents forest health status and trends from a national or multi-State regional perspective using a variety of sources, introduces new techniques for analyzing forest health data, and summarizes results of recently completed Evaluation Monitoring...

Adaptable System for Vehicle Health and Usage Monitoring

NASA Technical Reports Server (NTRS)

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

2005-01-01

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

More frequent, more costly? Health economic modelling aspects of monitoring glaucoma patients in England.

PubMed

Boodhna, Trishal; Crabb, David P

2016-10-22

Chronic open angle glaucoma (COAG) is an age-related eye disease causing irreversible loss of visual field (VF). Health service delivery for COAG is challenging given the large number of diagnosed patients requiring lifelong periodic monitoring by hospital eye services. Yet frequent examination better determines disease worsening and speed of VF loss under treatment. We examine the cost-effectiveness of increasing frequency of VF examinations during follow-up using a health economic model. Two different VF monitoring schemes defined as current practice (annual VF testing) and proposed practice (three VF tests per year in the first 2 years after diagnosis) were examined. A purpose written health economic Markov model is used to test the hypothesis that cost effectiveness improves by implementing proposed practice on groups of patients stratified by age and severity of COAG. Further, a new component of the model, estimating costs of visual impairment, was added. Results were derived from a simulated cohort of 10000 patients with quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs) used as main outcome measures. An ICER of £21,392 per QALY was derived for proposed practice improving to a value of £11,382 once savings for prevented visual impairment was added to the model. Proposed practice was more cost-effective in younger patients. Proposed practice for patients with advanced disease at diagnosis generated ICERs > £60,000 per QALY; these cases would likely be on the most intensive treatment pathway making clinical information on speed of VF loss redundant. Sensitivity analysis indicated results to be robust in relation to hypothetical willingness to pay threshold identified by national guidelines, although greatest uncertainty was allied to estimates of implementation and visual impairment costs. Increasing VF monitoring at the earliest stages of follow-up for COAG appears to be cost-effective depending on reasonable

Summary report: Forest health monitoring in the South, 1992

Treesearch

John S. Vissage; William H. Hoffard

1997-01-01

In 1990, the U.S. Department of Agriculture, Forest Service and the U.S. Environmental Protection Agency launched a cooperative program, Forest Health Monitoring, to monitor the health of the Nation's forests. Several indicators of forest health have been measured on permanent plots in 14 States. Data gathered from Alabama, Georgia, and Virginia in 1992 are...

Equity-Oriented Monitoring in the Context of Universal Health Coverage

PubMed Central

Hosseinpoor, Ahmad Reza; Bergen, Nicole; Koller, Theadora; Prasad, Amit; Schlotheuber, Anne; Valentine, Nicole; Lynch, John; Vega, Jeanette

2014-01-01

Monitoring inequalities in health is fundamental to the equitable and progressive realization of universal health coverage (UHC). A successful approach to global inequality monitoring must be intuitive enough for widespread adoption, yet maintain technical credibility. This article discusses methodological considerations for equity-oriented monitoring of UHC, and proposes recommendations for monitoring and target setting. Inequality is multidimensional, such that the extent of inequality may vary considerably across different dimensions such as economic status, education, sex, and urban/rural residence. Hence, global monitoring should include complementary dimensions of inequality (such as economic status and urban/rural residence) as well as sex. For a given dimension of inequality, subgroups for monitoring must be formulated taking into consideration applicability of the criteria across countries and subgroup heterogeneity. For economic-related inequality, we recommend forming subgroups as quintiles, and for urban/rural inequality we recommend a binary categorization. Inequality spans populations, thus appropriate approaches to monitoring should be based on comparisons between two subgroups (gap approach) or across multiple subgroups (whole spectrum approach). When measuring inequality absolute and relative measures should be reported together, along with disaggregated data; inequality should be reported alongside the national average. We recommend targets based on proportional reductions in absolute inequality across populations. Building capacity for health inequality monitoring is timely, relevant, and important. The development of high-quality health information systems, including data collection, analysis, interpretation, and reporting practices that are linked to review and evaluation cycles across health systems, will enable effective global and national health inequality monitoring. These actions will support equity-oriented progressive realization of UHC

[Equity-oriented monitoring in the context of universal health coverage].

PubMed

Hosseinpoor, Ahmad Reza; Bergen, Nicole; Koller, Theadora; Prasad, Amit; Schlotheuber, Anne; Valentine, Nicole; Lynch, John; Vega, Jeanette

2015-07-01

Monitoring inequalities in health is fundamental to the equitable and progressive realization of universal health coverage (UHC). A successful approach to global inequality monitoring must be intuitive enough for widespread adoption, yet maintain technical credibility. This article discusses methodological considerations for equity-oriented monitoring of UHC, and proposes recommendations for monitoring and target setting. Inequality is multidimensional, such that the extent of inequality may vary considerably across different dimensions such as economic status, education, sex, and urban/rural residence. Hence, global monitoring should include complementary dimensions of inequality (such as economic status and urban/rural residence) as well as sex. For a given dimension of inequality, subgroups for monitoring must be formulated taking into consideration applicability of the criteria across countries and subgroup heterogeneity. For economic-related inequality, we recommend forming subgroups as quintiles, and for urban/rural inequality we recommend a binary categorization. Inequality spans populations, thus appropriate approaches to monitoring should be based on comparisons between two subgroups (gap approach) or across multiple subgroups (whole spectrum approach). When measuring inequality absolute and relative measures should be reported together, along with disaggregated data; inequality should be reported alongside the national average. We recommend targets based on proportional reductions in absolute inequality across populations. Building capacity for health inequality monitoring is timely, relevant, and important. The development of high-quality health information systems, including data collection, analysis, interpretation, and reporting practices that are linked to review and evaluation cycles across health systems, will enable effective global and national health inequality monitoring. These actions will support equity-oriented progressive realization of UHC.

Structural health monitoring system/method using electroactive polymer fibers

NASA Technical Reports Server (NTRS)

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

2013-01-01

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

Mundane? Demographic characteristics as predictors of enrolment onto the National Health Insurance Scheme in two districts of Ghana.

PubMed

Seddoh, Anthony; Sataru, Fuseini

2018-05-04

In 2003, Ghana passed a law to establish a National Health Insurance Scheme (NHIS) to serve as the main vehicle for achieving universal health coverage. Over 60% of the population had registered by 2009. Current active membership is however 40%. The stagnation in growth has been recorded across all the membership categories. Clearly, the Scheme is falling short of its core objective. This analysis is a critical thematic contextual examination of the effects of demographic factors on enrolment onto the Scheme. Demographic secondary data for 625 respondents collected (using a structured questionnaire) during a cross-sectional household survey in an urban, Ashaiman, and rural, Adaklu, districts was analyzed in univariate and multivariate logistic regression models using Statistical Package for Social Scientists (SPSS). Statistical significance was set at P-value < 0.05. Variables included in the analysis were age, gender, education, occupation and knowledge about the NHIS. Seventy-nine percent of the survey respondents have ever enrolled onto the NHIS with three-fifths being females. Of the ever enrolled, 63% had valid cards. Age, gender and educational level were significant predictors of enrolment in the multivariate analysis. Respondents between the ages 41-60 years were twice (p = 0.05) more likely to be enrolled onto a district Scheme compared with respondents between the ages 21-40 years. Females were thrice (p = 0.00) more likely to enroll compared with males. Respondents educated to the tertiary, five times (p = 0.02), and post-graduate, four times (p = 0.05), levels were more likely to enroll compared with non-educated respondents. No significant association was observed between occupation and enrolment. Uptake of the scheme is declining despite high awareness and knowledge. Leadership, innovation and collaboration are required at the district Scheme level to curtail issues of low self-enrolment and to grow membership. Otherwise, the goal of

Rajiv Aarogyasri Community Health Insurance Scheme in Andhra Pradesh, India: a comprehensive analytic view of private public partnership model.

PubMed

Reddy, Sunita; Mary, Immaculate

2013-01-01

The Rajiv Aarogyasri Community Health Insurance (RACHI) in Andhra Pradesh (AP) has been very popular social insurance scheme with a private public partnership model to deal with the problems of catastrophic medical expenditures at tertiary level care for the poor households. A brief analysis of the RACHI scheme based on officially available data and media reports has been undertaken from a public health perspective to understand the nature and financing of partnership and the lessons it provides. The analysis of the annual budget spent on the surgeries in private hospitals compared to tertiary public hospitals shows that the current scheme is not sustainable and pose huge burden on the state exchequers. The private hospital association's in AP, further acts as pressure groups to increase the budget or threaten to withdraw services. Thus, profits are privatized and losses are socialized.

Principles in wireless building health monitoring systems.

NASA Astrophysics Data System (ADS)

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

2012-04-01

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

Physical health care monitoring for people with serious mental illness.

PubMed

Tosh, Graeme; Clifton, Andrew; Mala, Shereen; Bachner, Mick

2010-03-17

Current guidance suggests that we should monitor the physical health of people with serious mental illness and there has been a significant financial investment over recent years to provide this. To assess the effectiveness of physical health monitoring as a means of reducing morbidity, mortality and reduction in quality of life in people with serious mental illness. We searched the Cochrane Schizophrenia Group Trials Register (October 2009) which is based on regular searches of CINAHL, EMBASE, MEDLINE and PsycINFO. All randomised or quasi-randomised clinical trials focusing on physical health monitoring versus standard care or comparing i) self monitoring vs monitoring by health care professional; ii) simple vs complex monitoring; iii) specific vs non-specific checks iv) once only vs regular checks or v) comparison of different guidance. The authors (GT, AC, SM) independently screened search results and identified three studies as possibly fulfilling the review's criteria. On examination, however, all three were subsequently excluded. We did not identify any randomised trials which assessed the effectiveness of physical health monitoring in people with serious mental illness. There is no evidence from randomised trials to support current guidance and practice. Guidance and practice are based on expert consensus, clinical experience and good intentions rather than high quality evidence.

The Socioeconomic and Institutional Determinants of Participation in India’s Health Insurance Scheme for the Poor

PubMed Central

Nandi, Arindam; Ashok, Ashvin; Laxminarayan, Ramanan

2013-01-01

The Rashtriya Swasthya Bima Yojana (RSBY), which was introduced in 2008 in India, is a social health insurance scheme that aims to improve healthcare access and provide financial risk protection to the poor. In this study, we analyse the determinants of participation and enrolment in the scheme at the level of districts. We used official data on RSBY enrolment, socioeconomic data from the District Level Household Survey 2007–2008, and additional state-level information on fiscal health, political affiliation, and quality of governance. Results from multivariate probit and OLS analyses suggest that political and institutional factors are among the strongest determinants explaining the variation in participation and enrolment in RSBY. In particular, districts in state governments that are politically affiliated with the opposition or neutral parties at the centre are more likely to participate in RSBY, and have higher levels of enrolment. Districts in states with a lower quality of governance, a pre-existing state-level health insurance scheme, or with a lower level of fiscal deficit as compared to GDP, are significantly less likely to participate, or have lower enrolment rates. Among socioeconomic factors, we find some evidence of weak or imprecise targeting. Districts with a higher share of socioeconomically backward castes are less likely to participate, and their enrolment rates are also lower. Finally, districts with more non-poor households may be more likely to participate, although with lower enrolment rates. PMID:23805211

Health insurance subsidies and deductible choice: Evidence from regional variation in subsidy schemes.

PubMed

Kaufmann, Cornel; Schmid, Christian; Boes, Stefan

2017-09-01

The extent to which premium subsidies can influence health insurance choices is an open question. In this paper, we explore the regional variation in subsidy schemes in Switzerland, designed as either in-kind or cash transfers, to study their impact on the choice of health insurance deductibles. Using health survey data and a difference-in-differences methodology, we find that in-kind transfers increase the likelihood of choosing a low deductible plan by approximately 4 percentage points (or 7%). Our results indicate that the response to in-kind transfers is strongest among women, middle-aged and unmarried individuals, which we explain by differences in risk-taking behavior, health status, financial constraints, health insurance and financial literacy. We discuss our results in the light of potential extra-marginal effects on the demand for health care services, which are however not supported by our data. Copyright © 2017 Elsevier B.V. All rights reserved.

Traditional healers as service providers in Ghana's National Health Insurance Scheme: the wrong way forward?

PubMed

Barimah, Kofi Bobi

2013-01-01

Concerned with the negative impacts of user fees on healthcare access and utilisation, following the enactment of a law in 2003, the Ghanaian government replaced the 'cash-and-carry' system with a National Health Insurance Scheme (NHIS). Even though many Ghanaians rely on traditional medicine (TRM) for reasons of culture, cost and personal preference, the incipient NHIS does not cover the services of TRM practitioners. Consultations with health policy-makers suggest that, in as much as the government recognises the invaluable contributions of TRM practitioners and would like to incorporate them in the incipient scheme, the provision of TRM in the country is still too disorganised, with few if any formal protocols and codes of conduct. Consequently, the inclusion of TRM practitioners in the NHIS is premature. This scholarly review seeks to bring TRM and its practitioners into the mainstream of healthcare provision in Ghana. Possibilities for medical pluralism in Ghana will be discussed with reference to best practices in countries such as China, India and Vietnam. This paper promotes medical pluralism in the form of Active Collaboration Between Fully Recognised Health Systems where there will be equity, mutual respect and understanding among traditional healers and physicians.

A System for Monitoring Employee Health in a Navy Occupational Setting.

DTIC Science & Technology

1980-12-30

AD0AIGI 064 NAVAL HEALTH RESEARCH CENTER SAN DIEGO CA F/G 6/5 A SYSTEM FOR MONITORING EMPLOYEE HEALTH IN A NAVY OCCUPATIONAL --ETC(U) DEC 80 L...CALORWIM , NAVAL IMEDCAL. REEARC AIND DEVELOPMUT Claww KWh~v, - ji, A System for Monitoring Employee Health in a Navy Occupational Setting Larry Hermansen...and Health Act of 1970 and Executive Order 11807 have engendered a need for a comprehensive system that can monitor and document employee health and

Health Monitoring of a Satellite System

NASA Technical Reports Server (NTRS)

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

2004-01-01

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

Addressing healthcare needs of people living below the poverty line: a rapid assessment of the Andhra Pradesh Health Insurance Scheme.

PubMed

Rao, M; Ramachandra, S S; Bandyopadhyay, S; Chandran, A; Shidhaye, R; Tamisettynarayana, S; Thippaiah, A; Sitamma, M; Sunil George, M; Singh, V; Sivasankaran, S; Bangdiwala, S I

2011-01-01

Families living below the poverty line in countries which do not have universal healthcare coverage are drawn into indebtedness and bankruptcy. The state of Andhra Pradesh in India established the Rajiv Aarogyasri Community Health Insurance Scheme (RACHIS) in 2007 with the aim of breaking this cycle by improving the access of below the poverty line (BPL) families to secondary and tertiary healthcare. It covered a wide range of surgical and medical treatments for serious illnesses requiring specialist healthcare resources not always available at district-level government hospitals. The impact of this scheme was evaluated by a rapid assessment, commissioned by the government of Andhra Pradesh. The aim of the assessment was to explore the contribution of the scheme to the reduction of catastrophic health expenditure among the poor and to recommend ways by which delivery of the scheme could be improved. We report the findings of this assessment. Two types of data were used for the assessment. Patient data pertaining to 89 699 treatment requests approved by the scheme during its first 18 months were examined. Second, surveys of scheme beneficiaries and providers were undertaken in 6 randomly selected districts of Andhra Pradesh. This novel scheme was beginning to reach the BPL households in the state and providing access to free secondary and tertiary healthcare to seriously ill poor people. An integrated model encompassing primary, secondary and tertiary care would be of greater benefit to families below the poverty line and more cost-effective for the government. There is considerable potential for the government to build on this successful start and to strengthen equity of access and the quality of care provided by the scheme. Copyright 2011, NMJI.

National health insurance scheme: how protected are households in Oyo State, Nigeria from catastrophic health expenditure?

PubMed Central

Ilesanmi, Olayinka Stephen; Adebiyi, Akindele Olupelumi; Fatiregun, Akinola Ayoola

2014-01-01

Background: The major objective of the National Health Insurance Scheme (NHIS) in Nigeria is to protect families from the financial hardship of large medical bills. Catastrophic Health Expenditure (CHE) is rampart in Nigeria despite the take-off of the NHIS. This study aimed to determine if households enrolled in the NHIS were protected from having CHE. Methods: The study took place among 714 households in urban communities of Oyo State. CHE was measured using a threshold of 40% of monthly non-food expenditure. Descriptive statistics were done, Principal Component Analysis was used to divide households into wealth quintiles. Chi-square test and binary logistic regression were done. Results: The mean age of household respondent was 33.5 years. The median household income was 43,500 naira (290 US dollars) and the range was 7,000–680,000 naira (46.7–4,533 US dollars) in 2012. The overall median household healthcare cost was 890 naira (5.9 US dollars) and the range was 10-17,700 naira (0.1–118 US dollars) in 2012. In all, 67 (9.4%) households were enrolled in NHIS scheme. Healthcare services was utilized by 637 (82.9%) and CHE occurred in 42 (6.6%) households. CHE occurred in 14 (10.9%) of the households in the lowest quintile compared to 3 (2.5%) in the highest wealth quintile (P= 0.004). The odds of CHE among households in lowest wealth quintile is about 5 times. They had Crude OR (CI): 4.7 (1.3–16.8), P= 0.022. Non enrolled households were two times likely to have CHE, though not significant Conclusion: Households in the lowest wealth quintiles were at higher risk of CHE. Universal coverage of health insurance in Nigeria should be fast-tracked to give the expected financial risk protection and decreased incidence of CHE. PMID:24847483

National health insurance scheme: how protected are households in Oyo State, Nigeria from catastrophic health expenditure?

PubMed

Ilesanmi, Olayinka Stephen; Adebiyi, Akindele Olupelumi; Fatiregun, Akinola Ayoola

2014-05-01

The major objective of the National Health Insurance Scheme (NHIS) in Nigeria is to protect families from the financial hardship of large medical bills. Catastrophic Health Expenditure (CHE) is rampart in Nigeria despite the take-off of the NHIS. This study aimed to determine if households enrolled in the NHIS were protected from having CHE. The study took place among 714 households in urban communities of Oyo State. CHE was measured using a threshold of 40% of monthly non-food expenditure. Descriptive statistics were done, Principal Component Analysis was used to divide households into wealth quintiles. Chi-square test and binary logistic regression were done. The mean age of household respondent was 33.5 years. The median household income was 43,500 naira (290 US dollars) and the range was 7,000-680,000 naira (46.7-4,533 US dollars) in 2012. The overall median household healthcare cost was 890 naira (5.9 US dollars) and the range was 10-17,700 naira (0.1-118 US dollars) in 2012. In all, 67 (9.4%) households were enrolled in NHIS scheme. Healthcare services was utilized by 637 (82.9%) and CHE occurred in 42 (6.6%) households. CHE occurred in 14 (10.9%) of the households in the lowest quintile compared to 3 (2.5%) in the highest wealth quintile (P= 0.004). The odds of CHE among households in lowest wealth quintile is about 5 times. They had Crude OR (CI): 4.7 (1.3-16.8), P= 0.022. Non enrolled households were two times likely to have CHE, though not significant Conclusion: Households in the lowest wealth quintiles were at higher risk of CHE. Universal coverage of health insurance in Nigeria should be fast-tracked to give the expected financial risk protection and decreased incidence of CHE.

Efficient security mechanisms for mHealth applications using wireless body sensor networks.

PubMed

Sahoo, Prasan Kumar

2012-01-01

Recent technological advances in wireless communications and physiological sensing allow miniature, lightweight, ultra-low power, intelligent monitoring devices, which can be integrated into a Wireless Body Sensor Network (WBSN) for health monitoring. Physiological signals of humans such as heartbeats, temperature and pulse can be monitored from a distant location using tiny biomedical wireless sensors. Hence, it is highly essential to combine the ubiquitous computing with mobile health technology using wireless sensors and smart phones to monitor the well-being of chronic patients such as cardiac, Parkinson and epilepsy patients. Since physiological data of a patient are highly sensitive, maintaining its confidentiality is highly essential. Hence, security is a vital research issue in mobile health (mHealth) applications, especially if a patient has an embarrassing disease. In this paper a three tier security architecture for the mHealth application is proposed, in which light weight data confidentiality and authentication protocols are proposed to maintain the privacy of a patient. Moreover, considering the energy and hardware constraints of the wireless body sensors, low complexity data confidential and authentication schemes are designed. Performance evaluation of the proposed architecture shows that they can satisfy the energy and hardware limitations of the sensors and still can maintain the secure fabrics of the wireless body sensor networks. Besides, the proposed schemes can outperform in terms of energy consumption, memory usage and computation time over standard key establishment security scheme.

