Design options for sample-based mortality surveillance

Background Reliable information on causes of death is a fundamental component of health development strategies, yet globally only about one-third of countries have access to such information. For countries currently without adequate mortality reporting systems there are useful models other than resource-intensive population-wide medical certification. Sample-based mortality surveillance is one such approach. This paper provides methods for addressing appropriate sample size considerations in relation to mortality surveillance, with particular reference to situations in which prior information on mortality is lacking. Methods The feasibility of model-based approaches for predicting the expected mortality structure and cause composition is demonstrated for populations in which only limited empirical data is available. An algorithm approach is then provided to derive the minimum person-years of observation needed to generate robust estimates for the rarest cause of interest in three hypothetical populations, each representing different levels of health development. Results Modelled life expectancies at birth and cause of death structures were within expected ranges based on published estimates for countries at comparable levels of health development. Total person-years of observation required in each population could be more than halved by limiting the set of age, sex, and cause groups regarded as 'of interest'. Discussion The methods proposed are consistent with the philosophy of establishing priorities across broad clusters of causes for which the public health response implications are similar. The examples provided illustrate the options available when considering the design of mortality surveillance for population health monitoring purposes.

Problem-based learning: a case study in providing e-health education using the Internet

The current trend among many universities is to increase the number of courses available online. However, there are fundamental problems in transferring traditional education courses to virtual formats. Delivering current curricula in an online format does not assist in overcoming the negative effects on student motivation which are inherent in providing information passively. Using problem-based learning (PBL) online is a method by which computers can become a tool to encourage active learning among students. The delivery of curricula via goal-based scenarios allows students to learn at different rates and can successfully shift online learning from memorization to discovery. This paper reports on a Web-based e-health course that has been delivered via PBL for the past 12 months. Thirty distance-learning students undertook postgraduate courses in e-health delivered via the Internet (asynchronous communication). Data collected via online student surveys indicated that the PBL format was both flexible and interesting. PBL has the potential to increase the quality of the educational experience of students in online environments.

Risk-based maintenance model for offshore oil and gas pipelines:a case study

Offshore oil and gas pipelines are vulnerable to environment as any leak and burst in pipelines cause oil/gas spill resulting in huge negative Impacts on marine lives. Breakdown maintenance of these pipelines is also cost-intensive and time-consuming resulting in huge tangible and intangible loss to the pipeline operators. Pipelines health monitoring and integrity analysis have been researched a lot for successful pipeline operations and risk-based maintenance model is one of the outcomes of those researches. This study develops a risk-based maintenance model using a combined multiple-criteria decision-making and weight method for offshore oil and gas pipelines in Thailand with the active participation of experienced executives. The model's effectiveness has been demonstrated through real life application on oil and gas pipelines in the Gulf of Thailand. Practical implications. Risk-based inspection and maintenance methodology is particularly important for oil pipelines system, as any failure in the system will not only affect productivity negatively but also has tremendous negative environmental impact. The proposed model helps the pipelines operators to analyze the health of pipelines dynamically, to select specific inspection and maintenance method for specific section in line with its probability and severity of failure.

A risk-based model for inspection and maintenance of cross-country petroleum pipeline

The existing method of pipeline health monitoring, which requires an entire pipeline to be inspected periodically, is both time-wasting and expensive. A risk-based model that reduces the amount of time spent on inspection has been presented. This model not only reduces the cost of maintaining petroleum pipelines, but also suggests efficient design and operation philosophy, construction methodology and logical insurance plans. The risk-based model uses Analytic Hierarchy Process (AHP), a multiple attribute decision-making technique, to identify the factors that influence failure on specific segments and analyzes their effects by determining probability of risk factors. The severity of failure is determined through consequence analysis. From this, the effect of a failure caused by each risk factor can be established in terms of cost, and the cumulative effect of failure is determined through probability analysis. The technique does not totally eliminate subjectivity, but it is an improvement over the existing inspection method.

