34,706 research outputs found

    Population Health Matters Spring 2014, Vol. 27, No. 2. Download PDF

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    A Survey of Access Control Models in Wireless Sensor Networks

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    Copyright 2014 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/3.0/)Wireless sensor networks (WSNs) have attracted considerable interest in the research community, because of their wide range of applications. However, due to the distributed nature of WSNs and their deployment in remote areas, these networks are vulnerable to numerous security threats that can adversely affect their proper functioning. Resource constraints in sensor nodes mean that security mechanisms with a large overhead of computation and communication are impractical to use in WSNs; security in sensor networks is, therefore, a challenge. Access control is a critical security service that offers the appropriate access privileges to legitimate users and prevents illegitimate users from unauthorized access. However, access control has not received much attention in the context of WSNs. This paper provides an overview of security threats and attacks, outlines the security requirements and presents a state-of-the-art survey on access control models, including a comparison and evaluation based on their characteristics in WSNs. Potential challenging issues for access control schemes in WSNs are also discussed.Peer reviewe

    Towards Data Protection Compliance

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    Privacy and data protection are fundamental issues nowadays for every organization. This paper calls for the development of methods, techniques and infrastructure to allow the deployment of privacy-aware IT systems, in which humans are integral part of the organizational processes and accountable for their possible misconduct. In particular, we discuss the challenges to be addressed in order to improve organizations privacy practices, as well as the approach to ensure compliance with legal requirements and increasing efficiency

    An integrated care pathway for menorrhagia across the primary–secondary interface : patients' experience, clinical outcomes, and service utilisation

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    Background: ‘‘Referral’’ characterises a significant area of interaction between primary and secondary care. Despite advantages, it can be inflexible, and may lead to duplication. Objective: To examine the outcomes of an integrated model that lends weight to general practitioner (GP)-led evidence based care. Design: A prospective, non-random comparison of two services: women attending the new (Bridges) pathway compared with those attending a consultant-led one-stop menstrual clinic (OSMC). Patients’ views were examined using patient career diaries, health and clinical outcomes, and resource utilisation. Follow-up was for 8 months. Setting: A large teaching hospital and general practices within one primary care trust (PCT). Results: Between March 2002 and June 2004, 99 women in the Bridges pathway were compared with 94 women referred to the OSMC by GPs from non-participating PCTs. The patient career diary demonstrated a significant improvement in the Bridges group for patient information, fitting in at the point of arrangements made for the patient to attend hospital (ease of access) (p,0.001), choice of doctor (p = 0.020), waiting time for an appointment (p,0.001), and less ‘‘limbo’’ (patient experience of non-coordination between primary and secondary care) (p,0.001). At 8 months there were no significant differences between the two groups in surgical and medical treatment rates or in the use of GP clinic appointments. Significantly fewer (traditional) hospital outpatient appointments were made in the Bridges group than in the OSMC group (p,0.001). Conclusion: A general practice-led model of integrated care can significantly reduce outpatient attendance while improving patient experience, and maintaining the quality of care

    To Reform Medicare, Reform Incentives and Organization

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    Alain C. Enthoven's paper, To Reform Medicare, Reform Incentives And Organization, explains how the principles of cost-responsible consumer choice among competing health-insurance plans, sometimes called "managed competition," can both improve quality and reduce cost in the federal government's Medicare program

    Joining up health and bioinformatics: e-science meets e-health

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    CLEF (Co-operative Clinical e-Science Framework) is an MRC sponsored project in the e-Science programme that aims to establish methodologies and a technical infrastructure forthe next generation of integrated clinical and bioscience research. It is developing methodsfor managing and using pseudonymised repositories of the long-term patient histories whichcan be linked to genetic, genomic information or used to support patient care. CLEF concentrateson removing key barriers to managing such repositories ? ethical issues, informationcapture, integration of disparate sources into coherent ?chronicles? of events, userorientedmechanisms for querying and displaying the information, and compiling the requiredknowledge resources. This paper describes the overall information flow and technicalapproach designed to meet these aims within a Grid framework

    What's the evidence that NICE guidance has been implemented? Results from a national evaluation using time series analysis, audit of patients' notes, and interviews

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    OBJECTIVES: To assess the extent and pattern of implementation of guidance issued by the National Institute for Clinical Excellence (NICE). DESIGN: Interrupted time series analysis, review of case notes, survey, and interviews. SETTING: Acute and primary care trusts in England and Wales. PARTICIPANTS: All primary care prescribing, hospital pharmacies; a random sample of 20 acute trusts, 17 mental health trusts, and 21 primary care trusts; and senior clinicians and managers from five acute trusts. MAIN OUTCOME MEASURES: Rates of prescribing and use of procedures and medical devices relative to evidence based guidance. RESULTS: 6308 usable patient audit forms were returned. Implementation of NICE guidance varied by trust and by topic. Prescribing of some taxanes for cancer (P <0.002) and orlistat for obesity (P <0.001) significantly increased in line with guidance. Prescribing of drugs for Alzheimer’s disease and prophylactic extraction of wisdom teeth showed trends consistent with, but not obviously a consequence of, the guidance. Prescribing practice often did not accord with the details of the guidance. No change was apparent in the use of hearing aids, hip prostheses, implantable cardioverter defibrillators, laparoscopic hernia repair, and laparoscopic colorectal cancer surgery after NICE guidance had been issued. CONCLUSIONS: Implementation of NICE guidance has been variable. Guidance seems more likely to be adopted when there is strong professional support, a stable and convincing evidence base, and no increased or unfunded costs, in organisations that have established good systems for tracking guidance implementation and where the professionals involved are not isolated. Guidance needs to be clear and reflect the clinical context
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