Efficient Security Mechanisms for mHealth Applications Using Wireless Body Sensor Networks

PubMed Central

Sahoo, Prasan Kumar

2012-01-01

Recent technological advances in wireless communications and physiological sensing allow miniature, lightweight, ultra-low power, intelligent monitoring devices, which can be integrated into a Wireless Body Sensor Network (WBSN) for health monitoring. Physiological signals of humans such as heartbeats, temperature and pulse can be monitored from a distant location using tiny biomedical wireless sensors. Hence, it is highly essential to combine the ubiquitous computing with mobile health technology using wireless sensors and smart phones to monitor the well-being of chronic patients such as cardiac, Parkinson and epilepsy patients. Since physiological data of a patient are highly sensitive, maintaining its confidentiality is highly essential. Hence, security is a vital research issue in mobile health (mHealth) applications, especially if a patient has an embarrassing disease. In this paper a three tier security architecture for the mHealth application is proposed, in which light weight data confidentiality and authentication protocols are proposed to maintain the privacy of a patient. Moreover, considering the energy and hardware constraints of the wireless body sensors, low complexity data confidential and authentication schemes are designed. Performance evaluation of the proposed architecture shows that they can satisfy the energy and hardware limitations of the sensors and still can maintain the secure fabrics of the wireless body sensor networks. Besides, the proposed schemes can outperform in terms of energy consumption, memory usage and computation time over standard key establishment security scheme. PMID:23112734

Delivery of a national home safety equipment scheme in England: a survey of local scheme leaders.

PubMed

Mulvaney, C A; Watson, M C; Hamilton, T; Errington, G

2013-11-01

Unintentional home injuries sustained by preschool children are a major cause of morbidity in the UK. Home safety equipment schemes may reduce home injury rates. In 2009, the Royal Society for the Prevention of Accidents was appointed as central coordinator of a two-year, £18m national home safety equipment scheme in England. This paper reports the findings from a national survey of all scheme leaders responsible for local scheme delivery. A questionnaire mailed to all local scheme leaders sought details of how the schemes were operated locally; barriers and facilitators to scheme implementation; evaluation of the local scheme and its sustainability. A response rate of 73% was achieved. Health visitors and family support workers played a key role in both the identification of eligible families and performing home safety checks. The majority of local scheme leaders (94.6%) reported that they thought their local scheme had been successful in including those families considered 'harder to engage'. Many scheme leaders (72.4%) reported that they had evaluated the provision of safety equipment in their scheme and over half (56.6%) stated that they would not be able to continue the scheme once funding ceased. Local schemes need support to effectively evaluate their scheme and to seek sustainability funding to ensure the future of the scheme. There remains a lack of evidence of whether the provision of home safety equipment reduces injuries in preschool children.

Forest Health Monitoring and Forest Inventory Analysis programs monitor climate change effects in forest ecosystems

Treesearch

Kenneth W. Stolte

2001-01-01

The Forest Health Monitoring (FHM) and Forest Inventory and Analyses (FIA) programs are integrated bilogical monitoring systems that use nationally standardized methods to evaluate and report on the health and sustainability of forest ecosystems in the United States. Many of the anticipated changes in forest ecosystems from climate change were also issues addressed in...

A Target Coverage Scheduling Scheme Based on Genetic Algorithms in Directional Sensor Networks

PubMed Central

Gil, Joon-Min; Han, Youn-Hee

2011-01-01

As a promising tool for monitoring the physical world, directional sensor networks (DSNs) consisting of a large number of directional sensors are attracting increasing attention. As directional sensors in DSNs have limited battery power and restricted angles of sensing range, maximizing the network lifetime while monitoring all the targets in a given area remains a challenge. A major technique to conserve the energy of directional sensors is to use a node wake-up scheduling protocol by which some sensors remain active to provide sensing services, while the others are inactive to conserve their energy. In this paper, we first address a Maximum Set Covers for DSNs (MSCD) problem, which is known to be NP-complete, and present a greedy algorithm-based target coverage scheduling scheme that can solve this problem by heuristics. This scheme is used as a baseline for comparison. We then propose a target coverage scheduling scheme based on a genetic algorithm that can find the optimal cover sets to extend the network lifetime while monitoring all targets by the evolutionary global search technique. To verify and evaluate these schemes, we conducted simulations and showed that the schemes can contribute to extending the network lifetime. Simulation results indicated that the genetic algorithm-based scheduling scheme had better performance than the greedy algorithm-based scheme in terms of maximizing network lifetime. PMID:22319387

Forest health monitoring in the United States: focus on national reports

Treesearch

Kurt Riitters; Kevin Potter

2013-01-01

The health and sustainability of United States forests have been monitored for many years from several different perspectives. The national Forest Health Monitoring (FHM) Program was established in 1990 by Federal and State agencies to develop a national system for monitoring and reporting on the status and trends of forest ecosystem health. We describe and illustrate...

'Just another incentive scheme': a qualitative interview study of a local pay-for-performance scheme for primary care.

PubMed

Hackett, Julia; Glidewell, Liz; West, Robert; Carder, Paul; Doran, Tim; Foy, Robbie

2014-10-25

A range of policy initiatives have addressed inequalities in healthcare and health outcomes. Local pay-for-performance schemes for primary care have been advocated as means of enhancing clinical ownership of the quality agenda and better targeting local need compared with national schemes such as the UK Quality and Outcomes Framework (QOF). We investigated whether professionals' experience of a local scheme in one English National Health Service (NHS) former primary care trust (PCT) differed from that of the national QOF in relation to the goal of reducing inequalities. We conducted retrospective semi-structured interviews with primary care professionals implementing the scheme and those involved in its development. We purposively sampled practices with varying levels of population socio-economic deprivation and achievement. Interviews explored perceptions of the scheme and indicators, likely mechanisms of influence on practice, perceived benefits and harms, and how future schemes could be improved. We used a framework approach to analysis. Thirty-eight professionals from 16 general practices and six professionals involved in developing local indicators participated. Our findings cover four themes: ownership, credibility of the indicators, influences on behaviour, and exacerbated tensions. We found little evidence that the scheme engendered any distinctive sense of ownership or experiences different from the national scheme. Although the indicators and their evidence base were seldom actively questioned, doubts were expressed about their focus on health promotion given that eventual benefits relied upon patient action and availability of local resources. Whilst practices serving more affluent populations reported status and patient benefit as motivators for participating in the scheme, those serving more deprived populations highlighted financial reward. The scheme exacerbated tensions between patient and professional consultation agendas, general practitioners

Monitoring the Health and Safety of the ACIS Instrument On-Board the Chandra X-ray Observatory

NASA Astrophysics Data System (ADS)

Virani, Shanil N.; Ford, Peter G.; DePasquale, Joseph M.; Plucinsky, Paul P.

2002-12-01

The Chandra X-ray Observatory (CXO), NASA's latest "Great Observatory", was launched on July 23, 1999 and reached its final orbit on August 7, 1999. The CXO is in a highly elliptical orbit, approximately 140,000 km × 10,000 km, and has a period of approximately 63.5 hours (≍2.65 days). Communication with the CXO nominally consists of 1-hour contacts spaced 8-hours apart. Thus, once a communication link has been established, it is very important that the health and safety status of the scientific instruments as well as the Observatory itself be determined as quickly as possible. In this paper, we focus exclusively on the automated health and safety monitoring scripts developed for the Advanced CCD Imaging Spectrometer (ACIS) during those 1-hour contacts. ACIS is one of the two focal plane instruments on-board the CXO. We present an overview of the real-time ACIS Engineering Data Web Page and the alert schemes developed for monitoring the instrument status during each communication contact. A suite of HTML and PERL scripts monitors the instrument hardware house-keeping electronics (i.e., voltages and currents) and temperatures during each contact. If a particular instrument component is performing either above or below pre- established operating parameters, a sequence of email and alert pages are spawned to the Science Operations Team of the Chandra X-ray Observatory Center so that the anomaly can be quickly investigated and corrective actions taken if necessary. We also briefly discuss the tools used to monitor the real-time science telemetry reported by the ACIS flight software. The authors acknowledge support for this research from NASA contract NAS8-39073.

Monitoring progress towards universal health coverage at country and global levels.

PubMed

Boerma, Ties; Eozenou, Patrick; Evans, David; Evans, Tim; Kieny, Marie-Paule; Wagstaff, Adam

2014-09-01

Universal health coverage (UHC) has been defined as the desired outcome of health system performance whereby all people who need health services (promotion, prevention, treatment, rehabilitation, and palliation) receive them, without undue financial hardship. UHC has two interrelated components: the full spectrum of good-quality, essential health services according to need, and protection from financial hardship, including possible impoverishment, due to out-of-pocket payments for health services. Both components should benefit the entire population. This paper summarizes the findings from 13 country case studies and five technical reviews, which were conducted as part of the development of a global framework for monitoring progress towards UHC. The case studies show the relevance and feasibility of focusing UHC monitoring on two discrete components of health system performance: levels of coverage with health services and financial protection, with a focus on equity. These components link directly to the definition of UHC and measure the direct results of strategies and policies for UHC. The studies also show how UHC monitoring can be fully embedded in often existing, regular overall monitoring of health sector progress and performance. Several methodological and practical issues related to the monitoring of coverage of essential health services, financial protection, and equity, are highlighted. Addressing the gaps in the availability and quality of data required for monitoring progress towards UHC is critical in most countries.

Monitoring Progress towards Universal Health Coverage at Country and Global Levels

PubMed Central

Boerma, Ties; Eozenou, Patrick; Evans, David; Evans, Tim; Kieny, Marie-Paule; Wagstaff, Adam

2014-01-01

Universal health coverage (UHC) has been defined as the desired outcome of health system performance whereby all people who need health services (promotion, prevention, treatment, rehabilitation, and palliation) receive them, without undue financial hardship. UHC has two interrelated components: the full spectrum of good-quality, essential health services according to need, and protection from financial hardship, including possible impoverishment, due to out-of-pocket payments for health services. Both components should benefit the entire population. This paper summarizes the findings from 13 country case studies and five technical reviews, which were conducted as part of the development of a global framework for monitoring progress towards UHC. The case studies show the relevance and feasibility of focusing UHC monitoring on two discrete components of health system performance: levels of coverage with health services and financial protection, with a focus on equity. These components link directly to the definition of UHC and measure the direct results of strategies and policies for UHC. The studies also show how UHC monitoring can be fully embedded in often existing, regular overall monitoring of health sector progress and performance. Several methodological and practical issues related to the monitoring of coverage of essential health services, financial protection, and equity, are highlighted. Addressing the gaps in the availability and quality of data required for monitoring progress towards UHC is critical in most countries. PMID:25243899

Demonstrating the viability and value of community-based monitoring schemes in catchment science

NASA Astrophysics Data System (ADS)

Starkey, Eleanor; Parkin, Geoff; Quinn, Paul; Large, Andy

2016-04-01

for the purpose of assessing the quality of citizen science observations. It has been found that citizen science observations are essential for capturing localised convective storms. Citizen scientists want their observations to be used to gain meaningful information and tackle local issues. Data has therefore been utilised to build, calibrate and validate hydrological models and support a range of catchment management applications. This has further demonstrated the value of citizen science, along with the social benefits it has to offer. Other communities are also beginning to source funding and implement their own monitoring schemes, indicating that they are both capable and self-motivated. Citizen science makes use of evolving and more readily available technology, providing catchment stakeholders with vital information. Although these types of observations present various challenges, it is argued that a citizen science approach is not intending to replace traditional techniques, rather they can be used to complement them, fill the gaps and/or provide an indication of catchment behaviour across space and through time.

Forest health monitoring: 2007 national technical report

Treesearch

Barbara L. Conkling

2011-01-01

The Forest Health Monitoring Program produces an annual technical report that has two main objectives. The first objective is to present information about forest health from a national perspective. The second objective is to present examples of useful techniques for analyzing forest health data new to the annual national reports and new applications of techniques...

Forest health monitoring: 2009 national technical report

Treesearch

Kevin M. Potter; Barbara L. Conkling

2012-01-01

The annual national technical report of the Forest Health Monitoring Program of the Forest Service, U.S. Department of Agriculture, presents forest health status and trends from a national or multi-State regional perspective using a variety of sources, introduces new techniques for analyzing forest health data, and summarizes results of recently completed Evaluation...

Dynamic Self-adaptive Remote Health Monitoring System for Diabetics

PubMed Central

Suh, Myung-kyung; Moin, Tannaz; Woodbridge, Jonathan; Lan, Mars; Ghasemzadeh, Hassan; Bui, Alex; Ahmadi, Sheila; Sarrafzadeh, Majid

2016-01-01

Diabetes is the seventh leading cause of death in the United States. In 2010, about 1.9 million new cases of diabetes were diagnosed in people aged 20 years or older. Remote health monitoring systems can help diabetics and their healthcare professionals monitor health-related measurements by providing real-time feedback. However, data-driven methods to dynamically prioritize and generate tasks are not well investigated in the remote health monitoring. This paper presents a task optimization technique used in WANDA (Weight and Activity with Blood Pressure and Other Vital Signs); a wireless health project that leverages sensor technology and wireless communication to monitor the health status of patients with diabetes. WANDA applies data analytics in real-time to improving the quality of care. The developed algorithm minimizes the number of daily tasks required by diabetic patients using association rules that satisfies a minimum support threshold. Each of these tasks maximizes information gain, thereby improving the overall level of care. Experimental results show that the developed algorithm can reduce the number of tasks up to 28.6% with minimum support 0.95, minimum confidence 0.97 and high efficiency. PMID:23366365

A synthesis of evaluation monitoring projects by the forest health monitoring program (1998-2007)

Treesearch

William A. Bechtold; Michael J. Bohne; Barbara L. Conkling; Dana L. Friedman

2012-01-01

The national Forest Health Monitoring Program of the Forest Service, U.S. Department of Agriculture, has funded over 200 Evaluation Monitoring projects. Evaluation Monitoring is designed to verify and define the extent of deterioration in forest ecosystems where potential problems have been identified. This report is a synthesis of results from over 150 Evaluation...

a Thtee-Dimensional Variational Assimilation Scheme for Satellite Aod

NASA Astrophysics Data System (ADS)

Liang, Y.; Zang, Z.; You, W.

2018-04-01

A three-dimensional variational data assimilation scheme is designed for satellite AOD based on the IMPROVE (Interagency Monitoring of Protected Visual Environments) equation. The observation operator that simulates AOD from the control variables is established by the IMPROVE equation. All of the 16 control variables in the assimilation scheme are the mass concentrations of aerosol species from the Model for Simulation Aerosol Interactions and Chemistry scheme, so as to take advantage of this scheme in providing comprehensive analyses of species concentrations and size distributions as well as be calculating efficiently. The assimilation scheme can save computational resources as the IMPROVE equation is a quadratic equation. A single-point observation experiment shows that the information from the single-point AOD is effectively spread horizontally and vertically.

Monitoring intervention coverage in the context of universal health coverage.

PubMed

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

2014-09-01

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

Monitoring Intervention Coverage in the Context of Universal Health Coverage

PubMed Central

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

2014-01-01

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

Application of near field communication for health monitoring in daily life.

PubMed

Strömmer, Esko; Kaartinen, Jouni; Pärkkä, Juha; Ylisaukko-Oja, Arto; Korhonen, Ilkka

2006-01-01

We study the possibility of applying an emerging RFID-based communication technology, NFC (Near Field Communication), to health monitoring. We suggest that NFC is, compared to other competing technologies, a high-potential technology for short-range connectivity between health monitoring devices and mobile terminals. We propose practices to apply NFC to some health monitoring applications and study the benefits that are attainable with NFC. We compare NFC to other short-range communication technologies such as Bluetooth and IrDA, and study the possibility of improving the usability of health monitoring devices with NFC. We also introduce a research platform for technical evaluation, applicability study and application demonstrations of NFC.

Secure anonymity-preserving password-based user authentication and session key agreement scheme for telecare medicine information systems.

PubMed

Sutrala, Anil Kumar; Das, Ashok Kumar; Odelu, Vanga; Wazid, Mohammad; Kumari, Saru

2016-10-01

Information and communication and technology (ICT) has changed the entire paradigm of society. ICT facilitates people to use medical services over the Internet, thereby reducing the travel cost, hospitalization cost and time to a greater extent. Recent advancements in Telecare Medicine Information System (TMIS) facilitate users/patients to access medical services over the Internet by gaining health monitoring facilities at home. Amin and Biswas recently proposed a RSA-based user authentication and session key agreement protocol usable for TMIS, which is an improvement over Giri et al.'s RSA-based user authentication scheme for TMIS. In this paper, we show that though Amin-Biswas's scheme considerably improves the security drawbacks of Giri et al.'s scheme, their scheme has security weaknesses as it suffers from attacks such as privileged insider attack, user impersonation attack, replay attack and also offline password guessing attack. A new RSA-based user authentication scheme for TMIS is proposed, which overcomes the security pitfalls of Amin-Biswas's scheme and also preserves user anonymity property. The careful formal security analysis using the two widely accepted Burrows-Abadi-Needham (BAN) logic and the random oracle models is done. Moreover, the informal security analysis of the scheme is also done. These security analyses show the robustness of our new scheme against the various known attacks as well as attacks found in Amin-Biswas's scheme. The simulation of the proposed scheme using the widely accepted Automated Validation of Internet Security Protocols and Applications (AVISPA) tool is also done. We present a new user authentication and session key agreement scheme for TMIS, which fixes the mentioned security pitfalls found in Amin-Biswas's scheme, and we also show that the proposed scheme provides better security than other existing schemes through the rigorous security analysis and verification tool. Furthermore, we present the formal security

Engine health monitoring: An advanced system

NASA Technical Reports Server (NTRS)

Dyson, R. J. E.

1981-01-01

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

[Part-time Work and Men's Health : Results based on Routine Data of a Statutory Health Insurance Scheme].

PubMed

Grobe, Thomas G

2016-08-01

With the introduction of a new occupational classification at the end of 2011, employment characteristics are reported by employees to social insurance agencies in Germany in more detail than in previous years. In addition to other changes, the new classification allows a distinction between full- and part-time work to be made. This provided a reason to consider the health-related aspects of part-time work on the basis of data from a statutory health insurance scheme. Our analysis is based on the data of 3.8 million employees insured with the Techniker Krankenkasse (TK), a statutory health insurance scheme, in 2012. In addition to daily information on employment situations, details of periods and diagnoses of sick leave and the drugs prescribed were available. Although approximately 50 % of women of middle to higher working age worked part-time in 2012, the corresponding percentage of men employed in part-time work was less than 10 %. Overall, part-time employees were on sick leave for fewer days than full-time employees, but among men, sick leave due to mental disorders was longer for part-time employees than for full-time employees, whereas women working part time were affected to a lesser extent by corresponding periods of absence than those working full time. The results provide indications for the assertion that men in gender-specifically atypical employment situations are more frequently affected by mental disorders. Further evidence supports this assertion. With the long-term availability of these new employment characteristics, longitudinal analyses could help to clarify this cause-effect relationship.

Barriers and facilitators to implementation, uptake and sustainability of community-based health insurance schemes in low- and middle-income countries: a systematic review.

