Analyzing the Optical Properties of Hemozoin to Expand the Disease Detection Applications of a Magneto-Optical Device (MOD)

Hemozoin crystals are the basis of a new approach for efficient, cost-effective malaria detection. Clinical success of malaria detection with a magneto-optical device (MOD) motivates quantification of the optical interactions forming the basis of the detection mechanism. The MOD is used to measure the intensity of polarized light transmitted through a sample of hemozoin suspended in phosphate-buffered saline, subject to a magnetic field, ⃗, that can be turned on and off. According to Beer’s law, ratios of transmitted light with different polarization directions and with on and off as a function of hemozoin concentration were related to change in absorption cross section, Δ , an important property for quantifying optical interactions. Using two methods, Δ was uniquely determined, producing similar results, supporting the physical and mathematical theory used to understand MOD’s detection mechanism. Successful quantification of Δ informs our understanding of the magneto-optical properties of hemozoin, which advances malaria detection, and expands potential applications of the MOD

Implementation and Evaluation of Power Consumption of an Iris Pre-processing Algorithm on Modern FPGA

In this article, the efficiency and applicability of several power reduction techniques applied on a modern 65nm FPGA is described. For image erosion and dilation algorithms, two major solutions were tested and compared with respect to power and energy consumption. Firstly the algorithm was run on a general purpose processor (gpp) NIOS and then hardware architecture of an Intellectual Property (IP) was designed. Furthermore IPs design was improved by applying a number of power optimization techniques. They involved RTL level clock gating, power driven synthesis with fitting and appropriate coding style. Results show that hardware implementation is much more energy efficient than a general purpose processor and power optimization schemes can reduce the overall power consumption on an FPGA

Examining sustainability in a hospital setting: Case of smoking cessation

<p>Abstract</p> <p>Background</p> <p>The Ottawa Model of Smoking Cessation (OMSC) is a hospital-based smoking cessation program that is expanding across Canada. While the short-term effectiveness of hospital cessation programs has been documented, less is known about long-term sustainability. The purpose of this exploratory study was to understand how hospitals using the OMSC were addressing sustainability and determine if there were critical factors or issues that should be addressed as the program expanded.</p> <p>Methods</p> <p>Six hospitals that differed on OMSC program activities (identify and document smokers, advise quitting, provide medication, and offer follow-up) were intentionally selected, and two key informants per hospital were interviewed using a semi-structured interview guide. Key informants were asked to reflect on the initial decision to implement the OMSC, the current implementation process, and perceived sustainability of the program. Qualitative analysis of the interview transcripts was conducted and themes related to problem definition, stakeholder influence, and program features emerged.</p> <p>Results</p> <p>Sustainability was operationalized as higher performance of OMSC activities than at baseline. Factors identified in the literature as important for sustainability, such as program design, differences in implementation, organizational characteristics, and the community environment did not explain differences in program sustainability. Instead, key informants identified factors that reflected the interaction between how the health problem was defined by stakeholders, how priorities and concerns were addressed, features of the program itself, and fit within the hospital context and resources as being influential to the sustainability of the program.</p> <p>Conclusions</p> <p>Applying a sustainability model to a hospital smoking cessation program allowed for an examination of how decisions made during implementation may impact sustainability. Examining these factors during implementation may provide insight into issues affecting program sustainability, and foster development of a sustainability plan. Based on this study, we suggest that sustainability plans should focus on enhancing interactions between the health problem, program features, and stakeholder influence.</p

The Role of Screenings Methods and Risk Profile Assessments in Prevention and Health Promotion Programmes: An Ethnographic Analysis

In prevention and health promotion interventions, screening methods and risk profile assessments are often used as tools for establishing the interventions’ effectiveness, for the selection and determination of the health status of participants. The role these instruments fulfil in the creation of effectiveness and the effects these instruments have themselves remain unexplored. In this paper, we have analysed the role screening methods and risk profile assessments fulfil as part of prevention and health promotion programmes in the selection, enrolment and participation of participants. Our analysis showed, that screening methods and health risk assessments create effects as they objectify health risks and/or the health status of individuals, i.e., they select the individuals ‘at risk’ and indicate the lifestyle modifications these people are required to make in order to improve their health. Yet, these instruments also reduce the group of participants thereby decreasing the possible effect of interventions, as they provide the legitimisation for people to make choices to whether they enrol or not and what lifestyle changes they incorporate into their lives. In other words, they present a space of interaction, in which agency is distributed across the practice nurses, the participants and the instruments. Decisions were not just made upon the projection of the outcomes of these instruments; decisions that were made by both the patients and practice nurses were the resultant of their opinions on these outcomes that were formed in interaction with the instruments

Building effective service linkages in primary mental health care: a narrative review part 2