The corporatization of community pharmacy:implications for service provision, the public health function, and pharmacy's claims to professional status in the United Kingdom

Background Pharmacy has experienced both incomplete professionalization and deprofessionalization. Since the late 1970s, a concerted attempt has been made to re-professionalize pharmacy in the United Kingdom (UK) through role extension—a key feature of which has been a drive for greater pharmacy involvement in public health. However, the continual corporatization of the UK community pharmacy sector may reduce the professional autonomy of pharmacists and may threaten to constrain attempts at reprofessionalization. Objectives The objectives of the research: to examine the public health activities of community pharmacists in the UK; to explore the attitudes of community pharmacists toward recent relevant UK policy and barriers to the development of their public health function; and, to investigate associations between activity, attitudes, and the type of community pharmacy worked in (eg, supermarket, chain, independent). Methods A self-completion postal questionnaire was sent to a random sample of practicing community pharmacists, stratified for country and sex, within Great Britain (n = 1998), with a follow-up to nonresponders 4 weeks later. Data were analyzed using SPSS (SPSS Inc., Chicago, IL, USA) (v12.0). A final response rate of 51% (n = 1023/1998) was achieved. Results The level of provision of emergency hormonal contraception on a patient group direction, supervised administration of medicines, and needle-exchange schemes was lower in supermarket pharmacies than in the other types of pharmacy. Respondents believed that supermarkets and the major multiple pharmacy chains held an advantageous position in terms of attracting financing for service development despite suggesting that the premises of such pharmacies may not be the most suitable for the provision of such services. Conclusions A mixed market in community pharmacy may be required to maintain a comprehensive range of pharmacy-based public health services and provide maximum benefit to all patients. Longitudinal monitoring is recommended to ensure that service provision is adequate across the pharmacy network.

High stress monitoring of prestressing tendons in nuclear concrete vessels using fibre-optic sensors

Maintaining the structural health of prestressed concrete nuclear containments is a key element in ensuring nuclear reactors are capable of meeting their safety requirements. This paper discusses the attachment, fabrication and characterisation of optical fibre strain sensors suitable for the prestress monitoring of irradiated steel prestressing tendons. The all-metal fabrication and welding process allowed the instrumented strand to simultaneously monitor and apply stresses up to 1300 MPa (80% of steel's ultimate tensile strength). There were no adverse effects to the strand's mechanical properties or integrity. After sensor relaxation through cyclic stress treatment, strain transfer between the optical fibre sensors and the strand remained at 69%. The fibre strain sensors could also withstand the non-axial forces induced as the strand was deflected around a 4.5 m bend radius. Further development of this technology has the potential to augment current prestress monitoring practices, allowing distributed measurements of short- and long-term prestress losses in nuclear prestressed-concrete vessels. © 2014 Elsevier B.V.

Model of Active Structural Monitoring and Decision-making for Dynamic Identification of Buildings, Monuments and Engineering Facilities

Structural monitoring and dynamic identification of the manmade and natural hazard objects is under consideration. Math model of testing object by set of weak stationary dynamic actions is offered. The response of structures to the set of signals is under processing for getting important information about object condition in high frequency band. Making decision procedure into active monitoring system is discussed as well. As an example the monitoring outcome of pillar-type monument is given.

Optimum wireless power transmission for sensors embedded in concrete

Various nondestructive testing (NDT) technologies for construction and performance monitoring have been studied for decades. Recently, the rapid evolution of wireless sensor network (WSN) technologies has enabled the development of sensors that can be embedded in concrete to monitor the structural health of infrastructure. Such sensors can be buried inside concrete and they can collect and report valuable volumetric data related to the health of a structure during and/or after construction. Wireless embedded sensors monitoring system is also a promising solution for decreasing the high installation and maintenance cost of the conventional wire based monitoring systems. Wireless monitoring sensors need to operate for long time. However, sensor batteries have finite life-time. Therefore, in order to enable long operational life of wireless sensors, novel wireless powering methods, which can charge the sensors’ rechargeable batteries wirelessly, need to be developed. The optimization of RF wireless powering of sensors embedded in concrete is studied here. First, our analytical results focus on calculating the transmission loss and propagation loss of electromagnetic waves penetrating into plain concrete at different humidity conditions for various frequencies. This analysis specifically leads to the identification of an optimum frequency range within 20–80 MHz that is validated through full-wave electromagnetic simulations. Second, the effects of various reinforced bar configurations on the efficiency of wireless powering are investigated. Specifically, effects of the following factors are studied: rebar types, rebar period, rebar radius, depth inside concrete, and offset placement. This analysis leads to the identification of the 902–928 MHz ISM band as the optimum power transmission frequency range for sensors embedded in reinforced concrete, since antennas working in this band are less sensitive to the effects of varying humidity as well as rebar configurations. Finally, optimized rectennas are designed for receiving and/or harvesting power in order to charge the rechargeable batteries of the embedded sensors. Such optimized wireless powering systems exhibit significantly larger efficiencies than the efficiencies of conventional RF wireless powering systems for sensors embedded in plain or reinforced concrete.