PubMed

Fadlallah, Racha; El-Jardali, Fadi; Hemadi, Nour; Morsi, Rami Z; Abou Samra, Clara Abou; Ahmad, Ali; Arif, Khurram; Hishi, Lama; Honein-AbouHaidar, Gladys; Akl, Elie A

2018-01-29

Community-based health insurance (CBHI) has evolved as an alternative health financing mechanism to out of pocket payments in low- and middle-income countries (LMICs), particularly in areas where government or employer-based health insurance is minimal. This systematic review aimed to assess the barriers and facilitators to implementation, uptake and sustainability of CHBI schemes in LMICs. We searched six electronic databases and grey literature. We included both quantitative and qualitative studies written in English language and published after year 1992. Two reviewers worked in duplicate and independently to complete study selection, data abstraction, and assessment of methodological features. We synthesized the findings based on thematic analysis and categorized according to the ecological model into individual, interpersonal, community and systems levels. Of 15,510 citations, 51 met the eligibility criteria. Individual factors included awareness and understanding of the concept of CBHI, trust in scheme and scheme managers, perceived service quality, and demographic characteristics, which influenced enrollment and sustainability. Interpersonal factors such as household dynamics, other family members enrolled in the scheme, and social solidarity influenced enrollment and renewal of membership. Community-level factors such as culture and community involvement in scheme development influenced enrollment and sustainability of scheme. Systems-level factors encompassed governance, financial and delivery arrangement. Government involvement, accountability of scheme management, and strong policymaker-implementer relation facilitated implementation and sustainability of scheme. Packages that covered outpatient and inpatient care and those tailored to community needs contributed to increased enrollment. Amount and timing of premium collection was reported to negatively influence enrollment while factors reported as threats to sustainability included facility

30 CFR 75.800-2 - Approved circuit schemes.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Approved circuit schemes. 75.800-2 Section 75.800-2 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY... § 75.800-2 Approved circuit schemes. The following circuit schemes will be regarded as providing the...

30 CFR 75.800-2 - Approved circuit schemes.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Approved circuit schemes. 75.800-2 Section 75.800-2 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY... § 75.800-2 Approved circuit schemes. The following circuit schemes will be regarded as providing the...

30 CFR 75.800-2 - Approved circuit schemes.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Approved circuit schemes. 75.800-2 Section 75.800-2 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY... § 75.800-2 Approved circuit schemes. The following circuit schemes will be regarded as providing the...

Classification schemes for knowledge translation interventions: a practical resource for researchers.

PubMed

Slaughter, Susan E; Zimmermann, Gabrielle L; Nuspl, Megan; Hanson, Heather M; Albrecht, Lauren; Esmail, Rosmin; Sauro, Khara; Newton, Amanda S; Donald, Maoliosa; Dyson, Michele P; Thomson, Denise; Hartling, Lisa

2017-12-06

As implementation science advances, the number of interventions to promote the translation of evidence into healthcare, health systems, or health policy is growing. Accordingly, classification schemes for these knowledge translation (KT) interventions have emerged. A recent scoping review identified 51 classification schemes of KT interventions to integrate evidence into healthcare practice; however, the review did not evaluate the quality of the classification schemes or provide detailed information to assist researchers in selecting a scheme for their context and purpose. This study aimed to further examine and assess the quality of these classification schemes of KT interventions, and provide information to aid researchers when selecting a classification scheme. We abstracted the following information from each of the original 51 classification scheme articles: authors' objectives; purpose of the scheme and field of application; socioecologic level (individual, organizational, community, system); adaptability (broad versus specific); target group (patients, providers, policy-makers), intent (policy, education, practice), and purpose (dissemination versus implementation). Two reviewers independently evaluated the methodological quality of the development of each classification scheme using an adapted version of the AGREE II tool. Based on these assessments, two independent reviewers reached consensus about whether to recommend each scheme for researcher use, or not. Of the 51 original classification schemes, we excluded seven that were not specific classification schemes, not accessible or duplicates. Of the remaining 44 classification schemes, nine were not recommended. Of the 35 recommended classification schemes, ten focused on behaviour change and six focused on population health. Many schemes (n = 29) addressed practice considerations. Fewer schemes addressed educational or policy objectives. Twenty-five classification schemes had broad applicability

Forest health monitoring: 2001 national technical report

Treesearch

Barbara L. Conkling; John W. Coulston; Mark J. Ambrose

2005-01-01

The Forest Health Monitoring (FHM) Program’s annual national report uses FHM data, as well as data from a variety of other programs, to provide an overview of forest health based on the criteria and indicators of sustainable forestry framework of the Santiago Declaration. It presents information about the status of and trends in various forest health indicators...

Scoping review: national monitoring frameworks for social determinants of health and health equity

PubMed Central

Pedrana, Leo; Pamponet, Marina; Walker, Ruth; Costa, Federico; Rasella, Davide

2016-01-01

Background The strategic importance of monitoring social determinants of health (SDH) and health equity and inequity has been a central focus in global discussions around the 2011 Rio Political Declaration on SDH and the Millennium Development Goals. This study is part of the World Health Organization (WHO) equity-oriented analysis of linkages between health and other sectors (EQuAL) project, which aims to define a framework for monitoring SDH and health equity. Objectives This review provides a global summary and analysis of the domains and indicators that have been used in recent studies covering the SDH. These studies are considered here within the context of indicators proposed by the WHO EQuAL project. The objectives are as follows: to describe the range of international and national studies and the types of indicators most frequently used; report how they are used in causal explanation of the SDH; and identify key priorities and challenges reported in current research for national monitoring of the SDH. Design We conducted a scoping review of published SDH studies in the PubMed® database to obtain evidence of socio-economic indicators. We evaluated, selected, and extracted data from national scale studies published from 2004 to 2014. The research included papers published in English, Italian, French, Portuguese, and Spanish. Results The final sample consisted of 96 articles. SDH monitoring is well reported in the scientific literature independent of the economic level of the country and magnitude of deprivation in population groups. The research methods were mostly quantitative and many papers used multilevel and multivariable statistical analyses and indexes to measure health inequalities and SDH. In addition to the usual economic indicators, a high number of socio-economic indicators were used. The indicators covered a broad range of social dimensions, which were given consideration within and across different social groups. Many indicators included in the

Efficient color correction method for smartphone camera-based health monitoring application.

PubMed

Duc Dang; Chae Ho Cho; Daeik Kim; Oh Seok Kwon; Jo Woon Chong

2017-07-01

Smartphone health monitoring applications are recently highlighted due to the rapid development of hardware and software performance of smartphones. However, color characteristics of images captured by different smartphone models are dissimilar each other and this difference may give non-identical health monitoring results when the smartphone health monitoring applications monitor physiological information using their embedded smartphone cameras. In this paper, we investigate the differences in color properties of the captured images from different smartphone models and apply a color correction method to adjust dissimilar color values obtained from different smartphone cameras. Experimental results show that the color corrected images using the correction method provide much smaller color intensity errors compared to the images without correction. These results can be applied to enhance the consistency of smartphone camera-based health monitoring applications by reducing color intensity errors among the images obtained from different smartphones.

Prevalence and economic burden of cardiovascular diseases in France in 2013 according to the national health insurance scheme database.

PubMed

Tuppin, Philippe; Rivière, Sébastien; Rigault, Alexandre; Tala, Stéphane; Drouin, Jérôme; Pestel, Laurence; Denis, Pierre; Gastaldi-Ménager, Christelle; Gissot, Claude; Juillière, Yves; Fagot-Campagna, Anne

2016-01-01

Cardiovascular diseases (CVDs) constitute the second leading cause of death in France. The Système national d'information interrégimes de l'assurance maladie (SNIIRAM; national health insurance information system) can be used to estimate the national medical and economic burden of CVDs. To describe the rates, characteristics and expenditure of people reimbursed for CVDs in 2013. Among 57 million general health scheme beneficiaries (86% of the French population), people managed for CVDs were identified using algorithms based on hospital diagnoses either during the current year (acute phase) or over the previous 5 years (chronic phase) and long-term diseases. The reimbursed costs attributable to CVDs were estimated. A total of 3.5 million people (mean age, 71 years; 42% women) were reimbursed by the general health scheme for CVDs (standardized rate, 6.5%; coronary heart disease, 2.7%; arrhythmias/conduction disorders, 2.1%; stroke, 1.1%; heart failure, 1.1%). These frequencies increased with age and social deprivation, and were higher in Northern and Eastern France and Réunion Island. The total sum reimbursed by all schemes for CVDs was € 15.1 billion (50% for hospital care and 43% for outpatient care [including 15% for drugs and 12% for nurses/physiotherapists]); coronary heart disease accounted for € 4 billion, stroke for € 3.5 billion and heart failure for € 2.5 billion (i.e. 10% of the total expenditure reimbursed by all national health insurance schemes for all conditions). CVDs constitute the leading group in terms of numbers of patients reimbursed and total reimbursed expenditure, despite a probable underestimation of both numbers and expenditure. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

National Antimicrobial Resistance Monitoring System: Two Decades of Advancing Public Health Through Integrated Surveillance of Antimicrobial Resistance.

PubMed

Karp, Beth E; Tate, Heather; Plumblee, Jodie R; Dessai, Uday; Whichard, Jean M; Thacker, Eileen L; Hale, Kis Robertson; Wilson, Wanda; Friedman, Cindy R; Griffin, Patricia M; McDermott, Patrick F

2017-10-01

Drug-resistant bacterial infections pose a serious and growing public health threat globally. In this review, we describe the role of the National Antimicrobial Resistance Monitoring System (NARMS) in providing data that help address the resistance problem and show how such a program can have broad positive impacts on public health. NARMS was formed two decades ago to help assess the consequences to human health arising from the use of antimicrobial drugs in food animal production in the United States. A collaboration among the Centers for Disease Control and Prevention, the U.S. Food and Drug Administration, the United States Department of Agriculture, and state and local health departments, NARMS uses an integrated "One Health" approach to monitor antimicrobial resistance in enteric bacteria from humans, retail meat, and food animals. NARMS has adapted to changing needs and threats by expanding surveillance catchment areas, examining new isolate sources, adding bacteria, adjusting sampling schemes, and modifying antimicrobial agents tested. NARMS data are not only essential for ensuring that antimicrobial drugs approved for food animals are used in ways that are safe for human health but they also help address broader food safety priorities. NARMS surveillance, applied research studies, and outbreak isolate testing provide data on the emergence of drug-resistant enteric bacteria; genetic mechanisms underlying resistance; movement of bacterial populations among humans, food, and food animals; and sources and outcomes of resistant and susceptible infections. These data can be used to guide and evaluate the impact of science-based policies, regulatory actions, antimicrobial stewardship initiatives, and other public health efforts aimed at preserving drug effectiveness, improving patient outcomes, and preventing infections. Many improvements have been made to NARMS over time and the program will continue to adapt to address emerging resistance threats, changes in

Forest health monitoring: 2004 national technical report

Treesearch

John W. Coulston; Mark J. Ambrose; Kurt H. Riitters; Barbara L. Conkling

2005-01-01

The Forest Health Monitoring (FHM) Program’s annual national technical report presents results of forest health analyses from a national perspective using data from a variety of sources. Results presented in the report pertain to the Santiago Declaration’s Criterion 1— Conservation of Biological Diversity and Criterion 3—Maintenance of Forest Ecosystem Health and...

Integrating Social Media Monitoring Into Public Health Emergency Response Operations.

PubMed

Hadi, Tamer A; Fleshler, Keren

2016-10-01

Social media monitoring for public health emergency response and recovery is an essential response capability for any health department. The value of social media for emergency response lies not only in the capacity to rapidly communicate official and critical incident information, but as a rich source of incoming data that can be gathered to inform leadership decision-making. Social media monitoring is a function that can be formally integrated into the Incident Command System of any response agency. The approach to planning and required resources, such as staffing, logistics, and technology, is flexible and adaptable based on the needs of the agency and size and scope of the emergency. The New York City Department of Health and Mental Hygiene has successfully used its Social Media Monitoring Team during public health emergency responses and planned events including major Ebola and Legionnaires' disease responses. The concepts and implementations described can be applied by any agency, large or small, interested in building a social media monitoring capacity. (Disaster Med Public Health Preparedness. 2016;page 1 of 6).

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

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

Michak, Patty

1991-12-01

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

Economic gains and health benefits from a new cigarette tax scheme in Taiwan: a simulation using the CGE model.

PubMed

Ye, Chun-Yuan; Lee, Jie-Min; Chen, Sheng-Hong

2006-03-10

This study evaluates the impact of an increase in cigarette tax in Taiwan in terms of the effects it has on the overall economy and the health benefits that it brings. The multisector computable general equilibrium (CGE) model was used to simulate the impact of reduced cigarette consumption resulting from a new tax scheme on the entire economy gains and on health benefits. The results predict that because of the new tax scheme, there should be a marked reduction in cigarette consumption but a notable increase in health benefits that include saving between 28,125 and 56,250 lives. This could save NTD 1.222 approximately 2.445 billion (where USD 1 = NTD 34.6) annually in life-threatening, cigarette-related health insurance expenses which exceeds the projected decrease of NTD 1.275 billion in Gross Domestic Product (GDP) because of reduced consumption and therefore tax revenue. Overall, the increased cigarette excise tax will be beneficial in terms of both the health of the general public and the economy as a whole.

Economic gains and health benefits from a new cigarette tax scheme in Taiwan: a simulation using the CGE model

PubMed Central

Ye, Chun-Yuan; Lee, Jie-Min; Chen, Sheng-Hong

2006-01-01

Background This study evaluates the impact of an increase in cigarette tax in Taiwan in terms of the effects it has on the overall economy and the health benefits that it brings. Methods The multisector computable general equilibrium (CGE) model was used to simulate the impact of reduced cigarette consumption resulting from a new tax scheme on the entire economy gains and on health benefits. Results The results predict that because of the new tax scheme, there should be a marked reduction in cigarette consumption but a notable increase in health benefits that include saving between 28,125 and 56,250 lives. This could save NT$1.222~2.445 billion (where US$1 = NT$34.6) annually in life-threatening, cigarette-related health insurance expenses which exceeds the projected decrease of NT$1.275 billion in Gross Domestic Product (GDP) because of reduced consumption and therefore tax revenue. Conclusion Overall, the increased cigarette excise tax will be beneficial in terms of both the health of the general public and the economy as a whole. PMID:16529653

The effect of the National Health Insurance Scheme (NHIS) on health service delivery in mission facilities in Ghana: a retrospective study.

PubMed

Aryeetey, Genevieve Cecilia; Nonvignon, Justice; Amissah, Caroline; Buckle, Gilbert; Aikins, Moses

2016-06-07

In 2004, Ghana began implementation of a National Health Insurance Scheme (NHIS) to minimize out-of-pocket expenditure at the point of use of service. The implementation of the scheme was accompanied by increased access and use of health care services. Evidence suggests most health facilities are faced with management challenges in the delivery of services. The study aimed to assess the effect of the introduction of the NHIS on health service delivery in mission health facilities in Ghana. We conceptualised the effect of NHIS on facilities using service delivery indicators such as outpatient and inpatient turn out, estimation of general service readiness, revenue and expenditure, claims processing and availability of essential medicines. We collected data from 38 mission facilities, grouped into the three ecological zones; southern, middle and northern. Structured questionnaires and exit interviews were used to collect data for the periods 2003 and 2010. The data was analysed in SPSS and MS Excel. The facilities displayed high readiness to deliver services. There were significant increases in outpatient and inpatient attendance, revenue, expenditure and improved access to medicines. Generally, facilities reported increased readiness to deliver services. However, challenging issues around high rates of non-reimbursement of NHIS claims due to errors in claims processing, lack of feedback regarding errors, and lack of clarity on claims reporting procedures were reported. The implementation of the NHIS saw improvement and expansion of services resulting in benefits to the facilities as well as constraints. The constraints could be minimized if claims processing is improved at the facility level and delays in reimbursements also reduced.

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

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

Michak, Patty

1991-05-01

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

Device-based monitoring in physical activity and public health research.

PubMed

Bassett, David R

2012-11-01

Measurement of physical activity is important, given the vital role of this behavior in physical and mental health. Over the past quarter of a century, the use of small, non-invasive, wearable monitors to assess physical activity has become commonplace. This review is divided into three sections. In the first section, a brief history of physical activity monitoring is provided, along with a discussion of the strengths and weaknesses of different devices. In the second section, recent applications of physical activity monitoring in physical activity and public health research are discussed. Wearable monitors are being used to conduct surveillance, and to determine the extent and distribution of physical activity and sedentary behaviors in populations around the world. They have been used to help clarify the dose-response relation between physical activity and health. Wearable monitors that provide feedback to users have also been used in longitudinal interventions to motivate research participants and to assess their compliance with program goals. In the third section, future directions for research in physical activity monitoring are discussed. It is likely that new developments in wearable monitors will lead to greater accuracy and improved ease-of-use.

An ex-ante economic evaluation of the Maternal and Child Health Voucher Scheme as a decision-making tool in Myanmar.

PubMed

Kingkaew, Pritaporn; Werayingyong, Pitsaphun; Aye, San San; Tin, Nilar; Singh, Alaka; Myint, Phone; Teerawattananon, Yot

2016-05-01

Reducing child and maternal mortality in order to meet the health-related Millennium Development Goals (MDGs) 4 and 5 remains a major challenge in Myanmar. Inadequate care during pregnancy and labour plays an important role in the maternal mortality rate in Myanmar. A Maternal and Child Health (MCH) Voucher Scheme comprising a subsidization for pregnant women to receive four antenatal care (ANC), delivery and postnatal care (PNC) free-of-charge was planned to help women overcome financial barriers in addition to raising awareness of ANC and delivery with skilled birth attendants (SBA), which can reduce the rate of maternal and neonatal death. This study is part of an ex-ante evaluation of a feasibility study of the MCH Voucher Scheme. A cost-utility analysis was conducted using a decision tree model to assess the cost per disability-adjusted life years (DALYs) averted from the MCH Voucher Scheme compared with the current situation. Most input parameters were obtained from Myanmar context. From the base-case analysis, where the financial burden on households was fully subsidized, the MCH Voucher Scheme increased utilization for ANC from 73% up to 93% and for delivery from SBAs from 51% up to and 71%, respectively; hence, it is considered to be very cost-effective with an incremental cost-effectiveness ratio of 381 027 kyats per DALY averted (2010, price year). From the probabilistic sensitivity analysis, the MCH Voucher Scheme had a 52% chance of being a cost-effective option at 1 GDP per capita threshold compared to the current situation. Given that the Voucher Scheme is currently being implemented in one township in Myanmar as a result of this study, ongoing evaluation of the effectiveness and cost-effectiveness of this scheme is warranted. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

An ex-ante economic evaluation of the Maternal and Child Health Voucher Scheme as a decision-making tool in Myanmar

PubMed Central

Kingkaew, Pritaporn; Werayingyong, Pitsaphun; Aye, San San; Tin, Nilar; Singh, Alaka; Myint, Phone; Teerawattananon, Yot

2016-01-01

Reducing child and maternal mortality in order to meet the health-related Millennium Development Goals (MDGs) 4 and 5 remains a major challenge in Myanmar. Inadequate care during pregnancy and labour plays an important role in the maternal mortality rate in Myanmar. A Maternal and Child Health (MCH) Voucher Scheme comprising a subsidization for pregnant women to receive four antenatal care (ANC), delivery and postnatal care (PNC) free-of-charge was planned to help women overcome financial barriers in addition to raising awareness of ANC and delivery with skilled birth attendants (SBA), which can reduce the rate of maternal and neonatal death. This study is part of an ex-ante evaluation of a feasibility study of the MCH Voucher Scheme. A cost-utility analysis was conducted using a decision tree model to assess the cost per disability-adjusted life years (DALYs) averted from the MCH Voucher Scheme compared with the current situation. Most input parameters were obtained from Myanmar context. From the base-case analysis, where the financial burden on households was fully subsidized, the MCH Voucher Scheme increased utilization for ANC from 73% up to 93% and for delivery from SBAs from 51% up to and 71%, respectively; hence, it is considered to be very cost-effective with an incremental cost-effectiveness ratio of 381 027 kyats per DALY averted (2010, price year). From the probabilistic sensitivity analysis, the MCH Voucher Scheme had a 52% chance of being a cost-effective option at 1 GDP per capita threshold compared to the current situation. Given that the Voucher Scheme is currently being implemented in one township in Myanmar as a result of this study, ongoing evaluation of the effectiveness and cost-effectiveness of this scheme is warranted. PMID:26412858

Evaluating the impact of the national health insurance scheme of Ghana on out of pocket expenditures: a systematic review.

