Embedded Based Smart ICU-For Intelligent Patient Monitoring

Smart ICUs are networks of audio-visual communication and computer systems that link critical care doctors and nurses (intensivists) to intensive care units (ICUs) in other, remote hospitals. The intensivists in the “command center” can communicate by voice with the remote ICU personnel and can receive video communication and clinical data about the patients. Direct patient care is provided by the doctors and nurses in the remote ICU who do not have to be intensivists themselves. In recent years there has been an increase in the number of patients needing ICU care without a corresponding increase in the supply of intensivists. Smart ICUs can be a valuable resource for hospitals faced with the need to expand capacity and improve care for a growing elderly population. Evidence from some early-adopter hospitals indicates that it can leverage management of patient care by intensivists, reduce mortality rates, and reduce LOS. However, positive outcomes appear to depend on the organizational environment into which the Smart ICU is introduced. The dramatic improvements in mortality and LOS reported by some early-adopter hospitals have not been matched in most. The limited research available suggests that the best outcomes may occur in ICUs that: Can make organizational arrangements to support the management of patient care by intensivists using Smart ICU; Have little or no intensivist staff available to them in the absence of Smart ICU; Have relatively high severity-adjusted mortality and LOS rates; Are located in remote or rural areas where safe and efficient transfer of patients to regional centers for advanced critical care presents difficulties. Smart ICU connects a central command center staffed by intensivists with patients in distant ICUs. Continuous, real-time audio, video, and electronic reports of vital signs connect the command center to the patients’ bedsides. Computer-managed decision support systems track each patient’s status and give alerts when negative trends are detected and when changes in treatment patterns are scheduled. The patient data include physiological status (e.g., ECG and blood oxygenation), treatment (e.g., the infusion rate for a specific medicine or the settings on a respirator), and medical records.

Challenges in diabetes mellitus type 2 management in Nepal: a literature review

BACKGROUND AND OBJECTIVES: Diabetes has become an increasingly prevalent and severe public health problem in Nepal. The Nepalese health system is struggling to deliver comprehensive, quality treatment and services for diabetes at all levels of health care. This study aims to review evidence on the prevalence, cost and treatment of diabetes mellitus type 2 and its complications in Nepal and to critically assess the challenges to be addressed to contain the epidemic and its negative economic impact. DESIGN: A comprehensive review of available evidence and data sources on prevalence, risk factors, cost, complications, treatment, and management of diabetes mellitus type 2 in Nepal was conducted through an online database search for articles published in English between January 2000 and November 2015. Additionally, we performed a manual search of articles and reference lists of published articles for additional references. RESULTS: Diabetes mellitus type 2 is emerging as a major health care problem in Nepal, with rising prevalence and its complications especially in urban populations. Several challenges in diabetes management were identified, including high cost of treatment, limited health care facilities, and lack of disease awareness among patients. No specific guideline was identified for the prevention and treatment of diabetes in Nepal. CONCLUSIONS: We conclude that a comprehensive national effort is needed to stem the tide of the growing burden of diabetes mellitus type 2 and its complications in Nepal. The government should develop a comprehensive plan to tackle diabetes and other non-communicable diseases supported by appropriate health infrastructure and funding

(Blue) Growth accounting in small-scale European Union fleets

Fisheries account for one-third of the total jobs in the global ocean economies. Small scale fleets (SSF) fisheries are the main segment from the number of jobs point of view, and in the EU, SSF account for over 40% of employment in the fisheries sector. Given this marine employment source, it is important to analyse SSF's productivity growth. This was done using Total Factor Productivity (TFP), which is dened as the portion of output not explained by the traditionally measured inputs of labour, energy and capital used in production. TFP calculation is relevant to understand the technology evolution in fisheries and as a reference for management assessment. TFP was calculated for SSF in two EU main sea areas, the Mediterranean (FAO area 37) and the North-East Atlantic (FAO area 27). Constant elasticity production functions were used to analyse the intensity of the use of production factors and how these are substituted or complemented when producing. Additionally, TFP was corrected by stock evolution indexes to evaluate the EU conservation policy. Results showed how the TFP presented signs of stagnation when stocks status were considered. This implies a low technological evolution and that the use of production factors is to be reduced in the following years. It was concluded that in the North-East Atlantic the EU conservation policy is obtaining the objective of restoring fish stocks and contributing to maintaining the productivity. In the Mediterranean, the stocks are not being restored, therefore not contributing to growth as a production factor. Finally, it is concluded that in neither areas the conservation policy is enough to provide positive productivity trends.JRC.D.2-Water and Marine Resource