What does it take to make integrated care work? A ‘cookbook’ for large-scale deployment of coordinated care and telehealth

The Advancing Care Coordination & Telehealth Deployment (ACT) Programme is the first to explore the organisational and structural processes needed to successfully implement care coordination and telehealth (CC&TH) services on a large scale. A number of insights and conclusions were identified by the ACT programme. These will prove useful and valuable in supporting the large-scale deployment of CC&TH. Targeted at populations of chronic patients and elderly people, these insights and conclusions are a useful benchmark for implementing and exchanging best practices across the EU. Examples are: Perceptions between managers, frontline staff and patients do not always match; Organisational structure does influence the views and experiences of patients: a dedicated contact person is considered both important and helpful; Successful patient adherence happens when staff are engaged; There is a willingness by patients to participate in healthcare programmes; Patients overestimate their level of knowledge and adherence behaviour; The responsibility for adherence must be shared between patients and health care providers; Awareness of the adherence concept is an important factor for adherence promotion; The ability to track the use of resources is a useful feature of a stratification strategy, however, current regional case finding tools are difficult to benchmark and evaluate; Data availability and homogeneity are the biggest challenges when evaluating the performance of the programmes

A systematic review of speech recognition technology in health care

BACKGROUND To undertake a systematic review of existing literature relating to speech recognition technology and its application within health care. METHODS A systematic review of existing literature from 2000 was undertaken. Inclusion criteria were: all papers that referred to speech recognition (SR) in health care settings, used by health professionals (allied health, medicine, nursing, technical or support staff), with an evaluation or patient or staff outcomes. Experimental and non-experimental designs were considered. Six databases (Ebscohost including CINAHL, EMBASE, MEDLINE including the Cochrane Database of Systematic Reviews, OVID Technologies, PreMED-LINE, PsycINFO) were searched by a qualified health librarian trained in systematic review searches initially capturing 1,730 references. Fourteen studies met the inclusion criteria and were retained. RESULTS The heterogeneity of the studies made comparative analysis and synthesis of the data challenging resulting in a narrative presentation of the results. SR, although not as accurate as human transcription, does deliver reduced turnaround times for reporting and cost-effective reporting, although equivocal evidence of improved workflow processes. CONCLUSIONS SR systems have substantial benefits and should be considered in light of the cost and selection of the SR system, training requirements, length of the transcription task, potential use of macros and templates, the presence of accented voices or experienced and in-experienced typists, and workflow patterns.Funding for this study was provided by the University of Western Sydney. NICTA is funded by the Australian Government through the Department of Communications and the Australian Research Council through the ICT Centre of Excellence Program. NICTA is also funded and supported by the Australian Capital Territory, the New South Wales, Queensland and Victorian Governments, the Australian National University, the University of New South Wales, the University of Melbourne, the University of Queensland, the University of Sydney, Griffith University, Queensland University of Technology, Monash University and other university partners

An Exploratory Study of Patient Falls

Debate continues between the contribution of education level and clinical expertise in the nursing practice environment. Research suggests a link between Baccalaureate of Science in Nursing (BSN) nurses and positive patient outcomes such as lower mortality, decreased falls, and fewer medication errors. Purpose: To examine if there a negative correlation between patient falls and the level of nurse education at an urban hospital located in Midwest Illinois during the years 2010-2014? Methods: A retrospective crosssectional cohort analysis was conducted using data from the National Database of Nursing Quality Indicators (NDNQI) from the years 2010-2014. Sample: Inpatients aged ≥ 18 years who experienced a unintentional sudden descent, with or without injury that resulted in the patient striking the floor or object and occurred on inpatient nursing units. Results: The regression model was constructed with annual patient falls as the dependent variable and formal education and a log transformed variable for percentage of certified nurses as the independent variables. The model overall is a good fit, F (2,22) = 9.014, p = .001, adj. R2 = .40. Conclusion: Annual patient falls will decrease by increasing the number of nurses with baccalaureate degrees and/or certifications from a professional nursing board-governing body

NDE: An effective approach to improved reliability and safety. A technology survey

Technical abstracts are presented for about 100 significant documents relating to nondestructive testing of aircraft structures or related structural testing and the reliability of the more commonly used evaluation methods. Particular attention is directed toward acoustic emission; liquid penetrant; magnetic particle; ultrasonics; eddy current; and radiography. The introduction of the report includes an overview of the state-of-the-art represented in the documents that have been abstracted

Study of space battery accelerated testing techniques. Phase 1 report. Survey of testing methods applicable to space battery evaluation

Testing methods applicable to space battery evaluation - literature surve

Methodology for designing accelerated aging tests for predicting life of photovoltaic arrays

A methodology for designing aging tests in which life prediction was paramount was developed. The methodology builds upon experience with regard to aging behavior in those material classes which are expected to be utilized as encapsulant elements, viz., glasses and polymers, and upon experience with the design of aging tests. The experiences were reviewed, and results are discussed in detail

Measurement techniques and instruments suitable for life-prediction testing of photovoltaic arrays

Array failure modes, relevant materials property changes, and primary degradation mechanisms are discussed as a prerequisite to identifying suitable measurement techniques and instruments. Candidate techniques and instruments are identified on the basis of extensive reviews of published and unpublished information. These methods are organized in six measurement categories - chemical, electrical, optical, thermal, mechanical, and other physicals. Using specified evaluation criteria, the most promising techniques and instruments for use in life prediction tests of arrays were selected

ADOPTION OF BIOENGINEERED CROPS

Use of crop biotechnology products, such as genetically engineered (GE) crops with input traits for pest management, has risen dramatically since commercial approval in the mid-1990s. This report addresses several of the economic dimensions regarding farmer adoption of bioengineered crops, including herbicidetolerant and insect-resistant varieties. In particular, the report examines: (1) the extent of adoption of bioengineered crops, their diffusion path, and expected adoption rates over the next few years; (2) factors affecting the adoption of bioengineered crops; and (3) farm-level impacts of the adoption of bioengineered crops. Data used in the analysis are mostly from USDA surveys.Biotechnology, technology adoption, genetic engineering, pest management, financial effects, tillage, herbicide-tolerant crops, Bt crops, corn, soybeans, cotton, Crop Production/Industries, Research and Development/Tech Change/Emerging Technologies,

Rationale for windshield glass system specification requirements for shuttle orbiter

A preliminary procurement specification for the space shuttle orbiter windshield pane, and some of the design considerations and rationale leading to its development are presented. The windshield designer is given the necessary methods and procedures for assuring glass pane structural integrity by proof test. These methods and procedures are fully developed for annealed and thermally tempered aluminosilicate, borosilicate, and soda lime glass and for annealed fused silica. Application of the method to chemically tempered glass is considered. Other considerations are vision requirements, protection against bird impact, hail, frost, rain, and meteoroids. The functional requirements of the windshield system during landing, ferrying, boost, space flight, and entry are included

Product assurance technology for custom LSI/VLSI electronics

The technology for obtaining custom integrated circuits from CMOS-bulk silicon foundries using a universal set of layout rules is presented. The technical efforts were guided by the requirement to develop a 3 micron CMOS test chip for the Combined Release and Radiation Effects Satellite (CRRES). This chip contains both analog and digital circuits. The development employed all the elements required to obtain custom circuits from silicon foundries, including circuit design, foundry interfacing, circuit test, and circuit qualification