MobiHealth-Innovative 2.5/3G mobile services and applications for health care

MobiHealth aims at introducing new mobile value added services in the area of healthcare, based on 2.5 (GPRS) and 3G (UMTS) technologies, thus promoting the use and deployment of GPRS and UMTS. This will be achieved by the integration of sensors and actuators to a Wireless Body Area Network (BAN). These sensors and actuators will continuously measure and transmit vital constants along with audio and video to health service providers and brokers, improving on one side the life of patients and allowing on the other side the introduction of new value-added services in the areas of disease prevention and diagnostic, remote assistance, para-health services, physical state monitoring (sports) and even clinical research. Furthermore, the MobiHealth BAN system will support the fast and reliable application of remote assistance in case of accidents by allowing the paramedics to send reliable vital constants data as well as audio and video directly from the accident site

Himalayan Trauma: Administrative Thrombosis and Citizens’ Response

In this paper, the author uses excerpts from social media postings and traditional media to highlight how various citizen and volunteer responses to the 2015 earthquake helped fill in the gaps created by institutional dysfunction. Further, he shows how these two types of media played a critical role in facilitating communication between grassroots aid initiatives and earthquake affected people and their families and friends, not only in Kathmandu but also in neglected mountainous areas as well. The author uses a personal, reflexive approach to help situate the distinct experiences of earthquake affected people including trauma patients, people with disabilities, and volunteer aid workers

Front and Center

Newsletter providing "a lighter, human interest side of the news" from the Boston University Medical Campus

No. 2: The Brain Drain of Health Professionals from Sub-Saharan Africa to Canada

Significant numbers of African-trained health workers migrate every year to developed countries including Canada. They leave severely crippled health systems in a region where life expectancy is only 50 years of age, 16 per cent of children die before their fifth birthday and the HIV/AIDS crisis continues to burgeon. The population of Sub-Saharan Africa (SSA) totals over 660 million, with a ratio of fewer than 13 physicians per 100,000. SSA has seen a resurgence of various diseases that were thought to be receding, while public health systems remain inadequately staffed. According to one report, the region needs approximately 700,000 physicians to meet the Millennium Development Goals. Understaffing results in stress and increased workloads. Many of the remaining health professionals are ill-motivated, not only because of their workload, but also because they are poorly paid, poorly equipped and have limited career opportunities. These, in turn, lead to a downward spiral where workers migrate, crippling the system, placing greater strain on the remaining workers who themselves seek to migrate out of the poor working conditions. The ultimate result is an incontestable crisis in health human resources throughout SSA, the region suffering most from the brain drain of health care professionals. The situation in SSA has become severe enough that the final report of the Joint Learning Initiative on Human Resources for Health – a two-year global initiative sponsored by a number of donors studying various aspects of human resources for health performance – has concluded that the future of global health and development in the 21st century lies in the management of the crisis in human resources for health. There is a considerable body of literature attesting to the fact that the migration of skilled professionals from developing to developed countries is large and increasing dramatically. While different experts espouse different reasons for the increase, all agree that it is happening. Developing countries are hit hardest by the brain drain as they lose sometimes staggering portions of their college-educated workers to wealthy countries which can better weather their relatively smaller losses of skilled workers. Highly skilled professionals account for 65 per cent of migrants moving to industrialized countries. The International Organization for Migration (IOM) estimates that about 20,000 Africans leave Africa every year to take up employment in industrialized countries. We do not know how many of these are health care professionals (largely because of inadequate systems for gathering such statistics in African countries).11 The World Health Organization (WHO), however, found that a quarter to two-thirds of health workers interviewed in a recent study expressed an intention to migrate. Historically, and specific to the SSA context, the brain drain has meant not only the exodus of human capital but financial resources as well, as African health care professionals left countries with their savings and reinvested very little of their foreign earnings back into the region. There is only recent evidence suggesting that, while the numbers of professionals leaving continue to increase, émigrés are slowly reinvesting some of their earnings back into their countries. Other research raises doubts about the value of such reinvestments, however, particularly when they are in the form of remittances that are generally private welfare transfers back to family members and are often used for consumption rather than for savings. In recognition of the enormous challenge posed by the international migration of health personnel to health systems in developing countries, the World Health Organization has proclaimed 2005-2015 the decade on human resources for health (HRH)

Human Resources for Health Migration: global policy responses, initiatives, and emerging issues

