Intelligent technologies for real-time monitoring and decision support systems

MPhilAutomation of data processing and control of operations involving intelligent technologies that is considered the next generation technology requires error-free data capture systems in both clinical research and healthcare. The presented research constitutes a step in the development of intelligent technologies in healthcare. The proposed improvement is by automation that includes the elements of intelligence and prediction. In particular automatic data acquisition systems for several devices are developed including pervasive computing technologies for mobility. The key feature of the system is the minimisation/near eradication of erroneous data input along with a number of other security measures ensuring completeness, accuracy and reliability of the patients‟ data. The development is based on utilising existing devices to keep the cost of Data Acquisition Systems down. However, with existing technology and devices one can be limited to features required to perform more refined analysis. Research of existing and development of a new device for assessment of neurological diseases, such as MS (Multiple Sclerosis) using Stroop test is performed. The software can also be customized for use in other diseases affecting Central Nervous System such as Parkinson‟s disease. The introduction of intelligent functions into the majority of operations enables quality checks and provides on-line user assistance. It could become a key tool in the first step of patient diagnosis before referring to more advanced tests for further investigation. Although the software cannot fully ensure the diagnosis of MS or PD but can make significant contribution in the process of diagnosis and monitorin

An Evaluation of Medication Safety related Communications in the Patient Healthcare Pathway in Kuwait

Background: Patient safety is a recognised public health issue. When post-market medication safety information emerges, the benefits and risks of the medication concerned are usually evaluated by drug regulatory agencies. The outcomes of such pharmacovigilance activities are communicated to the public, patients and other healthcare professionals (HCPs). The aim of these medication safety communications might vary from improving the intended recipients’ knowledge or attitudes to outlining specific actions to be followed by them. However, it is currently recognised that sharing medication-related information does not improve patients’ safety on its own if not accompanied by an accurate implementation of these recommendations in clinical practice. Despite their importance in protecting patient safety and subsequently affecting public health, no previous study was found to have evaluated or described the process of creating and disseminating medication safety communications by the Kuwaiti drug regulatory agency. Equally, no study was found to have investigated the impact of or the factors affecting the implementation of regulatory-related medication safety communications in Kuwait. Therefore, this thesis aimed to address these gaps in knowledge by evaluating medication safety communications in the patient healthcare pathway in Kuwait. Methods: This multiphase study was preceded by a systematic literature review of the factors affecting HCPs’ implementation of regulatory-related medication safety communications, using a narrative synthesis approach. Following the systematic review, multiphase research was initiated. This consisted of three phases, each of which focused on a specific stakeholder group involved in the process of medication safety communication. Phase 1 involved Kuwait Drug and Food Control (KDFC), an administration within the Ministry of Health (MOH), as the regulatory agency responsible for pharmacovigilance activities. This was a convergent mixed-methods study. Data collection in this phase included documents produced by KDFC or issued to KDFC relating to medication safety and three face-to-face interviews with KDFC employees involved in pharmacovigilance activities. Documents were analysed using a descriptive quantitative approach and a framework analysis technique. Phase 2 focused on healthcare professionals working in MOH hospitals in Kuwait. This phase was an exploratory mixed-methods study, where focus group discussions were conducted followed by the distribution of an online survey. The focus group discussions were analysed using a thematic analysis technique. In the second part of this phase, an online survey was developed based on Phase 1, the focus group discussions and the systematic literature review. Survey data analysis included descriptive analysis (frequency and percentile) and statistical analysis including principal component analysis (PCA) and the Kruskal–Wallis H test, which was followed by a post hoc analysis of variables that had significant results. Other statistical tests applied included Fisher’s exact test, the Mann–Whitney U Test, and multivariate regression analysis. Participants’ answers to open-ended survey questions were analysed using a conventional content analysis technique. Phase 3 was an interpretive phenomenology study. This phase involved semi-structured phone interviews with six female patients of childbearing age who used a valproate-related medication for epilepsy or migraine. These patients had been prescribed the valproate-related medication in one of six secondary hospitals and one specialist neurology hospital within the MOH hospitals. An interpretive phenomenological analysis technique was applied to analyse the transcripts. Results: The results of the systematic literature review indicated that the factors affecting HCPs’ implementation of medication safety communications occur at multiple levels. These levels included the sources or senders of the safety information (delays in the delivery of medications safety communications), healthcare institutions (hospitals’ position and interpretations of the recommendations), the HCPs (knowledge of the content of medications safety communications), and the patients and/or their carers (willingness to use the medication concerned). Phase 1 revealed a lack of legislation and a pharmacovigilance-specific policy. Results from Phase 2 reflected poor knowledge of the concept of medication safety communications within the context of pharmacovigilance and a lack of familiarity with the tools used by KDFC to communicate emerging medication information among HCPs. In the survey, although the majority of HCPs who responded were aware of the teratogenicity of VRM (65.1%, (n = 110/169)), only 2.6% had responded correctly to the statements of the VRM KDFC recommendations. More than half of the participants (57%) reported changing their practice to accommodate at least one intended KDFC recommendation. Providing female patients with written information (37.2%) and counselling female patients about contraceptive use (37.2%) were the most reported intended changes in practice. The most reported barriers to implementation included not having the capacity in terms of time and/or the infrastructure to implement the recommendations (33.8%). Four themes originating from patient interviews included (1) the timeline of the patient’s experience (2) varied knowledge and perception with valproate use, (3) patient’s expectations from HCPs and (4) experiences and preferences towards medication safety communications. Conclusion: Medication safety communications are essential tools for disseminating information related to medication safety updates to HCPs, patients and the public. This research identified challenges at the level of the sender (KDFC) and the intended recipients (HCPs and patients) that could reduce the ability of KDFC’s medication safety communications to reach clinical practices. The first step in increasing their reach is to adapt electronic methods for disseminating such information. Involving stakeholders, such as HCPs and patients, in evaluating the clarity and understandability of KDFC’s medication safety communications should be the focus of future research