<p>Abstract</p> <p>Background</p> <p>Primary care services have not generally been effective in meeting mental health care needs. There is evidence that collaboration between primary care and specialist mental health services can improve clinical and organisational outcomes. It is not clear however what factors enable or hinder effective collaboration. The objective of this study was to examine the factors that enable effective collaboration between specialist mental health services and primary mental health care.</p> <p>Methods</p> <p>A narrative and thematic review of English language papers published between 1998 and 2009. An expert reference group helped formulate strategies for policy makers. Studies of descriptive and qualitative design from Australia, New Zealand, UK, Europe, USA and Canada were included. Data were extracted on factors reported as enablers or barriers to development of service linkages. These were tabulated by theme at clinical and organisational levels and the inter-relationship between themes was explored.</p> <p>Results</p> <p>A thematic analysis of 30 papers found the most frequently cited group of factors was "partnership formation", specifically role clarity between health care workers. Other factor groups supporting clinical partnership formation were staff support, clinician attributes, clinic physical features and evaluation and feedback. At the organisational level a supportive institutional environment of leadership and change management was important. The expert reference group then proposed strategies for collaboration that would be seen as important, acceptable and feasible. Because of the variability of study types we did not exclude on quality and findings are weighted by the number of studies. Variability in local service contexts limits the generalisation of findings.</p> <p>Conclusion</p> <p>The findings provide a framework for health planners to develop effective service linkages in primary mental health care. Our expert reference group proposed five areas of strategy for policy makers that address organisational level support, joint clinical problem solving, local joint care guidelines, staff training and supervision and feedback.</p

Collaborative care for depression and anxiety problems

This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 2012, Issue 10. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.Common mental health problems, such as depression and anxiety, are estimated to affect up to 15% of the UK population at any one time, and health care systems worldwide need to implement interventions to reduce the impact and burden of these conditions. Collaborative care is a complex intervention based on chronic disease management models that may be effective in the management of these common mental health problems

A multi-level system quality improvement intervention to reduce racial disparities in hypertension care and control: study protocol

BACKGROUND: Racial disparities in blood pressure control have been well documented in the United States. Research suggests that many factors contribute to this disparity, including barriers to care at patient, clinician, healthcare system, and community levels. To date, few interventions aimed at reducing hypertension disparities have addressed factors at all of these levels. This paper describes the design of Project ReD CHiP (Reducing Disparities and Controlling Hypertension in Primary Care), a multi-level system quality improvement project. By intervening on multiple levels, this project aims to reduce disparities in blood pressure control and improve guideline concordant hypertension care. METHODS: Using a pragmatic trial design, we are implementing three complementary multi-level interventions designed to improve blood pressure measurement, provide patient care management services and offer expanded provider education resources in six primary care clinics in Baltimore, Maryland. We are staggering the introduction of the interventions and will use Statistical Process Control (SPC) charting to determine if there are changes in outcomes at each clinic after implementation of each intervention. The main hypothesis is that each intervention will have an additive effect on improvements in guideline concordant care and reductions in hypertension disparities, but the combination of all three interventions will result in the greatest impact, followed by blood pressure measurement with care management support, blood pressure measurement with provider education, and blood pressure measurement only. This study also examines how organizational functioning and cultural competence affect the success of the interventions. DISCUSSION: As a quality improvement project, Project ReD CHiP employs a novel study design that specifically targets multi-level factors known to contribute to hypertension disparities. To facilitate its implementation and improve its sustainability, we have incorporated stakeholder input and tailored components of the interventions to meet the specific needs of the involved clinics and communities. Results from this study will provide knowledge about how integrated multi-level interventions can improve hypertension care and reduce disparities. TRIAL REGISTRATION: ClinicalTrials.gov NCT0156686

An ON-OFF Magneto-Optical Probe of Anisotropic Biofluid Crystals: A β-Hematin Case Study

We have designed, developed, and evaluated an innovative portable magneto-optical detector (MOD) in which a light beam with variable polarization passes through a fluid sample immersed in a variable magnetic field. The light intensity is measured downstream along the forward scattering direction. The field is turned on and off through the in-and-out motion of nearby permanent magnets. As a result, for sufficiently, magnetically, and optically anisotropic samples, the optical absorption is sensitive to changes in the light polarization. Both detection and characterization applications are, therefore, available. For instance, both the degree of malaria infection and hemozoin crystalline properties can be measured and studied, respectively. We present experimental results for synthetic hemozoin and describe them in terms of the basic physics and chemistry underlying the correlations of the directions of the external magnetic field and the light beam polarization. We connect this work to a commercialized product for malaria detection and compare it with other magneto-optical instruments and methods. We conduct tests of absorption parameters and the electric polarizability tensor, and we discuss the connection to magnetic and electric dipole moments