938 resultados para Field of Healthcare


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Diffraction gratings are not always ideal but, due to the fabrication process, several errors can be produced. In this work we show that when the strips of a binary phase diffraction grating present certain randomness in their height, the intensity of the diffraction orders varies with respect to that obtained with a perfect grating. To show this, we perform an analysis of the mutual coherence function and then, the intensity distribution at the far field is obtained. In addition to the far field diffraction orders, a "halo" that surrounds the diffraction order is found, which is due to the randomness of the strips height.

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The goal of my Ph.D. thesis is to enhance the visualization of the peripheral retina using wide-field optical coherence tomography (OCT) in a clinical setting.

OCT has gain widespread adoption in clinical ophthalmology due to its ability to visualize the diseases of the macula and central retina in three-dimensions, however, clinical OCT has a limited field-of-view of 300. There has been increasing interest to obtain high-resolution images outside of this narrow field-of-view, because three-dimensional imaging of the peripheral retina may prove to be important in the early detection of neurodegenerative diseases, such as Alzheimer's and dementia, and the monitoring of known ocular diseases, such as diabetic retinopathy, retinal vein occlusions, and choroid masses.

Before attempting to build a wide-field OCT system, we need to better understand the peripheral optics of the human eye. Shack-Hartmann wavefront sensors are commonly used tools for measuring the optical imperfections of the eye, but their acquisition speed is limited by their underlying camera hardware. The first aim of my thesis research is to create a fast method of ocular wavefront sensing such that we can measure the wavefront aberrations at numerous points across a wide visual field. In order to address aim one, we will develop a sparse Zernike reconstruction technique (SPARZER) that will enable Shack-Hartmann wavefront sensors to use as little as 1/10th of the data that would normally be required for an accurate wavefront reading. If less data needs to be acquired, then we can increase the speed at which wavefronts can be recorded.

For my second aim, we will create a sophisticated optical model that reproduces the measured aberrations of the human eye. If we know how the average eye's optics distort light, then we can engineer ophthalmic imaging systems that preemptively cancel inherent ocular aberrations. This invention will help the retinal imaging community to design systems that are capable of acquiring high resolution images across a wide visual field. The proposed model eye is also of interest to the field of vision science as it aids in the study of how anatomy affects visual performance in the peripheral retina.

Using the optical model from aim two, we will design and reduce to practice a clinical OCT system that is capable of imaging a large (800) field-of-view with enhanced visualization of the peripheral retina. A key aspect of this third and final aim is to make the imaging system compatible with standard clinical practices. To this end, we will incorporate sensorless adaptive optics in order to correct the inter- and intra- patient variability in ophthalmic aberrations. Sensorless adaptive optics will improve both the brightness (signal) and clarity (resolution) of features in the peripheral retina without affecting the size of the imaging system.

The proposed work should not only be a noteworthy contribution to the ophthalmic and engineering communities, but it should strengthen our existing collaborations with the Duke Eye Center by advancing their capability to diagnose pathologies of the peripheral retinal.

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This research assesses the impact of user charges in the context of consumer choice to ascertain how user charges in healthcare impact on patient behaviour in Ireland. Quantitative data is collected from a subset of the population in walk-in Urgent Care Clinics and General Practitioner surgeries to assess their responses to user charges and whether user charges are a viable source of part-funding healthcare in Ireland. Examining the economic theories of Becker (1965) and Grossman (1972), the research has assessed the impact of user charges on patient choice in terms of affordability and accessibility in healthcare. The research examined a number of private, public and part-publicly funded healthcare services in Ireland for which varying levels of user charges exist depending on patients’ healthcare cover. Firstly, the study identifies the factors affecting patient choice of privately funded walk-in Urgent Care Clinics in Ireland given user charges. Secondly, the study assesses patient response to user charges for a mainly public or part-publicly provided service; prescription drugs. Finally, the study examines patients’ attitudes towards the potential application of user charges for both public and private healthcare services when patient choice is part of a time-money trade-off, convenience choice or preference choice. These services are valued in the context of user charges becoming more prevalent in healthcare systems over time. The results indicate that the impact of user charges on healthcare services vary according to socio-economic status. The study shows that user charges can disproportionately affect lower income groups and consequently lead to affordability and accessibility issues. However, when valuing the potential application of user charges for three healthcare services (MRI scans, blood tests and a branded over a generic prescription drug), this research indicates that lower income individuals are willing to pay for healthcare services, albeit at a lower user charge than higher income earners. Consequently, this study suggests that user charges may be a feasible source of part-financing Irish healthcare, once the user charge is determined from the patients’ perspective, taking into account their ability to pay.