Primary Health Care

This book presents examples from various countries about the provision of health services at the primary care level. Chapters examine the role of professionals in primary healthcare services and how they can work to improve the health of individuals and communities. Written by authors from Africa, Asia, America, Europe, and Australia, this book provides up-to-date information on primary health care, including telehealth services in the era of COVID-19

Spinoff, 1976

This report is divided into three sections: 1. The Research Payoff, 2. Technology Twice Used, and 3. Technology Utilization at Work. The first describes a wide variety of current space spinoffs of use in business or personal life, as well as the space explorations from which they have been derived. The second provides information on specific examples of technology transfer that are typical of the spinoffs resulting from NASA's Technology Utilization Program. The third briefly describes the different activities of the Technology Utilization Office, all of which have as their purpose the profitable utilization of aerospace technology

Practical issues arising from the use of telemedicine applications: An evaluation of equipment used for colour imaging in teledermatology, automated weight monitoring and patient-operated 12-lead ECG recording in arrhythmia.

Three telemedicine applications which depend on relatively simple telephone technology to transfer data in the care of patients managing chronic conditions at home are investigated in order to evaluate their application from the users’ perspectives. Part one provides an evaluation of four mobile cameraphones, of varying quality, such as those commonly used to photograph patients for remote diagnosis. The cameraphones are compared with a digital camera, two videophones and an ISDN6 conferencing facility, in their ability to replicate colour and shape. The effects of uploading the images to a laptop computer and of transferring an image by MSN messaging are also evaluated. Part two provides an evaluation of electronic weighing scales connected via a wireless gateway to a landline telephone for the purpose of remote weight monitoring in patients with chronic heart failure. Self-reported experiences of patients, carers and specialist nurses are explored and outcomes compared with previously published opinion. The idiosyncratic nature of health care is highlighted as a main factor in the success or failure of the system. The third application is a patient-operated 12-lead ECG unit which transmits data via a home landline to a call centre, where it is displayed as an ECG trace and a report is given by specialist clinicians. Self-reported experiences of patients with arrhythmia reveal systematic phenomena which hinder the effectiveness of the device and which are related to human, not technological, failings. ECG traces obtained by unskilled lay persons on paediatric patients are compared with the ECG traces obtained by skilled and experienced paediatric nurses on the same patients. The results show that in the case of the cameraphones the technology is less accurate than normally assumed. In the case of the weight monitoring and ECG equipment however it is more usually human factors which cause a disappointing outcome

