9,375 research outputs found

    Heart failure nursing in Australia: Challenges, strengths, and opportunities

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    Australia has a land mass similar to the United States of America, supporting a population of just over 20 million, which is distributed predominantly across the coastal perimeter. The Australian society is rich in cultural diversity fostered by decades of migration. Both these factors present challenges for health care. First, because resources are scare in rural and remote regions, health outcomes are poorer in these regions, especially among indigenous populations. Second, the cultural diversity of Australians is a challenge to providing evidence-based treatment recommendations. In Australia, in parallel with international trends, there is a strong association between socioeconomic status, chronic conditions, and health outcomes

    Echocardiography curriculum development for physician assistants using entrustable professional activities

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    BACKGROUND: With the projected increase of cardiovascular disease in the aging population, a higher demand for echocardiography use is predicted. However, there is a shortage in the supply of cardiologists, to the point that a 2009 American College of Cardiology survey report called it a "cardiology workforce crisis". The report also recommends a more aggressive use of PAs and NPs as one of the solutions to fill the shortage. Currently, echocardiography is not routinely included in the scope of practice for PAs in cardiology. While PAs attain strong basic science knowledge and clinical training experience in PA school, they typically do not receive additional formal postgraduate training. PAs have limited training opportunities to train in echocardiography and receive certification of recognition, but a formally standardized training program and certifying examination geared specifically for PAs are yet to be developed. This study seeks to develop a pilot curriculum in training echocardiography which can be standardized for utilization across various regions and medical subspecialties. The curriculum draws on the concept of Entrustable Professional Activities (EPA), which is being actively used in graduate medical education. HYPOTHESIS: After participating in the proposed pilot curriculum which involves online didactic learning and supervised hands-on clinical training, trained PAs will be able to reach proficiency in echocardiography operation and interpretation at level 4 supervision according to the EPA guidelines. METHODS: This study proposes a pilot curriculum with framework based on the EPA titled “performing and interpreting echocardiography” by PAs. The curriculum involves didactic and clinical training in echocardiography, with the goal to achieve mastery of level 4 supervision (minimal supervision). 2 subjects will be recruited from a teaching medical institution in the Greater Boston area with an IAC accredited echocardiography laboratory. After the 12-month training, participants will take ASCeXAM/ReASCE Online Practice Exam Simulation offered by the ASE. Upon 1) achievement of individualized EPAs as assessed by supervisor, and 2) simulation exam score of >80%, participants will earn a STAR in echocardiography. CONCLUSION: The study is the first step to establishing an effective training curriculum that will eventually be a basis for creating a certifying exam in echocardiography, designed specifically for PAs. As this study merely suggests a new curriculum, future studies should focus on identifying strengths and weaknesses of the curriculum after implementation and expansion to multiple sites, and gather data to use for continual improvement of the training curriculum

    mCollector: Sensor-enabled health-data collection system for rural areas in the developing world

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    Health data collection poses unique challenges in rural areas of the developing world. mHealth systems that are used by health workers to collect data in remote rural regions should also record contextual information to increase confidence in the fidelity of the collected data. We built a user-friendly, mobile health-data collection system using wireless medical sensors that interface with an Android application. The data-collection system was designed to support minimally trained, non-clinical health workers to gather data about blood pressure and body weight using off-the-shelf medical sensors. This system comprises a blood-pressure cuff, a weighing scale and a portable point-of-sales printer. With this system, we introduced a new method to record contextual information associated with a blood-pressure reading using a tablet’s touchscreen and accelerometer. This contextual information can be used to verify that a patient’s lower arm remained well-supported and stationary during her blood-pressure measurement. This method can allow mHealth applications to guide untrained patients (or health workers) in measuring blood pressure correctly. Usability is a particularly important design and deployment challenge in remote, rural areas, given the limited resources for technology training and support. We conducted a field study to assess our system’s usability in rural India, where we logged health worker interactions with the app’s interface using an existing usability toolkit. Researchers analyzed logs from this toolkit to evaluate the app’s user experience and quantify specific usability challenges in the app. We have recorded experiential notes from the field study in this document. We present four contributions to future mHealth projects in this document: \u3e We describe a method for measuring lower-arm stillness and support during a blood-pressure measurement, using an off-the-shelf Android tablet. \u3e We evaluate our method for measuring lower-arm stillness with a preliminary user study of 12 subjects and found that our method can distinguish stationary arms from different types of lower-arm movement with 90% accuracy. \u3e We conduct an experiential study with 28 participants and three app operators. In this study, we evaluate our system’s field usability by deploying it in rural India. \u3e We provide a quantitative usability analysis of our mobile-data-collection app’s interface using an existing usability toolkit

    Med-e-Tel 2017

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    National Aboriginal and Torres Strait Islander health plan 2013-2023

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    In 2008 Australian Governments committed to work with Aboriginal and Torres Strait Islander people on an incredibly important task - to achieve equality in health status and life expectancy between Aboriginal and Torres Strait Islander people and non-Indigenous Australians by the year 2031. The commitment – in the form of the Close the Gap Statement of Intent – creates the platform for this National Aboriginal and Torres Strait Islander Health Plan, which has been developed in partnership with Aboriginal and Torres Strait Islander people and their representatives. This Health Plan provides a long-term, evidence-based policy framework as part of the overarching Council of Australian Governments’ (COAG) approach to Closing the Gap in Indigenous disadvantage, which has been set out in the National Indigenous Reform Agreement (NIRA) signed in 2008. The NIRA has established a framework of national targets and policy building blocks. Two of the Closing the Gap targets, to halve the gap in child mortality by 2018 and close the life expectancy gap by 2031, go directly to health outcomes, while others address social determinants of health such as education and employment. The Health Plan builds on the United Nations Declaration on the Rights of Indigenous Peoples. It adopts a strengths-based approach to ensure policies and programs improve health, social and emotional wellbeing, and resilience and promote positive health behaviours. It emphasises the centrality of culture in the health of Aboriginal and Torres Strait Islander people and the rights of individuals to a safe, healthy and empowered life. The Health Plan also builds on existing strategies and planning approaches to improving Aboriginal and Torres Strait Islander health,

    Telemedicine

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    Telemedicine is a rapidly evolving field as new technologies are implemented for example for the development of wireless sensors, quality data transmission. Using the Internet applications such as counseling, clinical consultation support and home care monitoring and management are more and more realized, which improves access to high level medical care in underserved areas. The 23 chapters of this book present manifold examples of telemedicine treating both theoretical and practical foundations and application scenarios

    Med-e-Tel 2014

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    Med-e-Tel 2013

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