PubMed

Okoroh, Juliet; Essoun, Samuel; Seddoh, Anthony; Harris, Hobart; Weissman, Joel S; Dsane-Selby, Lydia; Riviello, Robert

2018-06-07

Approximately 150 million people suffer from financial catastrophe annually because of out-of-pocket expenditures (OOPEs) on health. Although the National Health Insurance Scheme (NHIS) of Ghana was designed to promote universal health coverage, OOPEs as a proportion of total health expenditures remains elevated at 26%, exceeding the WHO's recommendations of less than 15-20%. To determine whether enrollment in the NHIS reduces the likelihood of OOPEs and catastrophic health expenditures (CHEs) in Ghana, we undertook a systematic review of the published literature. We searched for quantitative articles published in English between January 1, 2003 and August 22, 2017 in PubMed, Google Scholar, Economic Literature, Global Health, PAIS International, and African Index Medicus. Two independent authors (J.S.O. & S.E.) reviewed the articles for inclusion, extracted the data, and conducted a quality assessment of the studies. We accepted the World Health Organization definition of catastrophic health expenditures which is out of pocket payments for health care which exceeds 20% of annual house hold income, 10% of household expenditures, or 40% of subsistence expenditures (total household expenditures net food expenditures). Of the 1094 articles initially identified, 7 were eligible for inclusion. These were cross-sectional household studies published between 2008 and 2016 in Ghana. They demonstrated that the uninsured paid 1.4 to 10 times more in out-of-pocket payments (OOPs) and were more likely to incur CHEs than the insured. Yet, 6 to 18% of insured households made catastrophic payments for healthcare and all studies reported insured members making OOPs for medicines. Evidence suggests that the national health insurance scheme of Ghana over the last 14 years has made some impact on reducing OOPEs, and yet healthcare costs remain catastrophic for a large proportion of insured households in Ghana. Future studies need to explore reasons for the persistence of OOPs for

Prioritizing hazardous pollutants in two Nigerian water supply schemes: a risk-based approach.

PubMed

Etchie, Ayotunde T; Etchie, Tunde O; Adewuyi, Gregory O; Krishnamurthi, Kannan; Saravanadevi, S; Wate, Satish R

2013-08-01

To rank pollutants in two Nigerian water supply schemes according to their effect on human health using a risk-based approach. Hazardous pollutants in drinking-water in the study area were identified from a literature search and selected pollutants were monitored from April 2010 to December 2011 in catchments, treatment works and consumer taps. The disease burden due to each pollutant was estimated in disability-adjusted life years (DALYs) using data on the pollutant's concentration, exposure to the pollutant, the severity of its health effects and the consumer population. The pollutants identified were microbial organisms, cadmium, cobalt, chromium, copper, iron, manganese, nickel, lead and zinc. All were detected in the catchments but only cadmium, cobalt, chromium, manganese and lead exceeded World Health Organization (WHO) guideline values after water treatment. Post-treatment contamination was observed. The estimated disease burden was greatest for chromium in both schemes, followed in decreasing order by cadmium, lead, manganese and cobalt. The total disease burden of all pollutants in the two schemes was 46 000 and 9500 DALYs per year or 0.14 and 0.088 DALYs per person per year, respectively, much higher than the WHO reference level of 1 × 10(-6) DALYs per person per year. For each metal, the disease burden exceeded the reference level and was comparable with that due to microbial contamination reported elsewhere in Africa. The estimated disease burden of metal contamination of two Nigerian water supply systems was high. It could best be reduced by protection of water catchment and pretreatment by electrocoagulation.

Analysis of multi drug resistant tuberculosis (MDR-TB) financial protection policy: MDR-TB health insurance schemes, in Chhattisgarh state, India.

PubMed

Kundu, Debashish; Sharma, Nandini; Chadha, Sarabjit; Laokri, Samia; Awungafac, George; Jiang, Lai; Asaria, Miqdad

2018-01-27

There are significant financial barriers to access treatment for multi drug resistant tuberculosis (MDR-TB) in India. To address these challenges, Chhattisgarh state in India has established a MDR-TB financial protection policy by creating MDR-TB benefit packages as part of the universal health insurance scheme that the state has rolled out in their effort towards attaining Universal Health Coverage for all its residents. In these schemes the state purchases health insurance against set packages of services from third party health insurance agencies on behalf of all its residents. Provider payment reform by strategic purchasing through output based payments (lump sum fee is reimbursed as per the MDR-TB benefit package rates) to the providers - both public and private health facilities empanelled under the insurance scheme was the key intervention. To understand the implementation gap between policy and practice of the benefit packages with respect to equity in utilization of package claims by the poor patients in public and private sector. Data from primary health insurance claims from January 2013 to December 2015, were analysed using an extension of 'Kingdon's multiple streams for policy implementation framework' to explain the implementation gap between policy and practice of the MDR-TB benefit packages. The total number of claims for MDR-TB benefit packages increased over the study period mainly from poor patients treated in public facilities, particularly for the pre-treatment evaluation and hospital stay packages. Variations and inequities in utilizing the packages were observed between poor and non-poor beneficiaries in public and private sector. Private providers participation in the new MDR-TB financial protection mechanism through the universal health insurance scheme was observed to be much lower than might be expected given their share of healthcare provision overall in India. Our findings suggest that there may be an implementation gap due to weak

Developing a risk-based trading scheme for cattle in England: farmer perspectives on managing trading risk for bovine tuberculosis.

PubMed

Little, R; Wheeler, K; Edge, S

2017-02-11

This paper examines farmer attitudes towards the development of a voluntary risk-based trading scheme for cattle in England as a risk mitigation measure for bovine tuberculosis (bTB). The research reported here was commissioned to gather evidence on the type of scheme that would have a good chance of success in improving the information farmers receive about the bTB risk of cattle they buy. Telephone interviews were conducted with a stratified random sample of 203 cattle farmers in England, splitting the interviews equally between respondents in the high-risk area and low-risk area for bTB. Supplementary interviews and focus groups with farmers were also carried out across the risk areas. Results suggest a greater enthusiasm for a risk-based trading scheme in low-risk areas compared with high-risk areas and among members of breed societies and cattle health schemes. Third-party certification of herds by private vets or the Animal and Plant Health Agency were regarded as the most credible source, with farmer self-certification being favoured by sellers, but being regarded as least credible by buyers. Understanding farmers' attitudes towards voluntary risk-based trading is important to gauge likely uptake, understand preferences for information provision and to assist in monitoring, evaluating and refining the scheme once established. British Veterinary Association.

Monitoring environmental hazards and public health

NASA Astrophysics Data System (ADS)

Showstack, Randy

Saying that no national system exists to monitor public health problems linked to environmental hazards, former U.S. Senator Lowell Weicker, Jr., announced on May 11 the launch of a Pew Charitable Trusts blue ribbon panel to focus on this issue.The panel, which includes representatives from academia and health care organizations, will focus on how the United States tracks diseases and recommend ways to fill data gaps; review what tools are needed to improve disease tracking; and focus on children's health issues, such as asthma, childhood cancer, and birth defects that may be linked to the environment, according to Pew Environmental Health Commission Executive Director Shelley Hearne.

Intelligent Control and Health Monitoring. Chapter 3

NASA Technical Reports Server (NTRS)

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

2009-01-01

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

Is demand-side financing equity enhancing? Lessons from a maternal health voucher scheme in Bangladesh.

PubMed

Ahmed, Shakil; Khan, M Mahmud

2011-05-01

Demand-side financing (DSF) is used in the less-developed countries of the world to improve access to healthcare and to encourage market supply. Under DSF, households receive vouchers that can be used to pay for healthcare services. This study evaluated the effects of a universal DSF on maternal healthcare service utilization in Bangladesh. A household survey was conducted in and around the voucher scheme area one year after the initiation of the project. Women who gave birth within a year prior to the survey were interviewed. The utilization rates of maternal health services were found to be higher for all socioeconomic groups in the project area than in the comparison areas. Voucher recipients in the project area were 3.6 times more likely to be assisted by skilled health personnel during delivery, 2.5 times more likely to deliver the baby in a health facility, 2.8 times more likely to receive postnatal care (PNC), 2.0 times more likely to get antenatal care (ANC) services and 1.5 times more likely to seek treatment for obstetric complications than pregnant women not in the program. The degree of socioeconomic inequality in maternal health service utilization was also lower in the project area than in the comparison area. The use of vouchers evidenced much stronger demand-increasing effects on the poor. Poor voucher recipients were 4.3 times more likely to deliver in a health facility and two times more likely to use skilled health personnel at delivery than the non-poor recipients. Contrary to the inverse equity hypothesis, the voucher scheme reduced inequality even in the short run. Despite these improvements, socioeconomic disparity in the use of maternal health services has remained pro-rich, implying that demand-side financing alone will be insufficient to achieve the Millennium Development Goal for maternal health. A comprehensive system-wide approach, including supply-side strengthening, will be needed to adequately address maternal health concerns in poor

Physical Layer Secret-Key Generation Scheme for Transportation Security Sensor Network

PubMed Central

Yang, Bin; Zhang, Jianfeng

2017-01-01

Wireless Sensor Networks (WSNs) are widely used in different disciplines, including transportation systems, agriculture field environment monitoring, healthcare systems, and industrial monitoring. The security challenge of the wireless communication link between sensor nodes is critical in WSNs. In this paper, we propose a new physical layer secret-key generation scheme for transportation security sensor network. The scheme is based on the cooperation of all the sensor nodes, thus avoiding the key distribution process, which increases the security of the system. Different passive and active attack models are analyzed in this paper. We also prove that when the cooperative node number is large enough, even when the eavesdropper is equipped with multiple antennas, the secret-key is still secure. Numerical results are performed to show the efficiency of the proposed scheme. PMID:28657588

Physical Layer Secret-Key Generation Scheme for Transportation Security Sensor Network.

PubMed

Yang, Bin; Zhang, Jianfeng

2017-06-28

Wireless Sensor Networks (WSNs) are widely used in different disciplines, including transportation systems, agriculture field environment monitoring, healthcare systems, and industrial monitoring. The security challenge of the wireless communication link between sensor nodes is critical in WSNs. In this paper, we propose a new physical layer secret-key generation scheme for transportation security sensor network. The scheme is based on the cooperation of all the sensor nodes, thus avoiding the key distribution process, which increases the security of the system. Different passive and active attack models are analyzed in this paper. We also prove that when the cooperative node number is large enough, even when the eavesdropper is equipped with multiple antennas, the secret-key is still secure. Numerical results are performed to show the efficiency of the proposed scheme.

Monitoring and Protecting Health and Human Rights in Mexico.

PubMed

Gómez-Dantés; Frenk; Zorrilla

1995-01-01

This paper describes a unique system through which health care-related human rights are now being monitored and protected in Mexico. Based on the ombudsman concept, the system focuses on identifying and responding to violations of human rights and dignity which may occur in the context of health care delivery. Experience thus far has been encouraging; the Mexican population has identified and used the National Commission of Human Rights as a forum for a variety of health-related complaints. The Mexican system, while requiring strengthening and expansion, is an effort to integrate the monitoring and protection of health-related human rights into the broader field of human rights work in Mexico.

Forest health monitoring: 2006 national technical report

Treesearch

Mark J. Ambrose; Barbara L. Conkling

2009-01-01

The Forest Health Monitoring Program’s annual national technical report presents results of forest health analyses from a national perspective using data from a variety of sources. The report is organized according to the Criteria and Indicators for the Conservation and Sustainable Management of Temperate and Boreal Forests of the...

Forest health monitoring: 2005 national technical report

Treesearch

Mark J. Ambrose; Barbara L. Conkling

2007-01-01

The Forest Health Monitoring program's annual national technical report presents results of forest health analyses from a national perspective using data from a variety of sources. The report is organized according to the Criteria and Indicators for the Conservation and Sustainable Management of Temperate and Boreal Forests of the Santiago Declaration. The results...

INDUCTIVE SYSTEM HEALTH MONITORING WITH STATISTICAL METRICS

NASA Technical Reports Server (NTRS)

Iverson, David L.

2005-01-01

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

Physical health care monitoring for people with serious mental illness.

PubMed

Tosh, Graeme; Clifton, Andrew V; Xia, Jun; White, Margueritte M

2014-01-17

Current guidance suggests that we should monitor the physical health of people with serious mental illness, and there has been a significant financial investment over recent years to provide this. To assess the effectiveness of physical health monitoring, compared with standard care for people with serious mental illness. We searched the Cochrane Schizophrenia Group Trials Register (October 2009, update in October 2012), which is based on regular searches of CINAHL, EMBASE, MEDLINE and PsycINFO. All randomised clinical trials focusing on physical health monitoring versus standard care, or comparing i) self monitoring versus monitoring by a healthcare professional; ii) simple versus complex monitoring; iii) specific versus non-specific checks; iv) once only versus regular checks; or v) different guidance materials. Initially, review authors (GT, AC, SM) independently screened the search results and identified three studies as possibly fulfilling the review's criteria. On examination, however, all three were subsequently excluded. Forty-two additional citations were identified in October 2012 and screened by two review authors (JX and MW), 11 of which underwent full screening. No relevant randomised trials which assess the effectiveness of physical health monitoring in people with serious mental illness have been completed. We identified one ongoing study. There is still no evidence from randomised trials to support or refute current guidance and practice. Guidance and practice are based on expert consensus, clinical experience and good intentions rather than high quality evidence.

[Monitoring social determinants of health].

PubMed

Espelt, Albert; Continente, Xavier; Domingo-Salvany, Antonia; Domínguez-Berjón, M Felicitas; Fernández-Villa, Tania; Monge, Susana; Ruiz-Cantero, M Teresa; Perez, Glòria; Borrell, Carme

2016-11-01

Public health surveillance is the systematic and continuous collection, analysis, dissemination and interpretation of health-related data for planning, implementation and evaluation of public health initiatives. Apart from the health system, social determinants of health include the circumstances in which people are born, grow up, live, work and age, and they go a long way to explaining health inequalities. A surveillance system of the social determinants of health requires a comprehensive and social overview of health. This paper analyses the importance of monitoring social determinants of health and health inequalities, and describes some relevant aspects concerning the implementation of surveillance during the data collection, compilation and analysis phases, as well as dissemination of information and evaluation of the surveillance system. It is important to have indicators from sources designed for this purpose, such as continuous records or periodic surveys, explicitly describing its limitations and strengths. The results should be published periodically in a communicative format that both enhances the public's ability to understand the problems that affect them, whilst at the same time empowering the population, with the ultimate goal of guiding health-related initiatives at different levels of intervention. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Occurrence of pharmaceutically active and non-steroidal estrogenic compounds in three different wastewater recycling schemes in Australia.

PubMed

Al-Rifai, Jawad H; Gabelish, Candace L; Schäfer, Andrea I

2007-10-01

The discovery that natural and synthetic chemicals, in the form of excreted hormones and pharmaceuticals, as well as a vast array of compounds with domestic and industrial applications, can enter the environment via wastewater treatment plants and cause a wide variety of environmental and health problems even at very low concentrations, suggests the need for improvement of water recycling. Three Australian wastewater recycling schemes, two of which employ reverse osmosis (RO) technology, the other applying ozonation and biological activated carbon filtration, have been studied for their ability to remove trace organic contaminants including 11 pharmaceutically active compounds and two non-steroidal estrogenic compounds. Contaminant concentrations were determined using a sensitive analytical method comprising solid phase extraction, derivatization and GC with MS using selected ion monitoring. In raw wastewater, concentrations of analgesics and non-steroidal anti-inflammatory medications were comparable to those found in wastewaters around the world. Remarkably, removal efficiencies for the three schemes were superior to literature values and RO was responsible for the greatest proportion of contaminant removal. The ability of RO membranes to concentrate many of the compounds was demonstrated and highlights the need for continued research into monitoring wastewater treatment, concentrate disposal, improved water recycling schemes and ultimately, safer water and a cleaner environment.

Smart homes and home health monitoring technologies for older adults: A systematic review.

PubMed

Liu, Lili; Stroulia, Eleni; Nikolaidis, Ioanis; Miguel-Cruz, Antonio; Rios Rincon, Adriana

2016-07-01

Around the world, populations are aging and there is a growing concern about ways that older adults can maintain their health and well-being while living in their homes. The aim of this paper was to conduct a systematic literature review to determine: (1) the levels of technology readiness among older adults and, (2) evidence for smart homes and home-based health-monitoring technologies that support aging in place for older adults who have complex needs. We identified and analyzed 48 of 1863 relevant papers. Our analyses found that: (1) technology-readiness level for smart homes and home health monitoring technologies is low; (2) the highest level of evidence is 1b (i.e., one randomized controlled trial with a PEDro score ≥6); smart homes and home health monitoring technologies are used to monitor activities of daily living, cognitive decline and mental health, and heart conditions in older adults with complex needs; (3) there is no evidence that smart homes and home health monitoring technologies help address disability prediction and health-related quality of life, or fall prevention; and (4) there is conflicting evidence that smart homes and home health monitoring technologies help address chronic obstructive pulmonary disease. The level of technology readiness for smart homes and home health monitoring technologies is still low. The highest level of evidence found was in a study that supported home health technologies for use in monitoring activities of daily living, cognitive decline, mental health, and heart conditions in older adults with complex needs. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

National Antimicrobial Resistance Monitoring System: Two Decades of Advancing Public Health Through Integrated Surveillance of Antimicrobial Resistance

PubMed Central

Tate, Heather; Plumblee, Jodie R.; Dessai, Uday; Whichard, Jean M.; Thacker, Eileen L.; Hale, Kis Robertson; Wilson, Wanda; Friedman, Cindy R.; Griffin, Patricia M.; McDermott, Patrick F.

2017-01-01

Abstract Drug-resistant bacterial infections pose a serious and growing public health threat globally. In this review, we describe the role of the National Antimicrobial Resistance Monitoring System (NARMS) in providing data that help address the resistance problem and show how such a program can have broad positive impacts on public health. NARMS was formed two decades ago to help assess the consequences to human health arising from the use of antimicrobial drugs in food animal production in the United States. A collaboration among the Centers for Disease Control and Prevention, the U.S. Food and Drug Administration, the United States Department of Agriculture, and state and local health departments, NARMS uses an integrated “One Health” approach to monitor antimicrobial resistance in enteric bacteria from humans, retail meat, and food animals. NARMS has adapted to changing needs and threats by expanding surveillance catchment areas, examining new isolate sources, adding bacteria, adjusting sampling schemes, and modifying antimicrobial agents tested. NARMS data are not only essential for ensuring that antimicrobial drugs approved for food animals are used in ways that are safe for human health but they also help address broader food safety priorities. NARMS surveillance, applied research studies, and outbreak isolate testing provide data on the emergence of drug-resistant enteric bacteria; genetic mechanisms underlying resistance; movement of bacterial populations among humans, food, and food animals; and sources and outcomes of resistant and susceptible infections. These data can be used to guide and evaluate the impact of science-based policies, regulatory actions, antimicrobial stewardship initiatives, and other public health efforts aimed at preserving drug effectiveness, improving patient outcomes, and preventing infections. Many improvements have been made to NARMS over time and the program will continue to adapt to address emerging resistance threats

Public-private delivery of insecticide-treated nets: a voucher scheme in Volta Region, Ghana

PubMed Central

Kweku, Margaret; Webster, Jayne; Taylor, Ian; Burns, Susan; Dedzo, McDamien

2007-01-01

Background Coverage of vulnerable groups with insecticide-treated nets (ITNs) in Ghana, as in the majority of countries of sub-Saharan Africa is currently low. A voucher scheme was introduced in Volta Region as a possible sustainable delivery system for increasing this coverage through scale-up to other regions. Successful scale-up of public health interventions depends upon optimal delivery processes but operational research for delivery processes in large-scale implementation has been inadequate. Methods A simple tool was developed to monitor numbers of vouchers given to each health facility, numbers issued to pregnant women by the health staff, and numbers redeemed by the distributors back to the management agent. Three rounds of interviews were undertaken with health facility staff, retailers and pregnant women who had attended antenatal clinic (ANC). Results During the one year pilot 25,926 vouchers were issued to eligible women from clinics, which equates to 50.7% of the 51,658 ANC registrants during this time period. Of the vouchers issued 66.7% were redeemed by distributors back to the management agent. Initially, non-issuing of vouchers to pregnant women was mainly due to eligibility criteria imposed by the midwives; later in the year it was due to decisions of the pregnant women, and supply constraints. These in turn were heavily influenced by factors external to the programme: current household ownership of nets, competing ITN delivery strategies, and competition for the limited number of ITNs available in the country from major urban areas of other regions. Conclusion Both issuing and redemption of vouchers should be monitored as factors assumed to influence voucher redemption had an influence on issuing, and vice versa. More evidence is needed on how specific contextual factors influence the success of voucher schemes and other models of delivery of ITNs. Such an evidence base will facilitate optimal strategic decision making so that the delivery model

Twenty five years of beach monitoring in Hong Kong: A re-examination of the beach water quality classification scheme from a comparative and global perspective.