This report identifies and maps contemporary global policy responses to, and initiatives on, international HRH migration, with particular reference to low‐income source countries. It reports on a systematic review and analysis of the responses and initiatives of twelve multilateral organisations and global fora: European Union; Global Forum on Migration and Development; Global Health Workforce Alliance; International Labour Organization; International Organization for Migration; Organisation for Economic Cooperation and Development; Pan‐American Health Organization; UN Global Migration Group; UN High‐Level Dialogue on Migration and Development; World Bank; World Health Organization; and the World Trade Organization. The report documents how these global policy actors are presently engaging with the HRH migration field through their activities, initiatives and policy responses. It situates this engagement within global policy initiatives spanning health, migration and development. In addition to reviewing and mapping current initiatives and policy responses and their outcomes, the report identifies emerging issues, upcoming promising initiatives and global policy scenarios

Nurses’ Perception of Discharging the Medically Complex Pediatric Patient

The purpose of this study is to query the nurses for their perceptions of the barriers and facilitators of discharging medically complex pediatric patients from a freestanding children’s hospital in central California. Using a mixed methods research design via an online survey, 90 nurses identified 3 distinct themes that act as barriers. Those barriers include: 1) knowing the plan of care, 2) time, and 3) disposition of the family. Several implications for improving the discharge process for medically complex patients and overcoming the identified barriers include strategies to improve multidisciplinary communication, implementation of a Family Learning Center, use of video interpreters when in-person interpreters are not available, and respect for discharge readiness. Recognizing and implementing the appropriate interventions based on nurses’ feedback have the potential to improve quality and patient safety

“Integrating ‘Traditional’ and ‘Scientific’ Medicine in contemporary Cuba”

Dissertation for the MSc in Globalisation & Latin American Development submitted September 2008. Supervisor: Dr Kate Quinn

No. 63: Dystopia and Disengagement: Diaspora Attitudes Towards South Africa

In 2008, South African Brandon Huntley was given refugee status in Canada by the Canadian Immigration and Refugee Board (IRB). The unprecedented decision, based on Huntley’s claim that as a white South African he was the victim of racial persecution in South Africa, caused a firestorm. Interest in the case was particularly intense in South Africa itself where the decision was derided in the media and the South African government lodged a formal protest with the Canadian government. Over 140 high-profile South African academics also filed a petition protesting the decision with the Canadian High Commission in Pretoria. Within weeks, the Canadian Minister of Citizenship and Immigration had lodged an appeal against the IRB decision with the Federal Court of Appeal. Some have claimed that the decision of the Canadian Government to seek to overturn the decision of the IRB was motivated by a desire to appease South Africa. This is highly unlikely. Rather, the Canadian government was concerned about the precedent-setting nature of the case and that it could set the stage for a flood of applications from similarly unskilled white South Africans seeking a route into Canada. In late 2010, Justice James Russell of the Federal Court of Appeal issued an extended judgment upholding the Canadian government’s appeal and sending the Huntley case back to the IRB for reconsideration. The Supreme Court of Canada declined to hear an appeal of this judgment in mid-2012, so the case will be got back to the IRB. Huntley’s lawyers are confident of a second success at the IRB, indicating that the attention given to his case will make him a marked man if he is returned to South Africa. However, Justice Russell provided a systematic and painstaking demolition of virtually every element of the original IRB decision and it seems highly unlikely that Huntley will ever be able to prove that he qualifies for refugee protection status in Canada. The case may still drag on for several more years, however, as Huntley would be entitled to institute a second round of appeals in the courts if his claim is rejected this time. In constructing a narrative to convince IRB judge William Davis that he qualified for protection under the UN Refugee Convention, Huntley and his lawyers attempted to show that he had been the victim of a series of racially-motivated personal assaults and that the state had failed in its duty to protect. None of these supposed attacks were ever reported to the police which proved rather awkward for his case. However, this was explained away with the circular argument that since the police did nothing when whites were attacked, there was no point in reporting the assaults. Huntley’s recounting of his experiences make interesting reading but they were not, in fact, central to the Davis decision. Here we focus on what Davis called the “lifeline” of the Huntley decision: that is, the case made by Huntley’s lawyer, Russell Kaplan and his sister Lara Kaplan, that all whites in South Africa are being systematically targeted because of the colour of their skin. Justice Russell rejected this argument, and the selective evidence presented by the Kaplans, in its entirety. He designated their portrayal of the situation in South Africa the “Kaplan view.” The core elements of the Kaplan view included assertions that all Black South Africans hated white South Africans; that the country was experiencing “reverse apartheid; that black South Africans have “no regard” for the lives of white South Africans; that most violent crimes are committed by black against white South Africans; that the police will do nothing about the crimes committed against white South Africans; that white South Africans are undergoing a form of racial genocide; and that there is systematic discrimination against whites in the workplace. Justice Russell concluded that the Kaplan view was rooted in the personal experience of violent crime by the Kaplan family itself in South Africa. This paper argues that to attribute the Kaplan view purely to the negative personal experiences of the Kaplan family in South Africa is to take too narrow an interpretation. The central elements of the Kaplan view are not unique to the Kaplan family but are produced and reproduced by the white South African diaspora in Canada more generally. The evidence for this assertion comes from a survey of 1,485 South African immigrants in Canada conducted by SAMP in 2010, some 80% of whom had left South Africa after 1990. Between 1991 and 2006, just over 19,000 South Africans moved to Canada, a migration that shows few signs of letting up. Most South African immigrants to Canada are white, highly skilled and educated with many professionals in their ranks. They enter Canada as permanent residents in the economic class. South Africans in Canada are high income earners. For example, 26% of the survey respondents earn more than $200,000 a year and 43$100,000 (compared with only 6% of the overall Canadian population.) The survey respondents reported visiting South Africa relatively often (only 18% had never been back since arriving in Canada) although only 20% return at least once a year. The rest make episodic visits and the vast majority of all visits are connected with family issues and events. Most have family in South Africa to visit. Half of the respondents (54%) have taken out Canadian citizenship and another 30% are permanent residents. South Africans in Canada are neither large nor frequent remitters. Forty-two percent had never remitted funds to South Africa and only 13% do so on a monthly basis. Patterns of asset holding in South Africa show systematic disinvestment over time. Allied to this pattern of disinvestment are low levels of interest in return migration to South Africa. The survey also collected information about the attitudes and perceptions of this group towards their country of origin. The dystopian views advanced by the Kaplan view in the Huntley case fit comfortably within a broader narrative about South Africa by white South Africans in Canada. A considerable number of survey respondents portrayed South Africa as an extremely violent society in which whites live in a constant state of fear and anxiety. Many argued that whites were targeted not because they own a disproportionate share of the wealth in a highly unequal society, but simply because of their colour. The idea that the white population is under siege because of their skin colour extends well beyond personal knowledge of incidents of crime and violence. The theme of racial targeting was driven home by the frequent use of terms such as “apartheid in reverse” and “reverse discrimination.” Attacks on white farmers feature prominently in the narratives and are used as a platform for broader commentary on the supposed brutality of Africa and all Africans. Personal and hearsay stories of violent crime were laced with vituperative accounts of the callous and indifferent response of the police and the government. Another recurrent complaint was how affirmative action discriminated against whites. There is no sympathy for or understanding of the reasons for these policies nor of how they personally might have benefited educationally and economically from the racist policies of the apartheid government. Instead, they represent themselves, and whites in general, as victims. In many cases, the sense of outrage spills over into overtly racist diatribes about Africa and Africans. To rationalise their departure, disengagement and decision never to return to South Africa, this post-apartheid diaspora draws on the same narrative reservoir of images as the lawyers in the Huntley case. It is therefore inadequate to conclude that the Huntley case was simply a rather egregious but exceptional miscarriage of justice. Huntley is, in many ways, emblematic of a more general and troubling discourse about South Africa that circulates amongst white South Africans in Canada

