How a Diverse Research Ecosystem Has Generated New Rehabilitation Technologies: Review of NIDILRR’s Rehabilitation Engineering Research Centers

Over 50 million United States citizens (1 in 6 people in the US) have a developmental, acquired, or degenerative disability. The average US citizen can expect to live 20% of his or her life with a disability. Rehabilitation technologies play a major role in improving the quality of life for people with a disability, yet widespread and highly challenging needs remain. Within the US, a major effort aimed at the creation and evaluation of rehabilitation technology has been the Rehabilitation Engineering Research Centers (RERCs) sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research. As envisioned at their conception by a panel of the National Academy of Science in 1970, these centers were intended to take a “total approach to rehabilitation”, combining medicine, engineering, and related science, to improve the quality of life of individuals with a disability. Here, we review the scope, achievements, and ongoing projects of an unbiased sample of 19 currently active or recently terminated RERCs. Specifically, for each center, we briefly explain the needs it targets, summarize key historical advances, identify emerging innovations, and consider future directions. Our assessment from this review is that the RERC program indeed involves a multidisciplinary approach, with 36 professional fields involved, although 70% of research and development staff are in engineering fields, 23% in clinical fields, and only 7% in basic science fields; significantly, 11% of the professional staff have a disability related to their research. We observe that the RERC program has substantially diversified the scope of its work since the 1970’s, addressing more types of disabilities using more technologies, and, in particular, often now focusing on information technologies. RERC work also now often views users as integrated into an interdependent society through technologies that both people with and without disabilities co-use (such as the internet, wireless communication, and architecture). In addition, RERC research has evolved to view users as able at improving outcomes through learning, exercise, and plasticity (rather than being static), which can be optimally timed. We provide examples of rehabilitation technology innovation produced by the RERCs that illustrate this increasingly diversifying scope and evolving perspective. We conclude by discussing growth opportunities and possible future directions of the RERC program

Participatory research in complex marine conservation settings: A review of recent trends and lessons for the future

The conservation of marine ecosystems and species is inherently complex, plagued by social, political, economic and ecological uncertainty. Navigating these challenges to sustain marine systems requires the understanding, consideration and uptake of multiple knowledge systems within decision-making processes. Participatory research approaches, such as knowledge co-production, are advocated given their potential to generate knowledge with those who are most affected by the issue at hand and, based on that knowledge, develop and implement meaningful conservation practices collaboratively. In doing so participatory research is positioned to make marine research more democratic and impactful, and as such, has been a field of growing research enquiry. The aim of this study, therefore, is to synthesise (via a systematic scoping review) the existing literature to generate guidance that can help researchers and practitioners plan and apply participatory research approaches in a complex marine context. Results from systematically identifying and analyzing 337 articles show that the implementation of participatory research approaches are most common in the global north. Participatory research approaches most frequently included representatives from government, industry and civil society (e.g. community groups), while indigenous groups and communities were rarely included. A diversity of participatory research approaches have been used in relation to marine conservation in different settings and at various stages of the participatory process, each with their own challenges and benefits, that can lead to either positive outcomes for actors (e.g. social learning) or negative outcomes (e.g. disempowerment). We draw on our findings to provide guidance for improving the implementation of participatory research approaches in marine conservation such as taking the time to understand context before commencing participatory research approaches, and ensuring transparency with all actors throughout the process. We highlight key implications for researcher and practitioners implementing participatory research approaches including the importance of a diversity of approaches and methods to ensure access, supporting two way communication, addressing power imbalances, and the need to recognise, report on and address pre-existing barriers. Many of these require greater investment in terms of money or personnel, and new funding models are needed with a focus on longevity and sustainability

A Comparative Study on Blockchain-based Electronic Health Record Systems: Performance, Privacy, and Security Between Hyperledger Fabric and Ethereum Frameworks

Traditional data collection, storage, and processing of Electronic Health Records (EHR) utilize centralized techniques that pose several risks of single point of failure and lean the systems to a number of internal and external data breaches that compromise their reliability and availability. Addressing the challenges of conventional database techniques and improving the overall aspects of EHR application, blockchain technology is being evaluated to find a possible solution. Blockchain refers to an emerging distributed technology and incorruptible database of records or digital events which execute, validate, and maintain by a ledger technology to provide an immutable architecture and prevent records manipulation or alterations. However, there are multiple frameworks emerged in recent years where identifying the advantages and limitation is crucial. This thesis focuses on (i) introducing electronic health records systems using two widely used blockchain frameworks, Hyperledger Fabric and Ethereum. (ii)aims to provide a comparative study on both frameworks from the performance, privacy, and security perspectives. Based on two different introduced EHR systems, we identify the strength and weaknesses of both frameworks and present the challenges and limitations of these systems. According to a comparative study, the Hyperledger Fabric framework demonstrates advanced features including private and consortium networks that can facilitate EHR systems from both security and performance perspectives. Taking the experience into consideration, we aim to extend our study in software engineering domain to evaluate the limits to developing blockchain-based software applications and highlight the way to improve current SE practices in future studies

Linking leadership development programs for physicians with organization-level outcomes:a realist review

Background: Hospitals invest in Leadership Development Programs (LDPs) for physicians, assuming they benefit the organization’s performance. Researchers have listed the advantages of LDPs, but knowledge of how and why organization-level outcomes are achieved is missing. Objective: To investigate how, why and under which circumstances LDPs for physicians can impact organization-level outcomes. Methods: We conducted a realist review, following the RAMESES guidelines. Scientific articles and grey literature published between January 2010 and March 2021 evaluating a leadership intervention for physicians in the hospital setting were considered for inclusion. The following databases were searched: Medline, PsycInfo, ERIC, Web of Science, and Academic Search Premier. Based on the included documents, we developed a LDP middle-range program theory (MRPT) consisting of Context-Mechanism-Outcome configurations (CMOs) describing how specific contexts (C) trigger certain mechanisms (M) to generate organization-level outcomes (O). Results: In total, 3904 titles and abstracts and, subsequently, 100 full-text documents were inspected; 38 documents with LDPs from multiple countries informed our MRPT. The MRPT includes five CMOs that describe how LDPs can impact the organization-level outcomes categories ‘culture’, ‘quality improvement’, and ‘the leadership pipeline’: 'Acquiring self-insight and people skills (CMO1)', 'Intentionally building professional networks (CMO2)', 'Supporting quality improvement projects (CMO3)', 'Tailored LDP content prepares physicians (CMO4)', and 'Valuing physician leaders and organizational commitment (CMO5)'. Culture was the outcome of CMO1 and CMO2, quality improvement of CMO2 and CMO3, and the leadership pipeline of CMO2, CMO4, and CMO5. These CMOs operated within an overarching context, the leadership ecosystem, that determined realizing and sustaining organization-level outcomes. Conclusions: LDPs benefit organization-level outcomes through multiple mechanisms. Creating the contexts to trigger these mechanisms depends on the resources invested in LDPs and adequately supporting physicians. LDP providers can use the presented MRPT to guide the development of LDPs when aiming for specific organization-level outcomes.</p

IOT Service Utilisation in Healthcare

Utilising the new trend technologies in healthcare sector could offer alternative ways in managing the patients’ health records and also improve the healthcare quality. As such, this chapter provides an overview of utilising the Internet of Things (IoT) technology in healthcare sector as an emerging research and practical trend nowadays. The main benefits and advantages have been discussed in this chapter. On the other hand, it has been found that most of the hospitals in different countries are still facing many issues regarding their health information exchange. Recently, various studies in the area of healthcare information system mentioned that the fragmentations of the health information are one of the most important challenges with the distribution of patient information records. Therefore, in this chapter, we gave an in detail overview regarding the current issues facing the health sector in line with the IoT technologies. Additionally, a full description of advantages and disadvantages has been highlighted for using IoT in healthcare that can be considered as solutions for the mentioned issues

The NIEHS Environmental Health Sciences Data Resource Portal: Placing Advanced Technologies in Service to Vulnerable Communities