PubMed

Thoe, W; Lee, Olive H K; Leung, K F; Lee, T; Ashbolt, Nicholas J; Yang, Ron R; Chui, Samuel H K

2018-06-01

Hong Kong's beach water quality classification scheme, used effectively for >25 years in protecting public health, was first established in local epidemiology studies during the late 1980s where Escherichia coli (E. coli) was identified as the most suitable faecal indicator bacteria. To review and further substantiate the scheme's robustness, a performance check was carried out to classify water quality of 37 major local beaches in Hong Kong during four bathing seasons (March-October) from 2010 to 2013. Given the enterococci and E. coli data collected, beach classification by the local scheme was found to be in line with the prominent international benchmarks recommended by the World Health Organization and the European Union. Local bacteriological studies over the last 15 years further confirmed that E. coli is the more suitable faecal indicator bacteria than enterococci in the local context. Copyright © 2018 Elsevier Ltd. All rights reserved.

Utilization of the Local Government Health Insurance Scheme (JKA) for Maternal Health Services Among Women Living in Underdeveloped Areas of Aceh Province, Indonesia.

PubMed

Kesuma, Zurnila Marli; Chongsuvivatwong, Virasakdi

2015-04-01

Aceh province of Indonesia created its own health coverage scheme called Jaminan Kesehatan Aceh (JKA) to cover Aceh's populations who were not registered under insurance for the poor (Jamkesmas). This study aims to compare the utilization rate of maternal health care (MHC) services and contraceptive prevalence rate (CPR) before JKA, during the transition period, and after JKA had been established. A cross-sectional household survey was conducted from June 2011 to July 2012. Utilization of MHC services and CPR during the 3 periods was assessed using a questionnaire. The Mantel-Haenszel χ(2) test was used to examine the association between period and coverage. Generalized estimating equations (GEEs) were used to examine utilization and type of service, period of service, and type of scheme. Coverage of utilization of skilled birth attendants significantly improved among the JKA holders (odds ratio = 1.84; 95% confidence interval = 1.18-2.89). JKA, thus, has shown its positive impact. © 2014 APJPH.

Peer counsellors' views on the collegial support scheme for doctors.

PubMed

Rø, Karin Isaksson; Aasland, Olaf Gjerløw

2016-02-23

The health condition and health-related behaviour of doctors are important to the doctors themselves as well as for their treatment of patients. The collegial support scheme is a county-based and easily accessible health and care service for doctors. We therefore wanted to describe the framework and functions of this scheme and examine its utility. Fourteen focus-group interviews with a total of 61 peer counsellors from all the counties were conducted. The interviews were recorded, transcribed and analysed with the aid of systematic text condensation. The framework--easy accessibility, a readily available offer of up to three sessions, a high degree of confidentiality and informal contact--was emphasised as crucial for doctors to make use of the scheme. The peer counsellors described their role as that of a listener and supportive helper. They helped bring clarity and discuss possible needs for further follow-up or treatment of numerous different and frequently complex issues. The peer counsellors highlighted three benefits in particular: the scheme helps raise awareness by legitimising help-seeking behaviour among doctors, it is a contingency scheme, and it eases the burden by lowering the threshold to seeking out further advice and treatment. A systematic evaluation of the collegial support scheme is important for an understanding of the totality of the collegial health and care services. The collegial support scheme may lower the threshold to seeking help, and encourage some doctors to seek necessary treatment.

A Framework for Monitoring Progress Using Summary Measures of Health.

PubMed

Madans, Jennifer H; Weeks, Julie D

2016-10-01

Initiatives designed to monitor health typically incorporate numerous specific measures of health and the health system to assess improvements, or lack thereof, for policy and program purposes. The addition of summary measures provides overarching information which is essential for determining whether the goals of such initiatives are met. Summary measures are identified that relate to the individual indicators but that also reflect movement in the various parts of the system. A hierarchical framework that is conceptually consistent and which utilizes a succinct number of summary measures incorporating indicators of functioning and participation is proposed. While a large set of individual indicators can be useful for monitoring progress, these individual indicators do not provide an overall evaluation of health, defined broadly, at the population level. A hierarchical framework consisting of summary measures is important for monitoring the success of health improvement initiatives. © The Author(s) 2016.

In situ health monitoring of piezoelectric sensors

NASA Technical Reports Server (NTRS)

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

2013-01-01

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

Forest health monitoring: 2002 national technical report

Treesearch

John W. Coulston; Mark J. Ambrose; Kurt H. Riitters; Barbara L. Conkling

2005-01-01

The Forest Health Monitoring (FHM) Program’s annual national technical report presents results of forest health analyses from a national perspective using data from a variety of sources. This annual report focuses on “Criterion 3—Maintenance of Forest Ecosystem Health and Vitality” from the “Criteria and Indicators of Sustainable Forestry of the Santiago Declaration”...

Autonomous self-powered structural health monitoring system

NASA Astrophysics Data System (ADS)

Qing, Xinlin P.; Anton, Steven R.; Zhang, David; Kumar, Amrita; Inman, Daniel J.; Ooi, Teng K.

2010-03-01

Structural health monitoring technology is perceived as a revolutionary method of determining the integrity of structures involving the use of multidisciplinary fields including sensors, materials, system integration, signal processing and interpretation. The core of the technology is the development of self-sufficient systems for the continuous monitoring, inspection and damage detection of structures with minimal labor involvement. A major drawback of the existing technology for real-time structural health monitoring is the requirement for external electrical power input. For some applications, such as missiles or combat vehicles in the field, this factor can drastically limit the use of the technology. Having an on-board electrical power source that is independent of the vehicle power system can greatly enhance the SHM system and make it a completely self-contained system. In this paper, using the SMART layer technology as a basis, an Autonomous Self-powered (ASP) Structural Health Monitoring (SHM) system has been developed to solve the major challenge facing the transition of SHM systems into field applications. The architecture of the self-powered SHM system was first designed. There are four major components included in the SHM system: SMART Layer with sensor network, low power consumption diagnostic hardware, rechargeable battery with energy harvesting device, and host computer with supporting software. A prototype of the integrated self-powered active SHM system was built for performance and functionality testing. Results from the evaluation tests demonstrated that a fully charged battery system is capable of powering the SHM system for active scanning up to 10 hours.

Setting monitoring objectives for landscape-size areas

Treesearch

Craig M. Olson; Dean Angelides

2000-01-01

The setting of objectives for monitoring schemes for landscape-size areas should be a complex task in today's regulatory and sociopolitical atmosphere. The technology available today, the regulatory environment, and the sociopolitical considerations require multiresource inventory and monitoring schemes, whether tile ownership is industrial or for preservation....

An Adaptive Monitoring Scheme for Automatic Control of Anaesthesia in dynamic surgical environments based on Bispectral Index and Blood Pressure.

PubMed

Yu, Yu-Ning; Doctor, Faiyaz; Fan, Shou-Zen; Shieh, Jiann-Shing

2018-04-13

During surgical procedures, bispectral index (BIS) is a well-known measure used to determine the patient's depth of anesthesia (DOA). However, BIS readings can be subject to interference from many factors during surgery, and other parameters such as blood pressure (BP) and heart rate (HR) can provide more stable indicators. However, anesthesiologist still consider BIS as a primary measure to determine if the patient is correctly anaesthetized while relaying on the other physiological parameters to monitor and ensure the patient's status is maintained. The automatic control of administering anesthesia using intelligent control systems has been the subject of recent research in order to alleviate the burden on the anesthetist to manually adjust drug dosage in response physiological changes for sustaining DOA. A system proposed for the automatic control of anesthesia based on type-2 Self Organizing Fuzzy Logic Controllers (T2-SOFLCs) has been shown to be effective in the control of DOA under simulated scenarios while contending with uncertainties due to signal noise and dynamic changes in pharmacodynamics (PD) and pharmacokinetic (PK) effects of the drug on the body. This study considers both BIS and BP as part of an adaptive automatic control scheme, which can adjust to the monitoring of either parameter in response to changes in the availability and reliability of BIS signals during surgery. The simulation of different control schemes using BIS data obtained during real surgical procedures to emulate noise and interference factors have been conducted. The use of either or both combined parameters for controlling the delivery Propofol to maintain safe target set points for DOA are evaluated. The results show that combing BIS and BP based on the proposed adaptive control scheme can ensure the target set points and the correct amount of drug in the body is maintained even with the intermittent loss of BIS signal that could otherwise disrupt an automated control system.

Public vs private administration of rural health insurance schemes: a comparative study in Zhejiang of China.

PubMed

Zhou, Xiaoyuan; Mao, Zhengzhong; Rechel, Bernd; Liu, Chaojie; Jiang, Jialin; Zhang, Yinying

2013-07-01

Since 2003, China has experimented in some of the country's counties with the private administration of the New Cooperative Medical Scheme (NCMS), a publicly subsidized health insurance scheme for rural populations. Our study compared the effectiveness and efficiency of private vs public administration in four counties in one of China's most affluent provinces in the initial stage of the NCMS's implementation. The study was undertaken in Ningbo city of Zhejiang province. Out of 10 counties in Ningbo, two counties with private administration for the NCMS (Beilun and Ninghai) were compared with two others counties with public administration (Zhenhai and Fenghua), using the following indicators: (1) proportion of enrollees who were compensated for inpatient care; (2) average reimbursement-expense ratio per episode of inpatient care; (3) overall administration cost; (4) enrollee satisfaction. Data from 2004 to 2006 were collected from the local health authorities, hospitals and the contracted insurance companies, supplemented by a randomized household questionnaire survey covering 176 households and 479 household members. In our sample counties, private administration of the NCMS neither reduced transaction costs, nor improved the benefits of enrollees. Enrollees covered by the publicly administered NCMS were more likely to be satisfied with the insurance scheme than those covered by the privately administered NCMS. Experience in the selected counties suggests that private administration of the NCMS did not deliver the hoped-for results. We conclude that caution needs to be exercised in extending private administration of the NCMS.

Introduction to: The Forest Health monitoring program

Treesearch

Barbara L. Conkling

2011-01-01

The National Forest Health Monitoring (FHM) Program of the Forest Service, U.S. Department of Agriculture, produces an annual technical report on forest health as one of its products. The report is organized using the Criteria and Indicators for the Conservation and Sustainable Management of Temperate and Boreal Forests (Montréal Process Working Group 2007) as a...

Forest health monitoring: 2003 national technical report

Treesearch

John W. Coulston; Mark J. Ambrose; Kurt H. Riitters; Barbara L. Conkling; William D. Smith

2005-01-01

The Forest Health Monitoring Program’s annual national reports present results from forest health data analyses focusing on a national perspective. The Criteria and Indicators for the Conservation and Sustainable Management of Temperate and Boreal Forests are used as a reporting framework. This report has five main sections. The first contains introductory material....

Study of Awareness, Enrollment, and Utilization of Rashtriya Swasthya Bima Yojana (National Health Insurance Scheme) in Maharashtra, India.

PubMed

Thakur, Harshad

2015-01-01

Government of India launched a social health protection program called Rashtriya Swasthya Bima Yojana (RSBY) in the year 2008 to provide financial protection from catastrophic health expenses to below poverty line households (HHs). The objectives of the current paper are to assess the current status of RSBY in Maharashtra at each step of awareness, enrollment, and utilization. In addition, urban and rural areas were compared, and social, political, economic, and cultural (SPEC) factors responsible for the better or poor proportions, especially for the awareness of the scheme, were identified. The study followed mixed methods approach. For quantitative data, a systematic multistage sampling design was adopted in both rural and urban areas covering 6000 HHs across 22 districts. For qualitative data, five districts were selected to conduct Stakeholder Analysis, Focused Group Discussions, and In-Depth Interviews with key informants to supplement the findings. The data were analyzed using innovative SPEC-by-steps tool developed by Health Inc. It is seen that that the RSBY had a very limited success in Maharashtra. Out of 6000 HHs, only 29.7% were aware about the scheme and 21.6% were enrolled during the period of 2010-2012. Only 11.3% HHs reported that they were currently enrolled for RSBY. Although 1886 (33.1%) HHs reported at least one case of hospitalization in the last 1 year, only 16 (0.3%) HHs could actually utilize the benefits during hospitalization. It is seen that at each step, there is an increase in the exclusion of eligible HHs from the scheme. The participants felt that such schemes did not reach their intended beneficiaries due to various SPEC factors. The results of this study were quite similar to other studies done in the recent past. RSBY might still be continued in Maharashtra with modified focus along with good and improved strategy. Various other similar schemes in India can definitely learn few important lessons such as the need to improve

Monitoring and Benchmarking eHealth in the Nordic Countries.

PubMed

Nøhr, Christian; Koch, Sabine; Vimarlund, Vivian; Gilstad, Heidi; Faxvaag, Arild; Hardardottir, Gudrun Audur; Andreassen, Hege K; Kangas, Maarit; Reponen, Jarmo; Bertelsen, Pernille; Villumsen, Sidsel; Hyppönen, Hannele

2018-01-01

The Nordic eHealth Research Network, a subgroup of the Nordic Council of Ministers eHealth group, is working on developing indicators to monitor progress in availability, use and outcome of eHealth applications in the Nordic countries. This paper reports on the consecutive analysis of National eHealth policies in the Nordic countries from 2012 to 2016. Furthermore, it discusses the consequences for the development of indicators that can measure changes in the eHealth environment arising from the policies. The main change in policies is reflected in a shift towards more stakeholder involvement and intensified focus on clinical infrastructure. This change suggests developing indicators that can monitor understandability and usability of eHealth systems, and the use and utility of shared information infrastructure from the perspective of the end-users - citizens/patients and clinicians in particular.

The effect of selected health education schemes on knowledge and attitude of the Kanuri towards certain parasitic diseases.

PubMed

Akogun, O B

1992-12-01

The effect of 3 types of intervention schemes on the scientific knowledge and attitude of Kanuri towards malaria, diarrhoea and dysentery and intestinal worms was assessed using the Likert scale response type statements. 1383 respondents in our identical Kanuri villages were used in the study. The effect of still pictures and card games (Goramari), drama songs, storytelling and discussions (Yerimari) and a combination of both (Shetimari) on knowledge and attitude was tested. Gotimari was used as the control. Quarterly assessment of changes in knowledge and attitude showed that Goramari was the least effective while Yerimari and Shetimari were the most effective. Women were more influenced than men by health education schemes which involve drama songs and stories while card games and still pictures had very little effect on them (women). The implication of these findings on disease management through health education is discussed.

Consumer Perception of the Healthfulness of Ultra-processed Products Featuring Different Front-of-Pack Nutrition Labeling Schemes.

PubMed

Machín, Leandro; Cabrera, Manuel; Curutchet, María Rosa; Martínez, Joseline; Giménez, Ana; Ares, Gastón

2017-04-01

To examine the influence of front-of-pack nutrition information on the perception of healthfulness of ultra-processed products across 2 income levels. A between-participants design was used to compare healthfulness perception of ultra-processed products featuring different front-of-pack nutrition information schemes (guideline daily amount system, traffic light system, and monochromatic traffic light system). A total of 300 people (aged 18-70 years, 75% female) from Montevideo, Uruguay, participated in the study; half were middle- or high-income people and the other half were low-income people. Participants were shown the labels of each product and asked to rate their perceived healthfulness and the frequency with which each product should be consumed. Results were analyzed using analysis of variance for statistical significance (P < .05). Low-income participants perceived ultra-processed products to be significantly (P < .05) more healthful than did middle- and high-income participants. The lowest perceived healthfulness scores for low-income participants were obtained for products featuring the colored and monochromatic traffic light system whereas no significant differences (P > .05) among schemes were found for middle- and high-income participants. Nutrition education programs aimed at increasing low-income people's knowledge of the nutritional composition of these products and their potential negative effects on health seem to be necessary. Although the inclusion of semidirective front-of-pack nutrition information decreased the perceived healthfulness of low-income people, it seemed unlikely to influence how they perceive these products. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Monitoring hemlock crown health in Delaware Water Gap National Recreation Area

Treesearch

Michael E. Montgomery; Bradley Onken; Richard A. Evans; Richard A. Evans

2005-01-01

Decline of the health of hemlocks in Delaware Water Gap National Recreation Area was noticeable in the southern areas of the park by 1992. The following year, a series of plots were established to monitor hemlock health and the abundance of hemlock woolly adelgid. This poster examines only the health rating of the hemlocks in the monitoring plots.

A secure user anonymity-preserving three-factor remote user authentication scheme for the telecare medicine information systems.

PubMed

Das, Ashok Kumar

2015-03-01

Recent advanced technology enables the telecare medicine information system (TMIS) for the patients to gain the health monitoring facility at home and also to access medical services over the Internet of mobile networks. Several remote user authentication schemes have been proposed in the literature for TMIS. However, most of them are either insecure against various known attacks or they are inefficient. Recently, Tan proposed an efficient user anonymity preserving three-factor authentication scheme for TMIS. In this paper, we show that though Tan's scheme is efficient, it has several security drawbacks such as (1) it fails to provide proper authentication during the login phase, (2) it fails to provide correct updation of password and biometric of a user during the password and biometric update phase, and (3) it fails to protect against replay attack. In addition, Tan's scheme lacks the formal security analysis and verification. Later, Arshad and Nikooghadam also pointed out some security flaws in Tan's scheme and then presented an improvement on Tan's s scheme. However, we show that Arshad and Nikooghadam's scheme is still insecure against the privileged-insider attack through the stolen smart-card attack, and it also lacks the formal security analysis and verification. In order to withstand those security loopholes found in both Tan's scheme, and Arshad and Nikooghadam's scheme, we aim to propose an effective and more secure three-factor remote user authentication scheme for TMIS. Our scheme provides the user anonymity property. Through the rigorous informal and formal security analysis using random oracle models and the widely-accepted AVISPA (Automated Validation of Internet Security Protocols and Applications) tool, we show that our scheme is secure against various known attacks, including the replay and man-in-the-middle attacks. Furthermore, our scheme is also efficient as compared to other related schemes.

Capacity building for health inequality monitoring in Indonesia: enhancing the equity orientation of country health information system.

PubMed

Hosseinpoor, Ahmad Reza; Nambiar, Devaki; Tawilah, Jihane; Schlotheuber, Anne; Briot, Benedicte; Bateman, Massee; Davey, Tamzyn; Kusumawardani, Nunik; Myint, Theingi; Nuryetty, Mariet Tetty; Prasetyo, Sabarinah; Suparmi; Floranita, Rustini

Inequalities in health represent a major problem in many countries, including Indonesia. Addressing health inequality is a central component of the Sustainable Development Goals and a priority of the World Health Organization (WHO). WHO provides technical support for health inequality monitoring among its member states. Following a capacity-building workshop in the WHO South-East Asia Region in 2014, Indonesia expressed interest in incorporating health-inequality monitoring into its national health information system. This article details the capacity-building process for national health inequality monitoring in Indonesia, discusses successes and challenges, and how this process may be adapted and implemented in other countries/settings. We outline key capacity-building activities undertaken between April 2016 and December 2017 in Indonesia and present the four key outcomes of this process. The capacity-building process entailed a series of workshops, meetings, activities, and processes undertaken between April 2016 and December 2017. At each stage, a range of stakeholders with access to the relevant data and capacity for data analysis, interpretation and reporting was engaged with, under the stewardship of state agencies. Key steps to strengthening health inequality monitoring included capacity building in (1) identification of the health topics/areas of interest, (2) mapping data sources and identifying gaps, (3) conducting equity analyses using raw datasets, and (4) interpreting and reporting inequality results. As a result, Indonesia developed its first national report on the state of health inequality. A number of peer-reviewed manuscripts on various aspects of health inequality in Indonesia have also been developed. The capacity-building process undertaken in Indonesia is designed to be adaptable to other contexts. Capacity building for health inequality monitoring among countries is a critical step for strengthening equity-oriented national health

Capacity building for health inequality monitoring in Indonesia: enhancing the equity orientation of country health information systems

PubMed Central

Tawilah, Jihane; Schlotheuber, Anne; Bateman, Massee; Davey, Tamzyn; Kusumawardani, Nunik; Myint, Theingi; Nuryetty, Mariet Tetty; Prasetyo, Sabarinah; Suparmi; Floranita, Rustini

2018-01-01

ABSTRACT Background: Inequalities in health represent a major problem in many countries, including Indonesia. Addressing health inequality is a central component of the Sustainable Development Goals and a priority of the World Health Organization (WHO). WHO provides technical support for health inequality monitoring among its member states. Following a capacity-building workshop in the WHO South-East Asia Region in 2014, Indonesia expressed interest in incorporating health-inequality monitoring into its national health information system. Objectives: This article details the capacity-building process for national health inequality monitoring in Indonesia, discusses successes and challenges, and how this process may be adapted and implemented in other countries/settings. Methods: We outline key capacity-building activities undertaken between April 2016 and December 2017 in Indonesia and present the four key outcomes of this process. Results: The capacity-building process entailed a series of workshops, meetings, activities, and processes undertaken between April 2016 and December 2017. At each stage, a range of stakeholders with access to the relevant data and capacity for data analysis, interpretation and reporting was engaged with, under the stewardship of state agencies. Key steps to strengthening health inequality monitoring included capacity building in (1) identification of the health topics/areas of interest, (2) mapping data sources and identifying gaps, (3) conducting equity analyses using raw datasets, and (4) interpreting and reporting inequality results. As a result, Indonesia developed its first national report on the state of health inequality. A number of peer-reviewed manuscripts on various aspects of health inequality in Indonesia have also been developed. Conclusions: The capacity-building process undertaken in Indonesia is designed to be adaptable to other contexts. Capacity building for health inequality monitoring among countries is a critical

Cooperative wireless network control based health and activity monitoring system.