Related Services for Vermont\u27s Students with Disabilities

The purpose of Related Services for Vermont’s Students with Disabilities is to offer information regarding related services that is consistent with IDEA and with Vermont Law and regulations. It also describes promising or exemplary practices in education, special education, and related services. The manual’s content applies to all related services disciplines which serve students with disabilities, ages 3 through 21, who have an Individualized Education Program (IEP)

Use of m-Health Technology for Preventive Interventions to Tackle Cardiometabolic Conditions and Other Non-Communicable Diseases in Latin America- Challenges and Opportunities

In Latin America, cardiovascular disease (CVD) mortality rates will increase by an estimated 145% from 1990 to 2020. Several challenges related to social strains, inadequate public health infrastructure, and underfinanced healthcare systems make cardiometabolic conditions and non-communicable diseases (NCDs) difficult to prevent and control. On the other hand, the region has high mobile phone coverage, making mobile health (mHealth) particularly attractive to complement and improve strategies toward prevention and control of these conditions in low- and middle-income countries. In this article, we describe the experiences of three Centers of Excellence for prevention and control of NCDs sponsored by the National Heart, Lung, and Blood Institute with mHealth interventions to address cardiometabolic conditions and other NCDs in Argentina, Guatemala, and Peru. The nine studies described involved the design and implementation of complex interventions targeting providers, patients and the public. The rationale, design of the interventions, and evaluation of processes and outcomes of each of these studies are described, together with barriers and enabling factors associated with their implementation.Fil: Beratarrechea, Andrea Gabriela. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Diez Canseco, Francisco. Universidad Peruana Cayetano Heredia; PerúFil: Irazola, Vilma. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Miranda, Jaime. Universidad Peruana Cayetano Heredia; PerúFil: Ramirez Zea, Manuel. Institute of Nutrition of Central America and Panama; GuatemalaFil: Rubinstein, Adolfo Luis. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin