Entwicklung, Aufbau und Betrieb einer telemetrischen Plattform zur Therapieüberwachung am Beispiel der Hämophilie

Ubiquitäres Computing aufgrund von High-Speed-Internet und mobilen Geräten ermöglicht grundlegende neue Möglichkeiten für das Gesundheitswesen. Patienten mit seltenen chronischen Erkrankungen, die häufig weit entfernt vom medizinischen Behandlungszentrum leben, profitieren dabei besonders von der Telemedizin und dem Telemonitoring. Diese Arbeit beschreibt in diesem Zusammenhang unter anderem die Erfahrungen bei der Entwicklung, dem Test, der Implementierung und dem Betrieb einer telemetrischen Plattform am Beispiel der Hämophilie. Dabei stehen funktionale und nicht-funktionale Anforderungen bei der Entwicklung mobiler Anwendungen, die im Gesundheitswesen eingesetzt werden, im Fokus. Die Ergebnisse verdeutlichen einerseits die Barrieren, Herausforderungen und Anforderungen für die Entwicklung von telemetrischen Plattformen, andererseits dass die Verwendung von adäquater Technologie die Gesundheitskosten senken, Patienten sich schnell an Telemonitoring-Systeme gewöhnen und sich die Lebensqualität des Nutzers wesentlich erhöht

World Compendium of Healthcare Facilities and Nonprofit Organizations

World Compendium of Healthcare Facilities and Nonprofit Organizations is the most comprehensive index of critical information on healthcare facilities and nonprofits in 72 low and lower-middle-income countries as classified by the World Bank. Presented in an easily accessible format and organized in 72 country chapters, the compendium allows stakeholders to better identify where healthcare services are available and where additional resources are needed

RESPECTING THE ETHICAL TENSION BETWEEN SURVEILLANCE AND PRIVACY IN PROMOTING PUBLIC HEALTH AND DISEASE MANAGEMENT

The recognition of the need to undertake surveillance and to protect privacy is well established. However, the continually changing circumstances and fast-paced development of healthcare today requires a continuing need to respect this ethical tension between surveillance and privacy. Hence, this dissertation is to respect the ethical tension between surveillance and privacy in promoting public health and disease management. This dissertation investigates the ethics of conducting public health surveillance, including the challenges associated with obtaining consent and protecting data from unauthorized access. The dissertation will focus on the ethical consequences of big data, including issues associated with obtaining informed consent, data ownership, and privacy. As the dissertation concludes, it will provide an ethical justification of observing privacy in public health surveillance. The analysis is pursued in the dissertation in the following manner. After a brief introduction in Chapter 1, the analysis begins in Chapter 2 by explaining the importance of consent with regard to protecting privacy, including confidentiality in clinical ethics. Chapter 3 moves the discussion to the realm of public health ethics, discussing two examples of population health matters to illustrate the dissertation’s focus. Chapter 4 focuses on the complex issue of disease management for which the ethical tension between surveillance and privacy is pivotal. Chapter 5 then discusses the critical need for respecting this ethical tension in research protocols from a global perspective. Chapter 6 moves the discussion to the fast-developing debate of data analysis in healthcare for which respecting the ethical tension between surveillance and privacy will be pivotal for the continuing success in this new arena. Finally, Chapter 7 provides a brief conclusion to the dissertation

Human Rights in Patient Care: A Practitioner Guide - Kazakhstan

Health systems can too often be places of punishment, coercion, and violations of basic rights—rather than places of treatment and care. In many cases, existing laws and tools that provide remedies are not adequately used to protect rights.This Practitioner Guide series presents practical how-to manuals for lawyers interested in taking cases around human rights in patient care. The manuals examine patient and provider rights and responsibilities, as well as procedures for protection through both the formal court system and alternative mechanisms in 10 countries.Each Practitioner Guide is country-specific, supplementing coverage of the international and regional framework with national standards and procedures in the following:ArmeniaGeorgiaKazakhstanKyrgyzstanMacedoniaMoldova (forthcoming)RomaniaRussia (forthcoming)SerbiaUkraineThis series is the first to systematically examine the application of constitutional, civil, and criminal laws; categorize them by right; and provide examples and practical tips. As such, the guides are useful for medical professionals, public health mangers, Ministries of Health and Justice personnel, patient advocacy groups, and patients themselves.Advancing Human Rights in Patient Care: The Law in Seven Transitional Countries is a compendium that supplements the practitioner guides. It provides the first comparative overview of legal norms, practice cannons, and procedures for addressing rights in health care in Armenia, Georgia, Kazakhstan, Kyrgyzstan, Macedonia, Russia, and Ukraine.A Legal Fellow in Human Rights in each country is undertaking the updating of each guide and building the field of human rights in patient care through trainings and the development of materials, networks, and jurisprudence. Fellows are recent law graduates based at a local organization with expertise and an interest in expanding work in law, human rights, and patient care. To learn more about the fellowships, please visit health-rights.org

UWOMJ Volume 73, No. 1, 2004

Schulich School of Medicine & Dentistryhttps://ir.lib.uwo.ca/uwomj/1082/thumbnail.jp

Development of immunosensors for the detection of malaria.