PubMed

Prakash, R; Ganesh, A Balaji; Girish, Siva V

2016-10-01

A real-time cooperative communication based wireless network is presented for monitoring health and activity of an end-user in their environment. The cooperative communication offers better energy consumption and also an opportunity to aware the current location of a user non-intrusively. The link between mobile sensor node and relay node is dynamically established by using Received Signal Strength Indicator (RSSI) and Link Quality Indicator (LQI) based on adaptive relay selection scheme. The study proposes a Linear Acceleration based Transmission Power Decision Control (LA-TPDC) algorithm to further enhance the energy efficiency of cooperative communication. Further, the occurrences of false alarms are carefully prevented by introducing three stages of sequential warning system. The real-time experiments are carried-out by using the nodes, namely mobile sensor node, relay nodes and a destination node which are indigenously developed by using a CC430 microcontroller integrated with an in-built transceiver at 868 MHz. The wireless node performance characteristics, such as energy consumption, Signal-Noise ratio (SNR), Bit Error Rate (BER), Packet Delivery Ratio (PDR) and transmission offset are evaluated for all the participated nodes. The experimental results observed that the proposed linear acceleration based transmission power decision control algorithm almost doubles the battery life time than energy efficient conventional cooperative communication.

Monitoring of hearing and language in primary health care: project pilot.

PubMed

Wagner, Julianne; Bonamigo, Andrea Wander; Oliveira, Fabiana de; Machado, Márcia Salgado

2017-11-01

This article analyzes the feasibility of implementing a program that monitors the hearing and language development in the first year of life. It is a prospective longitudinal study, in which 41 community health workers were invited to monitor, on a monthly basis, by means of a questionnaire validated earlier, the hearing and language of children born in their micro areas of expertise. Thirty-nine community health workers agreed to participate, with only two refusals. Five gave up participating. Twenty-six (66.66%) did not perform monitoring, seven (17.94%) monitored improperly and only six (15.38%) monitored properly. Just one child failed the quiz, who was forwarded to the hospital that conducted the auditory screening for retesting. These professionals' high activity demand was considered the main reason for the difficulties encountered in this project. In addition, there is the difficulty to have contact with the Family Health Strategy teams, as well as the impossibility of permanent face-to-face discussions and the influence of the community health agents' supervisors.

Treatment-seeking behaviour and social health insurance in Africa: the case of Ghana under the National Health Insurance Scheme.

PubMed

Fenny, Ama P; Asante, Felix A; Enemark, Ulrika; Hansen, Kristian S

2014-10-27

Health insurance is attracting more and more attention as a means for improving health care utilization and protecting households against impoverishment from out-of-pocket expenditures. Currently about 52 percent of the resources for financing health care services come from out of pocket sources or user fees in Africa. Therefore, Ghana serves as in interesting case study as it has successfully expanded coverage of the National Health Insurance Scheme (NHIS). The study aims to establish the treatment-seeking behaviour of households in Ghana under the NHI policy. The study relies on household data collected from three districts in Ghana covering the 3 ecological zones namely the coastal, forest and savannah.Out of the 1013 who sought care in the previous 4 weeks, 60% were insured and 71% of them sought care from a formal health facility. The results from the multinomial logit estimations show that health insurance and travel time to health facility are significant determinants of health care demand. Overall, compared to the uninsured, the insured are more likely to choose formal health facilities than informal care including self-medication when ill. We discuss the implications of these results as the concept of the NHIS grows widely in Ghana and serves as a good model for other African countries.

Treatment-Seeking Behaviour and Social Health Insurance in Africa: The Case of Ghana Under the National Health Insurance Scheme

PubMed Central

Fenny, Ama P.; Asante, Felix A.; Enemark, Ulrika; Hansen, Kristian S.

2015-01-01

Health insurance is attracting more and more attention as a means for improving health care utilization and protecting households against impoverishment from out-of-pocket expenditures. Currently about 52 percent of the resources for financing health care services come from out of pocket sources or user fees in Africa. Therefore, Ghana serves as in interesting case study as it has successfully expanded coverage of the National Health Insurance Scheme (NHIS). The study aims to establish the treatment-seeking behaviour of households in Ghana under the NHI policy. The study relies on household data collected from three districts in Ghana covering the 3 ecological zones namely the coastal, forest and savannah. Out of the 1013 who sought care in the previous 4 weeks, 60% were insured and 71% of them sought care from a formal health facility. The results from the multinomial logit estimations show that health insurance and travel time to health facility are significant determinants of health care demand. Overall, compared to the uninsured, the insured are more likely to choose formal health facilities than informal care including self-medication when ill. We discuss the implications of these results as the concept of the NHIS grows widely in Ghana and serves as a good model for other African countries. PMID:25560361

Frequency Selective Surface for Structural Health Monitoring

NASA Astrophysics Data System (ADS)

Norlyana Azemi, Saidatul; Mustaffa, Farzana Hazira Wan; Faizal Jamlos, Mohd; Abdullah Al-Hadi, Azremi; Soh, Ping Jack

2018-03-01

Structural health monitoring (SHM) technologies have attained attention to monitor civil structures. SHM sensor systems have been used in various civil structures such as bridges, buildings, tunnels and so on. However the previous sensor for SHM is wired and encounter with problem to cover large areas. Therefore, wireless sensor was introduced for SHM to reduce network connecting problem. Wireless sensors for Structural Health monitoring are new technology and have many advantages to overcome the drawback of conventional and wired sensor. This project proposed passive wireless SHM sensor using frequency selective surface (FSS) as an alternative to conventional sensors. The electromagnetic wave characteristic of FSS will change by geometrical changes of FSS due to mechanical strain or structural failure. The changes feature is used as a sensing function without any connecting wires. Two type of design which are circular ring and square loop along with the transmission and reflection characteristics of SHM using FSS were discussed in this project. A simulation process has shown that incident angle characteristics can be use as a data for SHM application.

Service Evaluation of an Exercise on Referral Scheme for Adults with Existing Health Conditions in the United Kingdom.

PubMed

McGeechan, Grant J; Phillips, Dawn; Wilson, Lynn; Whittaker, Vicki J; O'Neill, Gillian; Newbury-Birch, Dorothy

2018-06-01

This paper outlines a service evaluation of an exercise referral scheme for adults suffering from a variety of physical or mental health conditions or who were deemed are at risk of developing such conditions. The evaluation aimed to assess the impact of the scheme at increasing physical activity and at reducing BMI and waist circumference. This was a retrospective evaluation looking at levels of physical activity and changes to anthropometric measures over a period of 6 months. Each participant self-reported their levels of physical activity for the previous 7 days at three time points: baseline (T1), at 12-week exit from the scheme (T2), and at 6-month follow-up (T3). Waist circumference and BMI were also recorded by either a health professional or self-reported at these time points. Six hundred seventy participants were referred during the evaluation period, of whom 494 were eligible. Of those 494, 211 completed the 12-week scheme and 135 completed a 6-month follow-up. Significant increases in levels of physical activity were recorded between T1 and T2 and between T1 and T3. Furthermore, significant reductions in waist circumference were noted between T1 and T2 and between T1 and T3, and BMI significantly decreased between T1 and T2 but significantly increased between T2 and T3. The service has proven effective at increasing levels of physical activity among participants and has had a positive impact on waist circumference and body for clients who remain engaged with the programme.

Vibration health monitoring for tensegrity structures

NASA Astrophysics Data System (ADS)

Ashwear, Nasseradeen; Eriksson, Anders

2017-02-01

Tensegrities are assembly structures, getting their equilibrium from the interaction between tension in cables and compression in bars. During their service life, slacking in their cables and nearness to buckling in their bars need to be monitored to avoid a sudden collapse. This paper discusses how to design the tensegrities to make them feasible for vibrational health monitoring methods. Four topics are discussed; suitable finite elements formulation, pre-measurements analysis to find the locations of excitation and sensors for the interesting modes, the effects from some environmental conditions, and the pre-understanding of the effects from different slacking scenarios.

Wireless microsensors for health monitoring of aircraft structures

NASA Astrophysics Data System (ADS)

Varadan, Vijay K.

2003-01-01

The integration of MEMS, IDTs (interdigital transducers) and required microelectronics and conformal antennas to realize programmable, robust and low cost passive microsensors suitable for many military structures and systems including aircraft, missiles and munitions is presented in this paper. The technology is currently being applied to the structural health monitoring of critical aircraft components. The approach integrates acoustic emission, strain gauges, MEMS accelerometers, gyroscopes and vibration monitoring devices with signal processing electronics to provide real-time indicators of incipient failure of aircraft components with a known history of catastrophic failure due to fracture. Recently a combination of the need for safety in the air and the desire to control costs is encouraging the use of in-flight monitoring of aircraft components and systems using light-weight, wireless and cost effective microsensors and MEMS. An in-situ Aircraft structural health monitoring (ASHM) system, with sensors embedded in the composite structure or surface-mounted on the structure, would permit the timely detection of damage in aircraft. Micromachining offers the potential for fabricating a range of microsensors and MEMS for structural applications including load, vibration and acoustics characterization and monitoring. Such microsensors are extremely small; they can be embedded into structural materials, can be mass-produced and are therefore potentially cheap. Additionally a range of sensor types can be integrated onto a single chip with built-in electronics and ASIC (Application Specific Integrated Circuit), providing a low power Microsystems. The smart sensors are being developed using the standard microelectronics and micromachining in conjunction with novel Penn State smart electronics or wireless communication systems suitable for condition monitoring of aircraft structures in-flight. A hybrid accelerometer and gyroscope in a single chip suitable for inertial

[What potential do geographic information systems have for population-wide health monitoring in Germany? : Perspectives and challenges for the health monitoring of the Robert Koch Institute].

PubMed

Thißen, Martin; Niemann, Hildegard; Varnaccia, Gianni; Rommel, Alexander; Teti, Andrea; Butschalowsky, Hans; Manz, Kristin; Finger, Jonas David; Kroll, Lars Eric; Ziese, Thomas

2017-12-01

Geographic information systems (GISs) are computer-based systems with which geographical data can be recorded, stored, managed, analyzed, visualized and provided. In recent years, they have become an integral part of public health research. They offer a broad range of analysis tools, which enable innovative solutions for health-related research questions. An analysis of nationwide studies that applied geographic information systems underlines the potential this instrument bears for health monitoring in Germany. Geographic information systems provide up-to-date mapping and visualization options to be used for national health monitoring at the Robert Koch Institute (RKI). Furthermore, objective information on the residential environment as an influencing factor on population health and on health behavior can be gathered and linked to RKI survey data at different geographic scales. Besides using physical information, such as climate, vegetation or land use, as well as information on the built environment, the instrument can link socioeconomic and sociodemographic data as well as information on health care and environmental stress to the survey data and integrate them into concepts for analyses. Therefore, geographic information systems expand the potential of the RKI to present nationwide, representative and meaningful health-monitoring results. In doing so, data protection regulations must always be followed. To conclude, the development of a national spatial data infrastructure and the identification of important data sources can prospectively improve access to high quality data sets that are relevant for the health monitoring.

Mental health care Monitor Older adults (MEMO): monitoring patient characteristics and outcome in Dutch mental health services for older adults.

PubMed

Veerbeek, Marjolein; Oude Voshaar, Richard; Depla, Marja; Pot, Anne Margriet

2013-06-01

Information on which older adults attend mental health care and whether they profit from the care they receive is important for policy-makers. To assess this information in daily practice, the "Mental health care Monitor Older adults" (MEMO) was developed in the Netherlands. The aim of this paper is to describe MEMO and the older adults who attend outpatient mental health care regarding their predisposing and enabling characteristics and need for care. In MEMO all patients referred to the division of old age psychiatry of the participating mental health care organisations are assessed at baseline and monitored at 4, 8 and 12-month follow-up. Primary outcomes are mental and social functioning, consumer satisfaction, and type of treatment provided (MEMO Basic). Over the years, MEMO Basic is repeated. In each cycle, additional information on specific patient groups is added (e.g. mood disorders). Data collection is supported by a web-based system for clinicians, including direct feedback to monitor patients throughout treatment. First results at baseline showed that the majority of patients that entered the division of old age psychiatry was female (69%), had low education (83%), lived alone (53%), was depressed (42%) and had a comorbid condition (82%). It seemed that older immigrants were not sufficiently reached. The current study is the first in the Netherlands to evaluate patient characteristics and outcome in mental health care provided for older adults in day-to-day practice. If MEMO works out successfully, the method should be extended to other target groups. Copyright © 2013 John Wiley & Sons, Ltd.

Prioritizing hazardous pollutants in two Nigerian water supply schemes: a risk-based approach

PubMed Central

Etchie, Ayotunde T; Etchie, Tunde O; Krishnamurthi, Kannan; SaravanaDevi, S; Wate, Satish R

2013-01-01

Abstract Objective To rank pollutants in two Nigerian water supply schemes according to their effect on human health using a risk-based approach. Methods Hazardous pollutants in drinking-water in the study area were identified from a literature search and selected pollutants were monitored from April 2010 to December 2011 in catchments, treatment works and consumer taps. The disease burden due to each pollutant was estimated in disability-adjusted life years (DALYs) using data on the pollutant’s concentration, exposure to the pollutant, the severity of its health effects and the consumer population. Findings The pollutants identified were microbial organisms, cadmium, cobalt, chromium, copper, iron, manganese, nickel, lead and zinc. All were detected in the catchments but only cadmium, cobalt, chromium, manganese and lead exceeded World Health Organization (WHO) guideline values after water treatment. Post-treatment contamination was observed. The estimated disease burden was greatest for chromium in both schemes, followed in decreasing order by cadmium, lead, manganese and cobalt. The total disease burden of all pollutants in the two schemes was 46 000 and 9500 DALYs per year or 0.14 and 0.088 DALYs per person per year, respectively, much higher than the WHO reference level of 1 × 10−6 DALYs per person per year. For each metal, the disease burden exceeded the reference level and was comparable with that due to microbial contamination reported elsewhere in Africa. Conclusion The estimated disease burden of metal contamination of two Nigerian water supply systems was high. It could best be reduced by protection of water catchment and pretreatment by electrocoagulation. PMID:23940402

A robust trust establishment scheme for wireless sensor networks.

PubMed

Ishmanov, Farruh; Kim, Sung Won; Nam, Seung Yeob

2015-03-23

Security techniques like cryptography and authentication can fail to protect a network once a node is compromised. Hence, trust establishment continuously monitors and evaluates node behavior to detect malicious and compromised nodes. However, just like other security schemes, trust establishment is also vulnerable to attack. Moreover, malicious nodes might misbehave intelligently to trick trust establishment schemes. Unfortunately, attack-resistance and robustness issues with trust establishment schemes have not received much attention from the research community. Considering the vulnerability of trust establishment to different attacks and the unique features of sensor nodes in wireless sensor networks, we propose a lightweight and robust trust establishment scheme. The proposed trust scheme is lightweight thanks to a simple trust estimation method. The comprehensiveness and flexibility of the proposed trust estimation scheme make it robust against different types of attack and misbehavior. Performance evaluation under different types of misbehavior and on-off attacks shows that the detection rate of the proposed trust mechanism is higher and more stable compared to other trust mechanisms.

Structural health monitoring technology for bolted carbon-carbon thermal protection panels

NASA Astrophysics Data System (ADS)

Yang, Jinkyu

2005-12-01

The research in this dissertation is motivated by the need for reliable inspection technologies for the detection of bolt loosening in Carbon-Carbon (C-C) Thermal Protection System (TPS) panels on Space Operation Vehicles (SOV) using minimal human intervention. A concept demonstrator of the Structural Health Monitoring (SHM) system was developed to autonomously detect the degradation of the mechanical integrity of the standoff C-C TPS panels. This system assesses the torque levels of the loosened bolts in the C-C TPS panel, as well as identifies the location of those bolts accordingly. During the course of building the proposed SHM prototype, efforts have been focused primarily on developing a trustworthy diagnostic scheme and a responsive sensor suite. Based on the microcontact conditions and damping phenomena of ultrasonic waves across the bolted joints, an Attenuation-based Diagnostic Method was proposed to assess the fastener integrity by observing the attenuation patterns of the resultant sensor signals. Parametric model studies and prototype testing validated the theoretical explanation of the attenuation-based method. Once the diagnostic scheme was determined, the implementation of a sensor suite was the next step. A new PZT-embedded sensor washer was developed to enhance remote sensing capability and achieve sufficient sensitivity by guiding diagnostic waves primarily through the inspection areas. The sensor-embedded washers replace the existing washers to constitute the sensor network, as well as to avoid jeopardizing the integrity of the original fastener components. After sensor design evolution and appropriate algorithm development, verification tests were conducted using a shaker and a full-scale oven, which simulated the acoustic and thermal environments during the re-entry process, respectively. The test results revealed that the proposed system successfully identifies the loss of the preload for the bolted joints that were loosened. The sensors were

New Multilocus Variable-Number Tandem-Repeat Analysis (MLVA) Scheme for Fine-Scale Monitoring and Microevolution-Related Study of Ralstonia pseudosolanacearum Phylotype I Populations

PubMed Central

Guinard, Jérémy; Latreille, Anne; Guérin, Fabien; Poussier, Stéphane

2016-01-01

ABSTRACT Bacterial wilt caused by the Ralstonia solanacearum species complex (RSSC) is considered one of the most harmful plant diseases in the world. Special attention should be paid to R. pseudosolanacearum phylotype I due to its large host range, its worldwide distribution, and its high evolutionary potential. So far, the molecular epidemiology and population genetics of this bacterium are poorly understood. Until now, the genetic structure of the RSSC has been analyzed on the worldwide and regional scales. Emerging questions regarding evolutionary forces in RSSC adaptation to hosts now require genetic markers that are able to monitor RSSC field populations. In this study, we aimed to evaluate the multilocus variable-number tandem-repeat analysis (MLVA) approach for its ability to discriminate genetically close phylotype I strains and for population genetics studies. We developed a new MLVA scheme (MLVA-7) allowing us to genotype 580 R. pseudosolanacearum phylotype I strains extracted from susceptible and resistant hosts and from different habitats (stem, soil, and rhizosphere). Based on specificity, polymorphism, and the amplification success rate, we selected seven fast-evolving variable-number tandem-repeat (VNTR) markers. The newly developed MLVA-7 scheme showed higher discriminatory power than the previously published MLVA-13 scheme when applied to collections sampled from the same location on different dates and to collections from different locations on very small scales. Our study provides a valuable tool for fine-scale monitoring and microevolution-related study of R. pseudosolanacearum phylotype I populations. IMPORTANCE Understanding the evolutionary dynamics of adaptation of plant pathogens to new hosts or ecological niches has become a key point for the development of innovative disease management strategies, including durable resistance. Whereas the molecular mechanisms underlying virulence or pathogenicity changes have been studied thoroughly, the

[Economic efficiency of computer monitoring of health].