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The purpose of this study was to test Lotka’s law of scientific publication productivity using the methodology outlined by Pao (1985), in the field of Library and Information Studies (LIS). Lotka’s law has been sporadically tested in the field over the past 30+ years, but the results of these studies are inconclusive due to the varying methods employed by the researchers. A data set of 1,856 citations that were found using the ISI Web of Knowledge databases were studied. The values of n and c were calculated to be 2.1 and 0.6418 (64.18%) respectively. The Kolmogorov-Smirnov (K-S) one sample goodness-of-fit test was conducted at the 0.10 level of significance. The Dmax value is 0.022758 and the calculated critical value is 0.026562. It was determined that the null hypothesis stating that there is no difference in the observed distribution of publications and the distribution obtained using Lotka’s and Pao’s procedure could not be rejected. This study finds that literature in the field of library and Information Studies does conform to Lotka’s law with reliable results. As result, Lotka’s law can be used in LIS as a standardized means of measuring author publication productivity which will lead to findings that are comparable on many levels (e.g., department, institution, national). Lotka’s law can be employed as an empirically proven analytical tool to establish publication productivity benchmarks for faculty and faculty librarians. Recommendations for further study include (a) exploring the characteristics of the high and low producers; (b) finding a way to successfully account for collaborative contributions in the formula; and, (c) a detailed study of institutional policies concerning publication productivity and its impact on the appointment, tenure and promotion process of academic librarians.

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Introduction and background: Survival following critical illness is associated with a significant burden of physical, emotional and psychosocial morbidity. Recovery can be protracted and incomplete, with important and sustained effects upon everyday life, including family life, social participation and return to work. In stark contrast with other critically ill patient groups (eg, those following cardiothoracic surgery), there are comparatively few interventional studies of rehabilitation among the general intensive care unit patient population. This paper outlines the protocol for a sub study of the RECOVER study: a randomised controlled trial evaluating a complex intervention of enhanced ward-based rehabilitation for patients following discharge from intensive care. Methods and analysis: The RELINQUISH study is a nested longitudinal, qualitative study of family support and perceived healthcare needs among RECOVER participants at key stages of the recovery process and at up to 1 year following hospital discharge. Its central premise is that recovery is a dynamic process wherein patients’ needs evolve over time. RELINQUISH is novel in that we will incorporate two parallel strategies into our data analysis: (1) a pragmatic health services-oriented approach, using an a priori analytical construct, the ‘Timing it Right’ framework and (2) a constructivist grounded theory approach which allows the emergence of new themes and theoretical understandings from the data. We will subsequently use Qualitative Health Needs Assessment methodology to inform the development of timely and responsive healthcare interventions throughout the recovery process. Ethics and dissemination: The protocol has been approved by the Lothian Research Ethics Committee (protocol number HSRU011). The study has been added to the UK Clinical Research Network Database (study ID. 9986). The authors will disseminate the findings in peer reviewed publications and to relevant critical care stakeholder groups.

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International audience

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Background; Approach and Concept; Methods (Country reviews; Definition of Good Practice Criteria; Identification of Good Practice Examples; Identification of transferable practices / elements); Outputs

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Associated Partners in the Work Package 5: National Health Institute Doutor Ricardo Jorge (INSA), Portugal (Luciana Costa)

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We present a high resolution spectrometer consisting of dual solid Fabry-Perot Interferometers (FPIs). This work is intended to be an all inclusive documentation of the instrument including discussion of the design of this instrument, the methods used in data reduction, and the analysis of these data. Each FPI is made of a single piece of L-BBH2 glass which has a high index of refraction n~2.07 with a thickness on the order of 100 μm. Each is then coated with partially reflective mirrors to create a resonant cavity and thus achieve a spectral resolution of R~30,000. Running the FPIs in tandem reduces the overlapping orders and allows for a much wider free spectral range and higher contrast. We will also discuss the properties of the FPIs which we have measured. This includes the tuning of the FPIs which is achieved by adjusting the temperature and thus changing the FPI gap and the refractive index of the material. The spectrometer then moves spatially in order to get spectral information at every point in the field of view. We select spectral lines for further analysis and create maps of the line depths across the field. Using this technique we are able to measure the fluorescence of chlorophyll in plants and attempt to observe zodiacal light. In the chlorophyll analysis we are able to detect chlorophyll fluorescence using the line depth in a plant using the sky as a reference solar spectrum. This instrument has possible applications in either a cubesat or aerial observations to measure bulk plant activity over large areas.

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In this work, we propose an inexpensive laboratory practice for an introductory physics course laboratory for any grade of science and engineering study. This practice was very well received by our students, where a smartphone (iOS, Android, or Windows) is used together with mini magnets (similar to those used on refrigerator doors), a 20 cm long school rule, a paper, and a free application (app) that needs to be downloaded and installed that measures magnetic fields using the smartphone's magnetic field sensor or magnetometer. The apps we have used are: Magnetometer (iOS), Magnetometer Metal Detector, and Physics Toolbox Magnetometer (Android). Nothing else is needed. Cost of this practice: free. The main purpose of the practice is that students determine the dependence of the component x of the magnetic field produced by different magnets (including ring magnets and sphere magnets). We obtained that the dependency of the magnetic field with the distance is of the form x-3, in total agreement with the theoretical analysis. The secondary objective is to apply the technique of least squares fit to obtain this exponent and the magnetic moment of the magnets, with the corresponding absolute error.