Malaria is a disease of global importance caused by an Apicomplexan Plasmodium parasite and transmitted by adult female Anopheles mosquitoes. Malaria affects approximately 50% of the world’s population causing millions of deaths every year. Mostly affected are pregnant women and children under 5 years of age. Morbidity and mortality rates are on the decline in some areas. Despite control efforts the disease continues to affect productivity. Productivity can be increased by early detection. Methods for malaria detection include blood film microscopy, immunochromatographic, serological and molecular tests. Blood film microscopy shows the highest sensitivity and specificity when used by trained personnel with reliable instruments. It is however time-consuming and cannot be applied as a point-of-care diagnostic method. Two electrochemical immunosensors for malaria biomarkers Plasmodium falciparum histidine rich protein 2 (PfHRP 2) and parasite L-Lactate dehydrogenase (LDH) were developed in this work for the detection and quantification of Plasmodium species. The methods were based on screen-printed gold electrodes (SPGEs) with on board carbon counter and silver /silver chloride (Ag / AgCl) pseudo-reference electrode. The first stage of the work involved comparison by characterization of the bare SPGEs using potassium ferricyanide. Electrochemical techniques were used to compare bare and self-assembled monolayers of mercaptoundecanoic acid (MUA) and 3,3´- dithiodipropionic acid (DTDPA) against bare SPGE. The optimal sensor was then used for antibody attachment. For the second stage of the work, adsorption was investigated for capture antibody immobilization on the SPGE. HuCAL monoclonal antibodies against PfHRP 2 conjugated to the electroactive enzyme horseradish peroxidase (HRP) were then applied for signal generation. Electrochemical measurements were conducted using 3,3´ 5,5´-tetramethylbenzidine dihydrochloride and hydrogen,peroxide (TMB / H₂O₂) as the mediator / substrate system at potential of -0.2 V. The sensors utilized sandwich enzyme-linked immunosorbent assay (ELISA),format with HuCAL monoclonal antibodies against Plasmodium immobilized on the gold working electrode. The developed biosensor was capable of detecting sub-microscopic Plasmodium infection with a linear range from 1 to 100 ng mL⁻¹ and a limit of detection (LOD) as low as 2.14 ng mL⁻¹ and 2.95 ng mL⁻¹ for PfHRP 2 in buffer and serum assays respectively. When compared with AuNP enhanced assays, the LOD was 36 pg mL⁻¹ and 40 pg mL⁻¹.. Another biomarker Plasmodium falciparum parasite Lactate dehydrogenase (LDH) was also investigated and another sensor developed using a sandwich assay similar to the PfHRP 2 sensor, but incorporating different antibodies against LDH. LOD 1.80 ng mL⁻¹ and 0.70 ng mL⁻¹ for LDH was obtained in buffer and serum assays. When compared with AuNP enhanced assays, the LOD was 19 pg mL⁻¹ and 23 pg mL⁻¹ respectively. As part of the work, culture medium supernatant containing PfHRP 2 and LDH was used to compare the immunosensor sensitivity for the pan-malaria antigen LDH. Sensitivity of the immunosensor was compared against commercially available Plasmodium immunochromatographic (ICT) kits: OptiMAL-IT and BinaxNOW Malaria kits. The optimized immuno-electrochemical biosensor detected the antigen at 0.002 % parasitaemia whereas the OptiMAL-IT ICT was only able to detect the LDH antigen when concentrations were of 2% parasitaemia. BinaxNOW ICT detected both the LDH and PfHRP 2 antigens in concentrations of 4% parasitaemia and showed negative reading at 0.5%parasitaemia in both synchronized and asynchronized samples. This study has developed two highly sensitive, portable and low cost malaria immunosensors for the first time on JD SPGEs. LDH immunosensor detects all Plasmodium species while PfHRP 2 immunosensor is specific for the detection of Plasmodium falciparum biomarker. Both immunosensors detect quantifiable, sub-microscopic levels of the biomarkers with sensitivities higher than the ICT tests. The immunosensors are therefore recommended for field trial.PhD in the School of Engineerin