Lessons from monitoring the performance of highway bridges

Peer reviewed

Lessons from monitoring the performance of highway bridges

Peer reviewed

Two-Path All-pass Based Half-Band Infinite Impulse Response Decimation Filters and the Effects of Their Non-Linear Phase Response on ECG Signal Acquisition

This paper is based on the novel use of a very high fidelity decimation filter chain for Electrocardiogram (ECG) signal acquisition and data conversion. The multiplier-free and multi-stage structure of the proposed filters lower the power dissipation while minimizing the circuit area which are crucial design constraints to the wireless noninvasive wearable health monitoring products due to the scarce operational resources in their electronic implementation. The decimation ratio of the presented filter is 128, working in tandem with a 1-bit 3rd order Sigma Delta (ΣΔ) modulator which achieves 0.04 dB passband ripples and -74 dB stopband attenuation. The work reported here investigates the non-linear phase effects of the proposed decimation filters on the ECG signal by carrying out a comparative study after phase correction. It concludes that the enhanced phase linearity is not crucial for ECG acquisition and data conversion applications since the signal distortion of the acquired signal, due to phase non-linearity, is insignificant for both original and phase compensated filters. To the best of the authors’ knowledge, being free of signal distortion is essential as this might lead to misdiagnosis as stated in the state of the art. This article demonstrates that with their minimal power consumption and minimal signal distortion features, the proposed decimation filters can effectively be employed in biosignal data processing units.

Recruiting faith and non-faith based schools, adolescents and parents to a cluster randomised sexual-health trial: experiences, challenges and lessons from the mixed-methods Jack Feasibility Trial

Background: The move toward evidence-based education has led to increasing numbers of randomised trials in schools. However, the literature on recruitment to non-clinical trials is relatively underdeveloped, when compared to that of clinical trials. Recruitment to school-based randomised trials is, however, challenging; even more so when the focus of the study is a sensitive issue such as sexual health. This article reflects on the challenges of recruiting post-primary schools, adolescent pupils and parents to a cluster randomised feasibility trial of a sexual health intervention, and the strategies employed to address them.
Methods: The Jack Trial was funded by the UK National Institute for Health Research (NIHR). It comprised a feasibility study of an interactive film-based sexual health intervention entitled If I Were Jack, recruiting over 800 adolescents from eight socio-demographically diverse post-primary schools in Northern Ireland. It aimed to determine the facilitators and barriers to recruitment and retention to a school-based sexual health trial and identify optimal multi-level strategies for an effectiveness study. As part of an embedded process evaluation, we conducted semi-structured interviews and focus groups with principals, vice-principals, teachers, pupils and parents recruited to the study as well as classroom observations and a parents’ survey.
Results: With reference to Social Learning Theory, we identified a number of individual, behavioural and environmental level factors which influenced recruitment. Commonly identified facilitators included perceptions of the relevance and potential benefit of the intervention to adolescents, the credibility of the organisation and individuals running the study, support offered by trial staff, and financial incentives. Key barriers were prior commitment to other research, lack of time and resources, and perceptions that the intervention was incompatible with pupil or parent needs or the school ethos.
Conclusions: Reflecting on the methodological challenges of recruiting to a school-based sexual health feasibility trial, this study highlights pertinent general and trial-specific facilitators and barriers to recruitment, which will prove useful for future trials with schools, adolescent pupils and parents.