PubMed

Il'icheva, N P; Stazhadze, L L

2001-01-01

Presents the method of computer monitoring of health, based on utilization of modern information technologies in public health. The method helps organize preventive activities of an outpatient clinic at a high level and essentially decrease the time and money loss. Efficiency of such preventive measures, increased number of computer and Internet users suggests that such methods are promising and further studies in this field are needed.

Personalized Health Monitoring System for Managing Well-Being in Rural Areas.

PubMed

Nedungadi, Prema; Jayakumar, Akshay; Raman, Raghu

2017-12-14

Rural India lacks easy access to health practitioners and medical centers, depending instead on community health workers. In these areas, common ailments that are easy to manage with medicines, often lead to medical escalations and even fatalities due to lack of awareness and delayed diagnosis. The introduction of wearable health devices has made it easier to monitor health conditions and to connect doctors and patients in urban areas. However, existing initiatives have not succeeded in providing adequate health monitoring to rural and low-literate patients, as current methods are expensive, require consistent connectivity and expect literate users. Our design considerations address these concerns by providing low-cost medical devices connected to a low-cost health platform, along with personalized guidance based on patient physiological parameters in local languages, and alerts to medical practitioners in case of emergencies. This patient-centric integrated healthcare system is designed to manage the overall health of villagers with real-time health monitoring of patients, to offer guidance on preventive care, and to increase health awareness and self-monitoring at an affordable price. This personalized health monitoring system addresses the health-related needs in remote and rural areas by (1) empowering health workers in monitoring of basic health conditions for rural patients in order to prevent escalations, (2) personalized feedback regarding nutrition, exercise, diet, preventive Ayurveda care and yoga postures based on vital parameters and (3) reporting of patient data to the patient's health center with emergency alerts to doctor and patient. The system supports community health workers in the diagnostic procedure, management, and reporting of rural patients, and functions well even with only intermittent access to Internet.

An Efficient Audio Coding Scheme for Quantitative and Qualitative Large Scale Acoustic Monitoring Using the Sensor Grid Approach

PubMed Central

Gontier, Félix; Lagrange, Mathieu; Can, Arnaud; Lavandier, Catherine

2017-01-01

The spreading of urban areas and the growth of human population worldwide raise societal and environmental concerns. To better address these concerns, the monitoring of the acoustic environment in urban as well as rural or wilderness areas is an important matter. Building on the recent development of low cost hardware acoustic sensors, we propose in this paper to consider a sensor grid approach to tackle this issue. In this kind of approach, the crucial question is the nature of the data that are transmitted from the sensors to the processing and archival servers. To this end, we propose an efficient audio coding scheme based on third octave band spectral representation that allows: (1) the estimation of standard acoustic indicators; and (2) the recognition of acoustic events at state-of-the-art performance rate. The former is useful to provide quantitative information about the acoustic environment, while the latter is useful to gather qualitative information and build perceptually motivated indicators using for example the emergence of a given sound source. The coding scheme is also demonstrated to transmit spectrally encoded data that, reverted to the time domain using state-of-the-art techniques, are not intelligible, thus protecting the privacy of citizens. PMID:29186021

A broadcast-based key agreement scheme using set reconciliation for wireless body area networks.

PubMed

Ali, Aftab; Khan, Farrukh Aslam

2014-05-01

Information and communication technologies have thrived over the last few years. Healthcare systems have also benefited from this progression. A wireless body area network (WBAN) consists of small, low-power sensors used to monitor human physiological values remotely, which enables physicians to remotely monitor the health of patients. Communication security in WBANs is essential because it involves human physiological data. Key agreement and authentication are the primary issues in the security of WBANs. To agree upon a common key, the nodes exchange information with each other using wireless communication. This information exchange process must be secure enough or the information exchange should be minimized to a certain level so that if information leak occurs, it does not affect the overall system. Most of the existing solutions for this problem exchange too much information for the sake of key agreement; getting this information is sufficient for an attacker to reproduce the key. Set reconciliation is a technique used to reconcile two similar sets held by two different hosts with minimal communication complexity. This paper presents a broadcast-based key agreement scheme using set reconciliation for secure communication in WBANs. The proposed scheme allows the neighboring nodes to agree upon a common key with the personal server (PS), generated from the electrocardiogram (EKG) feature set of the host body. Minimal information is exchanged in a broadcast manner, and even if every node is missing a different subset, by reconciling these feature sets, the whole network will still agree upon a single common key. Because of the limited information exchange, if an attacker gets the information in any way, he/she will not be able to reproduce the key. The proposed scheme mitigates replay, selective forwarding, and denial of service attacks using a challenge-response authentication mechanism. The simulation results show that the proposed scheme has a great deal of

Design of a National Retail Data Monitor for Public Health Surveillance

PubMed Central

Wagner, Michael M.; Robinson, J. Michael; Tsui, Fu-Chiang; Espino, Jeremy U.; Hogan, William R.

2003-01-01

The National Retail Data Monitor receives data daily from 10,000 stores, including pharmacies, that sell health care products. These stores belong to national chains that process sales data centrally and utilize Universal Product Codes and scanners to collect sales information at the cash register. The high degree of retail sales data automation enables the monitor to collect information from thousands of store locations in near to real time for use in public health surveillance. The monitor provides user interfaces that display summary sales data on timelines and maps. Algorithms monitor the data automatically on a daily basis to detect unusual patterns of sales. The project provides the resulting data and analyses, free of charge, to health departments nationwide. Future plans include continued enrollment and support of health departments, developing methods to make the service financially self-supporting, and further refinement of the data collection system to reduce the time latency of data receipt and analysis. PMID:12807802

Ghana's National Health insurance scheme and maternal and child health: a mixed methods study.

PubMed

Singh, Kavita; Osei-Akoto, Isaac; Otchere, Frank; Sodzi-Tettey, Sodzi; Barrington, Clare; Huang, Carolyn; Fordham, Corinne; Speizer, Ilene

2015-03-17

Ghana is attracting global attention for efforts to provide health insurance to all citizens through the National Health Insurance Scheme (NHIS). With the program's strong emphasis on maternal and child health, an expectation of the program is that members will have increased use of relevant services. This paper uses qualitative and quantitative data from a baseline assessment for the Maternal and Newborn errals Evaluation from the Northern and Central Regions to describe women's experiences with the NHIS and to study associations between insurance and skilled facility delivery, antenatal care and early care-seeking for sick children. The assessment included a quantitative household survey (n = 1267 women), a quantitative community leader survey (n = 62), qualitative birth narratives with mothers (n = 20) and fathers (n = 18), key informant interviews with health care workers (n = 5) and focus groups (n = 3) with community leaders and stakeholders. The key independent variables for the quantitative analyses were health insurance coverage during the past three years (categorized as all three years, 1-2 years or no coverage) and health insurance during the exact time of pregnancy. Quantitative findings indicate that insurance coverage during the past three years and insurance during pregnancy were associated with greater use of facility delivery but not ANC. Respondents with insurance were also significantly more likely to indicate that an illness need not be severe for them to take a sick child for care. The NHIS does appear to enable pregnant women to access services and allow caregivers to seek care early for sick children, but both the quantitative and qualitative assessments also indicated that the poor and least educated were less likely to have insurance than their wealthier and more educated counterparts. Findings from the qualitative interviews uncovered specific challenges women faced regarding registration for the NHIS and other

Antipsychotic Cardiometabolic Side Effect Monitoring in a State Community Mental Health System.

PubMed

Cotes, Robert O; de Nesnera, Alex; Kelly, Michael; Orsini, Karen; Xie, Haiyi; McHugo, Greg; Bartels, Stephen; Brunette, Mary F

2015-08-01

Antipsychotic medications can cause serious cardiometabolic side effects. No recent research has broadly evaluated monitoring and strategies to improve monitoring in U.S. public mental health systems. To address this knowledge gap, we evaluated education with audit and feedback to leaders to improve cardiometabolic monitoring in a state mental health system. We used Chi square statistics and logistic regressions to explore changes in monitoring recorded in randomly sampled records over 2 years. In 2009, assessment of patients on antipsychotics was 29.6 % for cholesterol, 40.4 % for glucose, 29.1 % for triglycerides, 54.3 % for weight, 33.6 % for blood pressure, and 5.7 % for abdominal girth. In 2010, four of ten mental health centers improved their rate of adult laboratory monitoring. Overall monitoring in the state did not increase. Education for prescribers with audit and feedback to leaders can improve monitoring in some settings, but more intensive and/or prolonged interventions may be required.

Absorbable energy monitoring scheme: new design protocol to test vehicle structural crashworthiness.

PubMed

Ofochebe, Sunday M; Enibe, Samuel O; Ozoegwu, Chigbogu G

2016-05-01

In vehicle crashworthiness design optimization detailed system evaluation capable of producing reliable results are basically achieved through high-order numerical computational (HNC) models such as the dynamic finite element model, mesh-free model etc. However the application of these models especially during optimization studies is basically challenged by their inherent high demand on computational resources, conditional stability of the solution process, and lack of knowledge of viable parameter range for detailed optimization studies. The absorbable energy monitoring scheme (AEMS) presented in this paper suggests a new design protocol that attempts to overcome such problems in evaluation of vehicle structure for crashworthiness. The implementation of the AEMS involves studying crash performance of vehicle components at various absorbable energy ratios based on a 2DOF lumped-mass-spring (LMS) vehicle impact model. This allows for prompt prediction of useful parameter values in a given design problem. The application of the classical one-dimensional LMS model in vehicle crash analysis is further improved in the present work by developing a critical load matching criterion which allows for quantitative interpretation of the results of the abstract model in a typical vehicle crash design. The adequacy of the proposed AEMS for preliminary vehicle crashworthiness design is demonstrated in this paper, however its extension to full-scale design-optimization problem involving full vehicle model that shows greater structural detail requires more theoretical development.

Equitable access to health insurance for socially excluded children? The case of the National Health Insurance Scheme (NHIS) in Ghana.

PubMed

Williams, Gemma A; Parmar, Divya; Dkhimi, Fahdi; Asante, Felix; Arhinful, Daniel; Mladovsky, Philipa

2017-08-01

To help reduce child mortality and reach universal health coverage, Ghana extended free membership of the National Health Insurance Scheme (NHIS) to children (under-18s) in 2008. However, despite the introduction of premium waivers, a substantial proportion of children remain uninsured. Thus far, few studies have explored why enrolment of children in NHIS may remain low, despite the absence of significant financial barriers to membership. In this paper we therefore look beyond economic explanations of access to health insurance to explore additional wider determinants of enrolment in the NHIS. In particular, we investigate whether social exclusion, as measured through a sociocultural, political and economic lens, can explain poor enrolment rates of children. Data were collected from a cross-sectional survey of 4050 representative households conducted in Ghana in 2012. Household indices were created to measure sociocultural, political and economic exclusion, and logistic regressions were conducted to study determinants of enrolment at the individual and household levels. Our results indicate that socioculturally, economically and politically excluded children are less likely to enrol in the NHIS. Furthermore, households excluded in all dimensions were more likely to be non-enrolled or partially-enrolled (i.e. not all children enrolled within the household) than fully-enrolled. These results suggest that equity in access for socially excluded children has not yet been achieved. Efforts should be taken to improve coverage by removing the remaining small, annually renewable registration fee, implementing and publicising the new clause that de-links premium waivers from parental membership, establishing additional scheme administrative offices in remote areas, holding regular registration sessions in schools and conducting outreach sessions and providing registration support to female guardians of children. Ensuring equitable access to NHIS will contribute substantially

Accessing health care in a rural area: an evaluation of a voluntary medical transport scheme in the English Midlands.

PubMed

Sherwood, K B; Lewis, G J

2000-12-01

In recent years notions of self-help and voluntarism have emerged as key elements in the delivery of services in rural England. This paper explores these themes by reference to 'Rural Wheels', a voluntary medical transport scheme in rural Northamptonshire, introduced to overcome the closure of branch surgeries and to provide access to a new medical centre. By focusing upon the organisation and operations of the scheme, the paper highlights the important role it plays in the welfare of rural residents, particularly elderly women. Yet, because effectively it is run by a small core group, the paper raises questions not just about the viability of this scheme but also about the increasing commitment of central government to the voluntary sector as a means of delivering health care to rural people.

Macroinvertebrates as Indicators of Stream Health.

ERIC Educational Resources Information Center

McDonald, Brook S.; And Others

1991-01-01

Describes Ohio's Scenic Rivers Monitoring Program that uses benthic macroinvertebrates, such as the stonefly, mayfly, and water penny beetle larva, as key indicators of water quality and stream health. Presents a three-category scheme for invertebrates based upon their tolerance to pollution. Students can collect samples of these organisms,…

Assessing the catastrophic effects of out-of-pocket healthcare payments prior to the uptake of a nationwide health insurance scheme in Ghana

PubMed Central

Akazili, James; McIntyre, Diane; Kanmiki, Edmund W.; Gyapong, John; Oduro, Abraham; Sankoh, Osman; Ataguba, John E.

2017-01-01

ABSTRACT Background: Financial risk protection against the cost of unforeseen healthcare has gained global attention in recent years. Although Ghana implemented a nationwide health insurance scheme with a goal of reducing financial barriers to accessing healthcare and addressing impoverishing effects of out-of-pocket (OOP) healthcare payments, there is a paucity of knowledge on the extent of financial catastrophe of such payments in Ghana. Thus, this paper assesses the catastrophic effect of OOP healthcare payments in Ghana. Methods: Ghana Living Standard Survey (GLSS 5) data collected in 2005/2006 are used in this study. Catastrophic effect of OOP healthcare payments is assessed using various thresholds of total household expenditure and non-food expenditure. Furthermore, four indices, namely the catastrophic payment headcount, catastrophic payment gap, weighted catastrophic payment headcount and weighted catastrophic payment gap, are defined and computed. Results: As at 2005/2006, it was estimated that 11.0% of households in Ghana spent over 5% of their total household expenditure on healthcare OOP. However, after adjusting for the concentration of such spending, it decreased to 10.9%. Also 10.7% of households spent more than 10% of their non-food consumption expenditure on OOP healthcare payments. Furthermore, about 2.6% of households are observed to have spent in excess of 20% of their total household income on healthcare OOP. With the exception of the 5% threshold of household expenditure, because the concentration indices of these expenditures are negative, the burden of such expenditures rests more on the poor. Conclusions: Significant levels of financial catastrophe existed in Ghana prior to the uptake of the national health insurance scheme. Poorer households were at a higher risk than the relatively well-off households. The results of this study present baseline assessment of the impact of Ghana’s health insurance policy on catastrophic healthcare

Remote health monitoring using mobile phones and Web services.

PubMed

Agarwal, Sparsh; Lau, Chiew Tong

2010-06-01

Diabetes and hypertension have become very common perhaps because of increasingly busy lifestyles, unhealthy eating habits, and a highly competitive workplace. The rapid advancement of mobile communication technologies offers innumerable opportunities for the development of software and hardware applications for remote monitoring of such chronic diseases. This study describes a remote health-monitoring service that provides an end-to-end solution, that is, (1) it collects blood pressure readings from the patient through a mobile phone; (2) it provides these data to doctors through a Web interface; and (3) it enables doctors to manage the chronic condition by providing feedback to the patients remotely. This article also aims at understanding the requirements and expectations of doctors and hospitals from such a remote health-monitoring service.

Measures of Local Segregation for Monitoring Health Inequities by Local Health Departments.

PubMed

Krieger, Nancy; Waterman, Pamela D; Batra, Neelesh; Murphy, Johnna S; Dooley, Daniel P; Shah, Snehal N

2017-06-01

To assess the use of local measures of segregation for monitoring health inequities by local health departments. We analyzed preterm birth and premature mortality (death before the age of 65 years) rates for Boston, Massachusetts, for 2010 to 2012, using the Index of Concentration at the Extremes (ICE) and the poverty rate at both the census tract and neighborhood level. For premature mortality at the census tract level, the rate ratios comparing the worst-off and best-off terciles were 1.58 (95% confidence interval [CI] = 1.36, 1.83) for the ICE for income, 1.66 (95% CI = 1.43, 1.93) for the ICE for race/ethnicity, and 1.63 (95% CI = 1.40, 1.90) for the ICE combining income and race/ethnicity, as compared with 1.47 (95% CI = 1.27, 1.71) for the poverty measure. Results for the ICE and poverty measures were more similar for preterm births than for premature mortality. The ICE, a measure of social spatial polarization, may be useful for analyzing health inequities at the local level. Public Health Implications. Local health departments in US cities can meaningfully use the ICE to monitor health inequities associated with racialized economic segregation.

Assessment strategies for municipal selective waste collection schemes.

PubMed

Ferreira, Fátima; Avelino, Catarina; Bentes, Isabel; Matos, Cristina; Teixeira, Carlos Afonso

2017-01-01

An important strategy to promote a strong sustainable growth relies on an efficient municipal waste management, and phasing out waste landfilling through waste prevention and recycling emerges as a major target. For this purpose, effective collection schemes are required, in particular those regarding selective waste collection, pursuing a more efficient and high quality recycling of reusable materials. This paper addresses the assessment and benchmarking of selective collection schemes, relevant to guide future operational improvements. In particular, the assessment is based on the monitoring and statistical analysis of a core-set of performance indicators that highlights collection trends, complemented with a performance index that gathers a weighted linear combination of these indicators. This combined analysis underlines a potential tool to support decision makers involved in the process of selecting the collection scheme with best overall performance. The presented approach was applied to a case study conducted in Oporto Municipality, with data gathered from two distinct selective collection schemes. Copyright © 2016 Elsevier Ltd. All rights reserved.

In-service health monitoring of composite structures

NASA Technical Reports Server (NTRS)

Pinto, Gino A.; Ventres, C. S.; Ginty, Carol A.; Chamis, Christos C.

1990-01-01

The aerospace industry is witnessing a vast utilization of composites in critical structural applications and anticipates even more use of them in future aircraft. Therefore, a definite need exists for a composite health monitoring expert system to meet today's current needs and tomorrow's future demands. The primary goal for this conceptual health monitoring system is functional reliably for in-service operation in the environments of various composite structures. The underlying philosophy of this system is to utilize proven vibration techniques to assess the structural integrity of a fibrous composite. Statistical methods are used to determine if the variances in the measured data are acceptable for making a reliable decision on the health status of the composite. The flexible system allows for algorithms describing any composite fatigue or damage behavior characteristic to be provided as an input to the system. Alert thresholds and variances can also be provided as an input to this system and may be updated to allow for future changes/refinements in the composite's structural integrity behavior.

Development of a Video Coding Scheme for Analyzing the Usability and Usefulness of Health Information Systems.

PubMed

Kushniruk, Andre W; Borycki, Elizabeth M

2015-01-01

Usability has been identified as a key issue in health informatics. Worldwide numerous projects have been carried out in an attempt to increase and optimize health system usability. Usability testing, involving observing end users interacting with systems, has been widely applied and numerous publications have appeared describing such studies. However, to date, fewer works have been published describing methodological approaches to analyzing the rich data stream that results from usability testing. This includes analysis of video, audio and screen recordings. In this paper we describe our work in the development and application of a coding scheme for analyzing the usability of health information systems. The phases involved in such analyses are described.

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.

Tracking the health of trees over time on forest health monitoring plots

Treesearch

Jim Steinman

2000-01-01

The Forest Health Monitoring (FHM) Program was initiated in 1990 as a cooperative effort between the USDA Forest Service and the National Association of State Foresters. Program efforts include detecting changes in tree health from a national grid of one-sixth acre permanent sample plots. Tree data have been collected in various states since 1991, and include species,...

Tracking the health of trees over time on Forest Health Monitoring plots

Treesearch

Jim Steinman

2000-01-01

The Forest Health Monitoring (FHM) Program was initiated in 1990 as a cooperative effort between the USDA Forest Service and the National Association of State Foresters. Program efforts include detecting changes in tree health from a national grid of one-sixth acre permanent sample plots. Tree data have been collected in various States since 1991, and include species...

CSHM: Web-based safety and health monitoring system for construction management.

PubMed

Cheung, Sai On; Cheung, Kevin K W; Suen, Henry C H

2004-01-01

This paper describes a web-based system for monitoring and assessing construction safety and health performance, entitled the Construction Safety and Health Monitoring (CSHM) system. The design and development of CSHM is an integration of internet and database systems, with the intent to create a total automated safety and health management tool. A list of safety and health performance parameters was devised for the management of safety and health in construction. A conceptual framework of the four key components of CSHM is presented: (a) Web-based Interface (templates); (b) Knowledge Base; (c) Output Data; and (d) Benchmark Group. The combined effect of these components results in a system that enables speedy performance assessment of safety and health activities on construction sites. With the CSHM's built-in functions, important management decisions can theoretically be made and corrective actions can be taken before potential hazards turn into fatal or injurious occupational accidents. As such, the CSHM system will accelerate the monitoring and assessing of performance safety and health management tasks.