BACKGROUND: Two devastating hurricanes ripped across the Gulf Coast of the United States during 2005. The effects of Hurricane Katrina were especially severe: The human and environmental health impacts on New Orleans, Louisiana, and other Gulf Coast communities will be felt for decades to come. The Federal Emergency Management Agency (FEMA) estimates that Katrina’s destruction disrupted the lives of roughly 650,000 Americans. Over 1,300 people died. The projected economic costs for recovery and reconstruction are likely to exceed $125 billion. OBJECTIVES: The NIEHS (National Institute of Environmental Health Sciences) Portal aims to provide decision makers with the data, information, and the tools they need to a) monitor human and environmental health impacts of disasters; b) assess and reduce human exposures to contaminants; and c) develop science-based remediation, rebuilding, and repopulation strategies. METHODS: The NIEHS Portal combines advances in geographic information systems (GIS), data mining/integration, and visualization technologies through new forms of grid-based (distributed, web-accessible) cyberinfrastructure. RESULTS: The scale and complexity of the problems presented by Hurricane Katrina made it evident that no stakeholder alone could tackle them and that there is a need for greater collaboration. The NIEHS Portal provides a collaboration-enabling, information-laden base necessary to respond to environmental health concerns in the Gulf Coast region while advancing integrative multidisciplinary research. CONCLUSIONS: The NIEHS Portal is poised to serve as a national resource to track environmental hazards following natural and man-made disasters, focus medical and environmental response and recovery resources in areas of greatest need, and function as a test bed for technologies that will help advance environmental health sciences research into the modern scientific and computing era

Android security: analysis and applications

The Android mobile system is home to millions of apps that offer a wide range of functionalities. Users rely on Android apps in various facets of daily life, including critical, e.g., medical, settings. Generally, users trust that apps perform their stated purpose safely and accurately. However, despite the platform’s efforts to maintain a safe environment, apps routinely manage to evade scrutiny. This dissertation analyzes Android app behavior and has revealed several weakness: lapses in device authentication schemes, deceptive practices such as apps covering their traces, as well as behavioral and descriptive inaccuracies in medical apps. Examining a large corpus of applications has revealed that suspicious behavior is often the result of lax oversight, and can occur without an explicit intent to harm users. Nevertheless, flawed app behavior is present, and is especially problematic in apps that perform critical tasks. Additionally, manufacturer’s and app developer’s claims often do not mirror actual functionalities, e.g., as we reveal in our study of LG’s Knock Code authentication scheme, and as evidenced by the removal of Google Play medical apps due to overstated functionality claims. This dissertation makes the following contributions: (1) quantifying the security of LG’s Knock Code authentication method, (2) defining deceptive practices of self-hiding app behavior found in popular apps, (3) verifying abuses of device administrator features, (4) characterizing the medical app landscape found on Google Play, (5) detailing the claimed behaviors and conditions of medical apps using ICD codes and app descriptions, (6) verifying errors in medical score calculator app implementations, and (7) discerning how medical apps should be regulated within the jurisdiction of regulatory frameworks based on their behavior and data acquired from users

Exploring Regenerative Co-benefits of Biophilic Design for People and the Environment

There is an increasing awareness of the role that buildings, districts and neighbourhoods play on health in the wake of the Covid-19 pandemic that coincides with pressing climate concerns. This has renewed attention to the benefits of nature for both human and climate health. Buildings, cities, and regions are attempting to align regenerative design principles with human health goals but often lack the tools and knowledge to do so. This is partly rooted in a failure to understand how to apply research and policy for different contexts as well as at different scales. It is also still uncertain exactly what types of nature can lead to which types of benefit, and for whom, despite long-standing research within the environmental psychology, sustainability, and design fields. This chapter outlines key research paradigms that influence the way we understand the benefits of nature, where biophilic design theory sits in this field, and how it can be and has been applied at different scales through two case studies at the building and city scale. The chapter ends with the proposal of new directions for integrating biophilic design into regenerative design and policy