IoT Based Pain Management using Physiological Parameters

The continuous technology evaluation is benefiting our lives to a great extent. The evolution of Internet of things and deployment of wireless sensor networks is making it possible to have more connectivity between people and devices used extensively in our daily lives. Almost every discipline of daily life including health sector, transportation, agriculture etc. is benefiting from these technologies. There is a great potential of research and refinement of health sector as the current system is very often dependent on manual evaluations conducted by the clinicians. There is no automatic system for patient health monitoring and assessment which results to incomplete and less reliable heath information. Internet of things has a great potential to benefit health care applications by automated and remote assessment, monitoring and identification of diseases. Acute pain is the main cause of people visiting to hospitals. An automatic pain detection system based on internet of things with wireless devices can make the assessment and redemption significantly more efficient. The contribution of this research work is proposing pain assessment method based on physiological parameters. The physiological parameters chosen for this study are heart rate, electrocardiography, breathing rate and galvanic skin response. As a first step, the relation between these physiological parameters and acute pain experienced by the test persons is evaluated. The electrocardiography data collected from the test persons is analyzed to extract interbeat intervals. This evaluation clearly demonstrates specific patterns and trends in these parameters as a consequence of pain. This parametric behavior is then used to assess and identify the pain intensity by implementing machine learning algorithms. Support vector machines are used for classifying these parameters influenced by different pain intensities and classification results are achieved. The classification results with good accuracy rates between two and three levels of pain intensities shows clear indication of pain and the feasibility of this pain assessment method. An improved approach on the basis of this research work can be implemented by using both physiological parameters and electromyography data of facial muscles for classification.

Flexible Sensor for Wearable Vital Sign Monitoring System

In modern society, the body health is a very important issue to everyone. With the development of the science and technology, the new and developed body health monitoring device and technology will play the key role in the daily medical activities. This paper focus on making progress in the design of the wearable vital sign system. A vital sign monitoring system has been proposed and designed. The whole detection system is composed of signal collecting subsystem, signal processing subsystem, short-range wireless communication subsystem and user interface subsystem. The signal collecting subsystem is composed of light source and photo diode, after emiting light of two different wavelength, the photo diode collects the light signal reflected by human body tissue. The signal processing subsystem is based on the analog front end AFE4490 and peripheral circuits, the collected analog signal would be filtered and converted into digital signal in this stage. After a series of processing, the signal would be transmitted to the short-range wireless communication subsystem through SPI, this subsystem is mainly based on Bluetooth 4.0 protocol and ultra-low power System on Chip(SoC) nRF51822. Finally, the signal would be transmitted to the user end. After proposing and building the system, this paper focus on the research of the key component in the system, that is, the photo detector. Based on the study of the perovskite materials, a low temperature processed photo detector has been proposed, designed and researched. The device is made up of light absorbing layer, electron transporting and hole blocking layer, hole transporting and electron blocking layer, conductive substrate layer and metal electrode layer. The light absorbing layer is the important part of whole device, and it is fabricated by perovskite materials. After accepting the light, the electron-hole pair would be produced in this layer, and due to the energy level difference, the electron and hole produced would be transmitted to metal electrode and conductive substrate electrode through electron transporting layer and hole transporting layer respectively. In this way the response current would be produced. Based on this structure, the specific fabrication procedure including substrate cleaning; PEDOT:PSS layer preparation; pervoskite layer preparation; PCBM layer preparation; C60, BCP, and Ag electrode layer preparation. After the device fabrication, a series of morphological characterization and performance testing has been done. The testing procedure including film-forming quality inspection, response current and light wavelength analysis, linearity and response time and other optical and electrical properties testing. The testing result shows that the membrane has been fabricated uniformly; the device can produce obvious response current to the incident light with the wavelength from 350nm to 800nm, and the response current could be changed along with the light wavelength. When the light wavelength keeps constant, there exists a good linear relationship between the intensity of the response current and the power of the incident light, based on which the device could be used as the photo detector to collect the light information. During the changing period of the light signal, the response time of the device is several microseconds, which is acceptable working as a photo detector in our system. The testing results show that the device has good electronic and optical properties, and the fabrication procedure is also repeatable, the properties of the devices has good uniformity, which illustrates the fabrication method and procedure could be used to build the photo detector in our wearable system. Based on a series of testing results, the paper has drawn the conclusion that the photo detector fabricated could be integrated on the flexible substrate and is also suitable for the monitoring system proposed, thus made some progress on the research of the wearable monitoring system and device. Finally, some future prospect in system design aspect and device design and fabrication aspect are proposed.