Cardiac Arrhythmias

The most intimate mechanisms of cardiac arrhythmias are still quite unknown to scientists. Genetic studies on ionic alterations, the electrocardiographic features of cardiac rhythm and an arsenal of diagnostic tests have done more in the last five years than in all the history of cardiology. Similarly, therapy to prevent or cure such diseases is growing rapidly day by day. In this book the reader will be able to see with brighter light some of these intimate mechanisms of production, as well as cutting-edge therapies to date. Genetic studies, electrophysiological and electrocardiographyc features, ion channel alterations, heart diseases still unknown , and even the relationship between the psychic sphere and the heart have been exposed in this book. It deserves to be read

Estudio para la calculadora de edad vascular como herramienta para reducir el riesgo cardiovascular de la farmacia comunitaria

Tesis inédita de la Universidad Complutense de Madrid, Facultad de Farmacia, leída el 29-11-2021Background: Cardiovascular disease (CVD) is one of the leading causes of morbidity and mortality in Spain. According to the World Health Organization (WHO), 80% of these premature deaths are avoidable by reducing the modifiable risk factors of CVD. Research indicates that patients better understand their true risk when information is presented to them in vascular age (VA). Community pharmacists (CP) are well situated to assess patientsVA, provide professional educational advice, and implement interventions for reducing cardiovascular risk (CVR).Aim: The explicit objective of this thesis was to create a patient-centred, accurate and accessible tool that allows the CPs in Spain to estimate the VA and design a personalized intervention aimed at reducing the patient’s VA.Method: A website was created and included an original questionnaire, the vascular age calculator (VAC), detailed protocols for the pharmacist’s intervention and the patient’s information leaflets on CVR factors. The webpage user’s perceptions were analysed via a 26-item self-completion online survey distributed among CPs using a Google forum. Informed consent was taken from the CPs to participate in the study. The responses to the survey were collected anonymously. Open and closed questions were used to gain a wide range of replies and an in-depth understanding. The questionnaire from the pilot study was available online from the 1st August 2020 to the 31st of February 2021. The results were analysed using the STATA package version 12.0 (StataCorp LP, College Station, TX, USA). The NVivo software was used for assessing the descriptive findings...Antecedentes: La enfermedad cardiovascular (ECV) es una de las principales causas de morbilidad y mortalidad en España. Según la Organización Mundial de la Salud, el 80% de estas muertes prematuras se podrían evitar reduciendo los factores de riesgo cardiovascular modificables. Diversos estudios indican que los pacientes entienden mejor su riesgo real cuando se les presenta la información en forma de edad vascular. Los farmacéuticoscomunitarios (FC) están bien posicionados para evaluar la edad vascular de los pacientes, proporcionar asesoramiento educativo profesional y aplicar intervenciones para reducir el riesgo cardiovascular (RCV).Objetivo: El objetivo explícito de esta tesis fue crear una herramienta centrada en el paciente, precisa y accesible que permita a los FC de España estimar la edad vascular y diseñar un plan de intervención personalizado encaminado a reducirla. Método: Se creó una página web que incluía un cuestionario original, la calculadora de la edad vascular, protocolos detallados para la intervención del farmacéutico y folletos informativos para el paciente sobre factores de RCV. Se analizó la percepción de los usuarios sobre la página web a través de una encuesta online de veintiséis preguntas distribuida entre los FC mediante un formulario de Google. Se obtuvo el consentimiento informado de los FC para participar en el estudio. Las respuestas a la encuesta se recogieron de forma anónima. Se utilizaron preguntas abiertas y cerradas para obtener una amplia gama de respuestas y de mayor profundidad. El cuestionario del estudio piloto estuvo disponible en línea desde el 1de agosto de 2020 hasta el 31 de febrero de 2021. Los resultados se analizaron con el paquete STATA versión 12.0 (StataCorp LP, College Station, TX, USA). Para evaluar los resultados descriptivos se utilizó el programa informático NVivo...Fac. de FarmaciaTRUEunpu