Developing Syndromic Surveillance to Monitor and Respond to Adverse Health Events Related to Psychoactive Substance Use: Methods and Applications.

PubMed

Nolan, Michelle L; Kunins, Hillary V; Lall, Ramona; Paone, Denise

Recent increases in drug overdose deaths, both in New York City and nationally, highlight the need for timely data on psychoactive drug-related morbidity. We developed drug syndrome definitions for syndromic surveillance to monitor drug-related emergency department (ED) visits in real time. We used 2012 archived syndromic surveillance data from New York City hospitals to develop definitions for psychoactive drug-related syndromes. The dataset contained ED visit-level information that included patients' chief complaints, dates of visits, ZIP codes of residence, discharge diagnoses, and dispositions. After manually reviewing chief complaints, we developed a classification scheme comprising 3 categories (overdose, drug mention, and drug abuse/misuse), which we used to define 25 psychoactive drug syndromes. From July 2013 through December 2015, the New York City Department of Health and Mental Hygiene performed daily syndromic surveillance of psychoactive drug-related ED visits using the 25 syndrome definitions. Syndromic surveillance triggered 4 public health investigations, supported 8 other public health investigations that had been triggered by other mechanisms, and resulted in the identification of 5 psychoactive drug-related outbreaks. Syndromic surveillance also identified a substantial increase in synthetic cannabinoid-related visits (from an average of 3 per week in January 2014 to >300 per week in July 2015) and an increase in heroin overdose visits (from 80 to 171 in the first 3 quarters of 2012 and 2014, respectively) in a single neighborhood. Syndromic surveillance using these novel definitions enabled monitoring of trends in psychoactive drug-related morbidity, initiation and support of public health investigations, and targeting of interventions. Health departments can refine these definitions for their jurisdictions using the described methods and integrate them into existing syndromic surveillance systems.

Impact of the health insurance scheme for stateless people on inpatient utilization in Kraburi Hospital, Thailand

PubMed Central

Suphanchaimat, Rapeepong; Prakongsai, Phusit; Limwattananon, Supon; Mills, Anne

2016-01-01

Objectives This study sought to investigate the impact of the Thai “Health Insurance for People with Citizenship Problems” (HI-PCP) on access to care for stateless patients, compared to Universal Coverage Scheme patients and the uninsured, using inpatient utilization as a proxy for impact. Methods Secondary data analysis of inpatient records of Kraburi Hospital, Ranong province, between 2009 (pre-policy) and 2012 (post-policy) was employed. Descriptive statistics and multivariate analysis by difference-in-difference model were performed. Results The volume of inpatient service utilization by stateless patients expanded after the introduction of the HI-PCP. However, this increase did not appear to stem from the HI-PCP per se. After controlling for key covariates, including patients’ characteristics, disease condition, and domicile, there was only a weak positive association between the HI-PCP and utilization. Critical factors contributing significantly to increased utilization were older age, proximity to the hospital, and presence of catastrophic illness. Conclusion A potential explanation for the insignificant impact of the HI-PCP on access to inpatient care of stateless patients is likely to be a lack of awareness of the existence of the scheme among the stateless population and local health staff. This problem is likely to have been accentuated by operational constraints in policy implementation, including the poor performance of local offices in registering stateless people. A key limitation of this study is a lack of data on patients who did not visit the health facility at the first opportunity. Further study of health-seeking behavior of stateless people at the household level is recommended. PMID:27942240

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....

Forest health monitoring indicators and their interpretability: a Lithuanian case study

Treesearch

Romualdas Kuknys; Algirdas Augustaitis

1998-01-01

Growth and productivity of forests are important indicators for understanding the general condition and health of forests. It is very important that indicators detected during monitoring procedures afford an opportunity for direct or indirect evaluation of forest productivity and its natural and anthropogenic changes. Analysis of the U.S. Forest Health Monitoring (FHM...

To track or not to track: user reactions to concepts in longitudinal health monitoring.

PubMed

Beaudin, Jennifer S; Intille, Stephen S; Morris, Margaret E

2006-01-01

Advances in ubiquitous computing, smart homes, and sensor technologies enable novel, longitudinal health monitoring applications in the home. Many home monitoring technologies have been proposed to detect health crises, support aging-in-place, and improve medical care. Health professionals and potential end users in the lay public, however, sometimes question whether home health monitoring is justified given the cost and potential invasion of privacy. The aim of the study was to elicit specific feedback from health professionals and laypeople about how they might use longitudinal health monitoring data for proactive health and well-being. Interviews were conducted with 8 health professionals and 26 laypeople. Participants were asked to evaluate mock data visualization displays that could be generated by novel home monitoring systems. The mock displays were used to elicit reactions to longitudinal monitoring in the home setting as well as what behaviors, events, and physiological indicators people were interested in tracking. Based on the qualitative data provided by the interviews, lists of benefits of and concerns about health tracking from the perspectives of the practitioners and laypeople were compiled. Variables of particular interest to the interviewees, as well as their specific ideas for applications of collected data, were documented. Based upon these interviews, we recommend that ubiquitous "monitoring" systems may be more readily adopted if they are developed as tools for personalized, longitudinal self-investigation that help end users learn about the conditions and variables that impact their social, cognitive, and physical health.

An overview: modern techniques for railway vehicle on-board health monitoring systems

NASA Astrophysics Data System (ADS)

Li, Chunsheng; Luo, Shihui; Cole, Colin; Spiryagin, Maksym

2017-07-01

Health monitoring systems with low-cost sensor networks and smart algorithms are always needed in both passenger trains and heavy haul trains due to the increasing need for reliability and safety in the railway industry. This paper focuses on an overview of existing approaches applied for railway vehicle on-board health monitoring systems. The approaches applied in the data measurement systems and the data analysis systems in railway on-board health monitoring systems are presented in this paper, including methodologies, theories and applications. The pros and cons of the various approaches are analysed to determine appropriate benchmarks for an effective and efficient railway vehicle on-board health monitoring system. According to this review, inertial sensors are the most popular due to their advantages of low cost, robustness and low power consumption. Linearisation methods are required for the model-based methods which would inevitably introduce error to the estimation results, and it is time-consuming to include all possible conditions in the pre-built database required for signal-based methods. Based on this review, future development trends in the design of new low-cost health monitoring systems for railway vehicles are discussed.

Low-complexity R-peak detection for ambulatory fetal monitoring.

PubMed

Rooijakkers, Michael J; Rabotti, Chiara; Oei, S Guid; Mischi, Massimo

2012-07-01

Non-invasive fetal health monitoring during pregnancy is becoming increasingly important because of the increasing number of high-risk pregnancies. Despite recent advances in signal-processing technology, which have enabled fetal monitoring during pregnancy using abdominal electrocardiogram (ECG) recordings, ubiquitous fetal health monitoring is still unfeasible due to the computational complexity of noise-robust solutions. In this paper, an ECG R-peak detection algorithm for ambulatory R-peak detection is proposed, as part of a fetal ECG detection algorithm. The proposed algorithm is optimized to reduce computational complexity, without reducing the R-peak detection performance compared to the existing R-peak detection schemes. Validation of the algorithm is performed on three manually annotated datasets. With a detection error rate of 0.23%, 1.32% and 9.42% on the MIT/BIH Arrhythmia and in-house maternal and fetal databases, respectively, the detection rate of the proposed algorithm is comparable to the best state-of-the-art algorithms, at a reduced computational complexity.

Forest health monitoring: national status, trends, and analysis 2016

Treesearch

Kevin M. Potter; Barbara L. Conkling

2017-01-01

The annual national report of the Forest Health Monitoring (FHM) Program of the Forest Service, U.S. Department of Agriculture, presents forest health status and trends from a national or multi-State regional perspective using a variety of sources, introducesnew techniques for analyzing forest health data, and summarizes results of recently completed...

New Authentication Scheme for Wireless Body Area Networks Using the Bilinear Pairing.

PubMed

Wang, Chunzhi; Zhang, Yanmei

2015-11-01

Due to the development of information technologies and network technologies, healthcare systems have been employed in many countries. As an important part of healthcare systems, the wireless body area network (WBAN) could bring convenience to both patients and physicians because it could help physicians to monitor patients' physiological values remotely. It is essential to ensure secure communication in WBANs because patients' physiological values are very sensitive. Recently, Liu et al. proposed an efficient authentication scheme for WBANs. Unfortunately, Zhao pointed out that their scheme suffered from the stolen verifier-table attack. To improve security and efficiency, Zhao proposed an anonymous authentication scheme for WBANs. However, Zhao's scheme cannot provide real anonymity because the users' pseudo identities are constant value and the attack could tract the users. In this paper, we propose a new anonymous authentication scheme for WBANs. Security analysis shows that the proposed scheme could overcome weaknesses in previous scheme. We also use the BAN logic to demonstrate the security of the proposed scheme.

On the security of two remote user authentication schemes for telecare medical information systems.

PubMed

Kim, Kee-Won; Lee, Jae-Dong

2014-05-01

The telecare medical information systems (TMISs) support convenient and rapid health-care services. A secure and efficient authentication scheme for TMIS provides safeguarding patients' electronic patient records (EPRs) and helps health care workers and medical personnel to rapidly making correct clinical decisions. Recently, Kumari et al. proposed a password based user authentication scheme using smart cards for TMIS, and claimed that the proposed scheme could resist various malicious attacks. However, we point out that their scheme is still vulnerable to lost smart card and cannot provide forward secrecy. Subsequently, Das and Goswami proposed a secure and efficient uniqueness-and-anonymity-preserving remote user authentication scheme for connected health care. They simulated their scheme for the formal security verification using the widely-accepted automated validation of Internet security protocols and applications (AVISPA) tool to ensure that their scheme is secure against passive and active attacks. However, we show that their scheme is still vulnerable to smart card loss attacks and cannot provide forward secrecy property. The proposed cryptanalysis discourages any use of the two schemes under investigation in practice and reveals some subtleties and challenges in designing this type of schemes.

A Survey of Current Rotorcraft Propulsion Health Monitoring Technologies

NASA Technical Reports Server (NTRS)

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

2012-01-01

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

Effects of information, education, and communication campaign on a community-based health insurance scheme in Burkina Faso

PubMed Central

Cofie, Patience; De Allegri, Manuela; Kouyaté, Bocar; Sauerborn, Rainer

2013-01-01

Objective The study analysed the effect of Information, Education, and Communication (IEC) campaign activities on the adoption of a community-based health insurance (CHI) scheme in Nouna, Burkina Faso. It also identified the factors that enhanced or limited the campaign's effectiveness. Design Complementary data collection approaches were used. A survey was conducted with 250 randomly selected household heads, followed by in-depth interviews with 22 purposively selected community leaders, group discussions with the project management team, and field observations. Bivariate analysis and multivariate logistic regression models were used to assess the association between household exposure to campaign and acquisition of knowledge as well as household exposure to campaign and enrolment. Results The IEC campaign had a positive effect on households’ knowledge about the CHI and to a lesser extent on household enrolment in the scheme. The effectiveness of the IEC strategy was mainly influenced by: (1) frequent and consistent IEC messages from multiple media channels (mass and interpersonal channels), including the radio, a mobile information van, and CHI team, and (2) community heads’ participation in the CHI scheme promotion. Education was the only significantly influential socio-demographic determinant of knowledge and enrolment among household heads. The relatively low effects of the IEC campaign on CHI enrolment are indicative of other important IEC mediating factors, which should be taken into account in future CHI campaign evaluation. Conclusion The study concludes that an IEC campaign is crucial to improving the understanding of the CHI scheme concept, which is an enabler to enrolment, and should be integrated into scheme designs and evaluations. PMID:24314344

Effects of information, education, and communication campaign on a community-based health insurance scheme in Burkina Faso.

PubMed

Cofie, Patience; De Allegri, Manuela; Kouyaté, Bocar; Sauerborn, Rainer

2013-12-06

The study analysed the effect of Information, Education, and Communication (IEC) campaign activities on the adoption of a community-based health insurance (CHI) scheme in Nouna, Burkina Faso. It also identified the factors that enhanced or limited the campaign's effectiveness. Complementary data collection approaches were used. A survey was conducted with 250 randomly selected household heads, followed by in-depth interviews with 22 purposively selected community leaders, group discussions with the project management team, and field observations. Bivariate analysis and multivariate logistic regression models were used to assess the association between household exposure to campaign and acquisition of knowledge as well as household exposure to campaign and enrolment. The IEC campaign had a positive effect on households' knowledge about the CHI and to a lesser extent on household enrolment in the scheme. The effectiveness of the IEC strategy was mainly influenced by: (1) frequent and consistent IEC messages from multiple media channels (mass and interpersonal channels), including the radio, a mobile information van, and CHI team, and (2) community heads' participation in the CHI scheme promotion. Education was the only significantly influential socio-demographic determinant of knowledge and enrolment among household heads. The relatively low effects of the IEC campaign on CHI enrolment are indicative of other important IEC mediating factors, which should be taken into account in future CHI campaign evaluation. The study concludes that an IEC campaign is crucial to improving the understanding of the CHI scheme concept, which is an enabler to enrolment, and should be integrated into scheme designs and evaluations.

An intelligent health monitoring system using radio-frequency identification technology.

PubMed

Lai, Yeong-Lin; Chen, Chin-Ling; Chang, Ching-Hisang; Hsu, Chih-Yu; Lai, Yeong-Kang; Tseng, Kuo-Kun; Chen, Chih-Cheng; Zheng, Chun-Yi

2015-01-01

Long-term care (LTC) for the elderly has become extremely important in recent years. It is necessary for the different physiological monitoring systems to be integrated on the same interface to help oversee and manage the elderly's needs. This paper presents a novel health monitoring system for LTC services using radio-frequency identification (RFID) technology. Dual-band RFID protocols were included in the system, in which the high-frequency (HF) band of 13.56 MHz was used to identify individuals and the microwave band of 2.45 GHz was used to monitor physiological information. Distinct physiological data, including oxyhemoglobin saturation by pulse oximetry (SpO2), blood pressure, blood sugar, electrocardiogram (ECG) readings, body temperature, and respiration rate, were monitored by various biosensors. The intelligent RFID health monitoring system provided the features of the real-time acquisition of biomedical signals and the identification of personal information pertaining to the elderly and patients in nursing homes.

Validity and reliability of the South African health promoting schools monitoring questionnaire

PubMed Central

Struthers, Patricia; de Koker, Petra; Lerebo, Wondwossen; Blignaut, Renette J.

2017-01-01

Summary Health promoting schools, as conceptualised by the World Health Organisation, have been developed in many countries to facilitate the health-education link. In 1994, the concept of health promoting schools was introduced in South Africa. In the process of becoming a health promoting school, it is important for schools to monitor and evaluate changes and developments taking place. The Health Promoting Schools (HPS) Monitoring Questionnaire was developed to obtain opinions of students about their school as a health promoting school. It comprises 138 questions in seven sections: socio-demographic information; General health promotion programmes; health related Skills and knowledge; Policies; Environment; Community-school links; and support Services. This paper reports on the reliability and face validity of the HPS Monitoring Questionnaire. Seven experts reviewed the questionnaire and agreed that it has satisfactory face validity. A test-retest reliability study was conducted with 83 students in three high schools in Cape Town, South Africa. The kappa-coefficients demonstrate mostly fair (κ-scores between 0.21 and 0.4) to moderate (κ-scores between 0.41 and 0.6) agreement between test-retest General and Environment items; poor (κ-scores up to 0.2) agreement between Skills and Community test-retest items, fair agreement between Policies items, and for most of the questions focussing on Services a fair agreement was found. The study is a first effort at providing a tool that may be used to monitor and evaluate students’ opinions about changes in health promoting schools. Although the HPS Monitoring Questionnaire has face validity, the results of the reliability testing were inconclusive. Further research is warranted. PMID:27694227

Validity and reliability of the South African health promoting schools monitoring questionnaire.

PubMed

Struthers, Patricia; Wegner, Lisa; de Koker, Petra; Lerebo, Wondwossen; Blignaut, Renette J

2017-04-01

Health promoting schools, as conceptualised by the World Health Organisation, have been developed in many countries to facilitate the health-education link. In 1994, the concept of health promoting schools was introduced in South Africa. In the process of becoming a health promoting school, it is important for schools to monitor and evaluate changes and developments taking place. The Health Promoting Schools (HPS) Monitoring Questionnaire was developed to obtain opinions of students about their school as a health promoting school. It comprises 138 questions in seven sections: socio-demographic information; General health promotion programmes; health related Skills and knowledge; Policies; Environment; Community-school links; and support Services. This paper reports on the reliability and face validity of the HPS Monitoring Questionnaire. Seven experts reviewed the questionnaire and agreed that it has satisfactory face validity. A test-retest reliability study was conducted with 83 students in three high schools in Cape Town, South Africa. The kappa-coefficients demonstrate mostly fair (κ-scores between 0.21 and 0.4) to moderate (κ-scores between 0.41 and 0.6) agreement between test-retest General and Environment items; poor (κ-scores up to 0.2) agreement between Skills and Community test-retest items, fair agreement between Policies items, and for most of the questions focussing on Services a fair agreement was found. The study is a first effort at providing a tool that may be used to monitor and evaluate students' opinions about changes in health promoting schools. Although the HPS Monitoring Questionnaire has face validity, the results of the reliability testing were inconclusive. Further research is warranted. © The Author 2016. Published by Oxford University Press.

Smart sensor systems for human health breath monitoring applications.

PubMed

Hunter, G W; Xu, J C; Biaggi-Labiosa, A M; Laskowski, D; Dutta, P K; Mondal, S P; Ward, B J; Makel, D B; Liu, C C; Chang, C W; Dweik, R A

2011-09-01

Breath analysis techniques offer a potential revolution in health care diagnostics, especially if these techniques can be brought into standard use in the clinic and at home. The advent of microsensors combined with smart sensor system technology enables a new generation of sensor systems with significantly enhanced capabilities and minimal size, weight and power consumption. This paper discusses the microsensor/smart sensor system approach and provides a summary of efforts to migrate this technology into human health breath monitoring applications. First, the basic capability of this approach to measure exhaled breath associated with exercise physiology is demonstrated. Building from this foundation, the development of a system for a portable asthma home health care system is described. A solid-state nitric oxide (NO) sensor for asthma monitoring has been identified, and efforts are underway to miniaturize this NO sensor technology and integrate it into a smart sensor system. It is concluded that base platform microsensor technology combined with smart sensor systems can address the needs of a range of breath monitoring applications and enable new capabilities for healthcare.

Forest health monitoring: national status, trends, and analysis 2013

Treesearch

Kevin M. Potter; Barbara L. Conkling

2015-01-01

The annual national report of the Forest Health Monitoring (FHM) Program of the Forest Service, U.S. Department of Agriculture, presents forest health status and trends from a national or multi-State regional perspective using a variety of sources, introduces new techniques for analyzing forest health data, and summarizes results of recently completed Evaluation...

Forest Health Monitoring: national status, trends, and analysis 2014

Treesearch

Kevin M. Potter; Barbara L. Conkling

2015-01-01

The annual national report of the Forest Health Monitoring (FHM) Program of the Forest Service, U.S. Department of Agriculture, presents forest health status and trends from a national or multi-State regional perspective using a variety of sources, introduces new techniques for analyzing forest health data, and summarizes results of recently completed Evaluation...

Forest health monitoring: national status, trends, and analysis 2017

Treesearch

Kevin M. Potter; Barbara L. Conkling

2018-01-01

The annual national report of the Forest Health Monitoring (FHM) Program of the Forest Service, U.S. Department of Agriculture, presents forest health status and trends from a national or multi-State regional perspective using a variety of sources, introduces new techniques for analyzing forest health data, and summarizes results of recently completed Evaluation...

Novel railway-subgrade vibration monitoring technology using phase-sensitive OTDR

NASA Astrophysics Data System (ADS)

Wang, Zhaoyong; Lu, Bin; Zheng, Hanrong; Ye, Qing; Pan, Zhengqing; Cai, Haiwen; Qu, Ronghui; Fang, Zujie; Zhao, Howell

2017-04-01