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Aim: The purpose of the present study was to determine the impact of digitization in healthcare on health workers' perceptions in Armed Forces Hospital, Taif. Methodology: A quantitative descriptive design based on deductive approach was used in the study. 370 participants employed in Armed Force hospitals in Taif were recruited based on convenience sampling. A survey was distributed among participants to collect demographic data and data on digitization benefits, challenges, and status and perceptions of health workers. The collected responses were then entered into SPSS software for performing descriptive stats, ANOVA test and regression analysis to determine the relationship between research variables. Results: The demographic results showed more male participants (64.9%) than females (35%), with more participants having a Master's education. Results from the ANOVA test and regression analysis revealed a positive and significant correlation between digitization benefits (0.842), digitization challenges (0.838), and digitization status (0.898) with health workers' perceptions. Also, a 1% change in digitization benefits, challenges, and status can result in an 18% change in perceptions. Conclusion: Overall, the study found a significant and positive relationship impact of digitization of health on perceptions of health workers. Recommendation: It is suggested that future studies investigate the factors and strategies influencing the change of perceptions associated with the digitization of health.

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This study investigates interactions between parents and pediatricians during pediatric well-child visits. Despite constituting a pivotal moment for monitoring and evaluating children’s development during the critical ‘first thousand days of life’ and for family support, no study has so far empirically investigated the in vivo realization of pediatrician-parent interactions in the Italian context, especially not from a pedagogical perspective. Filling this gap, the present study draws on a corpus of 23 videorecorded well-child visits involving two pediatricians and twenty-two families with children aged between 0 and 18 months. Combining an ethnographic perspective and conversation analysis theoretical-analytical constructs, the micro-analysis of interactions reveals how well-child visits unfold as culture-oriented and culture-making sites. By zooming into what actually happens during these visits, the analysis shows that there is much more than the “mere” accomplishment of institutionally relevant activities like assessing children’s health or giving parents advice on baby care. Rather, through the interactional ways these institutional tasks are carried out, parents and pediatricians presuppose, ratify, and transmit culturally-informed models of “normal” growth, “healthy” development, “good” caring practices, and “competent” parenting, thereby enacting a pervasive yet unnoticed educational and moral work. Inaugurating a new promising line of inquiry within Italian pedagogical research, this study illuminates how a) pediatricians work as a “social antenna”, bridging families’ private “small cultures” and broader socio-cultural models of children’s well-being and caregiving practices, and b) parents act as agentive, knowledgeable, (communicatively) competent, and caring parents, while also sensitive to the pediatrician’s ultimate epistemic and deontic authority. I argue that a video-based, micro-analysis of interactions represents a heuristically powerful instrument for raising pediatricians’ and parents’ awareness of the educational and moral density of well-child visits. Insights from this study can constitute a valuable empirical resource for underpinning medical and parental training programs aimed at fostering pediatricians’ and parents’ reflexivity.

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The purpose of this research study is to discuss privacy and data protection-related regulatory and compliance challenges posed by digital transformation in healthcare in the wake of the COVID-19 pandemic. The public health crisis accelerated the development of patient-centred remote/hybrid healthcare delivery models that make increased use of telehealth services and related digital solutions. The large-scale uptake of IoT-enabled medical devices and wellness applications, and the offering of healthcare services via healthcare platforms (online doctor marketplaces) have catalysed these developments. However, the use of new enabling technologies (IoT, AI) and the platformisation of healthcare pose complex challenges to the protection of patient’s privacy and personal data. This happens at a time when the EU is drawing up a new regulatory landscape for the use of data and digital technologies. Against this background, the study presents an interdisciplinary (normative and technology-oriented) critical assessment on how the new regulatory framework may affect privacy and data protection requirements regarding the deployment and use of Internet of Health Things (hardware) devices and interconnected software (AI systems). The study also assesses key privacy and data protection challenges that affect healthcare platforms (online doctor marketplaces) in their offering of video API-enabled teleconsultation services and their (anticipated) integration into the European Health Data Space. The overall conclusion of the study is that regulatory deficiencies may create integrity risks for the protection of privacy and personal data in telehealth due to uncertainties about the proper interplay, legal effects and effectiveness of (existing and proposed) EU legislation. The proliferation of normative measures may increase compliance costs, hinder innovation and ultimately, deprive European patients from state-of-the-art digital health technologies, which is paradoxically, the opposite of what the EU plans to achieve.