Co-innovation: the future of telemedicine in developing countries

Telemedicine which has been widely adopted in developed countries to reach all its citizens irrespective of their location is only being used for education purposes or disaster relief in developing countries. Since developing countries already suffer inadequate healthcare provision especially in remote areas, it would be essential to implement telemedicine practices for daily clinical uses rather than education use. This research argues that to understand the future of telemedicine in developing countries, both well-established technology innovations adoption factors as well as co-innovation factors should be addressed. In the context of healthcare provision, we propose a conceptual framework that integrates the healthcare resources and the organisational affiliations in co-innovation

Statistical framework for estimating GNSS bias

We present a statistical framework for estimating global navigation satellite system (GNSS) non-ionospheric differential time delay bias. The biases are estimated by examining differences of measured line integrated electron densities (TEC) that are scaled to equivalent vertical integrated densities. The spatio-temporal variability, instrumentation dependent errors, and errors due to inaccurate ionospheric altitude profile assumptions are modeled as structure functions. These structure functions determine how the TEC differences are weighted in the linear least-squares minimization procedure, which is used to produce the bias estimates. A method for automatic detection and removal of outlier measurements that do not fit into a model of receiver bias is also described. The same statistical framework can be used for a single receiver station, but it also scales to a large global network of receivers. In addition to the Global Positioning System (GPS), the method is also applicable to other dual frequency GNSS systems, such as GLONASS (Globalnaya Navigazionnaya Sputnikovaya Sistema). The use of the framework is demonstrated in practice through several examples. A specific implementation of the methods presented here are used to compute GPS receiver biases for measurements in the MIT Haystack Madrigal distributed database system. Results of the new algorithm are compared with the current MIT Haystack Observatory MAPGPS bias determination algorithm. The new method is found to produce estimates of receiver bias that have reduced day-to-day variability and more consistent coincident vertical TEC values.Comment: 18 pages, 5 figures, submitted to AM

Nuclear binding energies: Global collective structure and local shell-model correlations

Nuclear binding energies and two-neutron separation energies are analyzed starting from the liquid-drop model and the nuclear shell model in order to describe the global trends of the above observables. We subsequently concentrate on the Interacting Boson Model (IBM) and discuss a new method in order to provide a consistent description of both, ground-state and excited-state properties. We address the artefacts that appear when crossing mid-shell using the IBM formulation and perform detailed numerical calculations for nuclei situated in the 50-82 shell. We also concentrate on local deviations from the above global trends in binding energy and two-neutron separation energies that appear in the neutron-deficient Pb region. We address possible effects on the binding energy, caused by mixing of low-lying $0^{+}$ intruder states into the ground state, using configuration mixing in the IBM framework. We also study ground-state properties using a deformed mean-field approach. Detailed comparisons with recent experimental data in the Pb region are amply discussed.Comment: 69 pages, TeX (ReVTeX). 23 eps figures. 1 table. Modified version. Accepted in Nucl. Phys.

Fear of exercise and health-related quality of life in patients with an implantable cardioverter defibrillator

Several studies have reported improved survival rates thanks to the use of an implantable cardioverter defibrillator (ICD) in the treatment of patients with life-threatening arrhythmia. However, the effects of the ICD on health-related quality of life (HR-QoL) of these patients are not clear. The aim of this study is to describe HR-QoL and fear of exercise in ICD patients. Eighty-nine ICD patients from the University Hospital in Groningen, the Netherlands, participated in this study. HR-QoL was measured using the Rand-36 and the Quality of Life After Myocardial Infarction Dutch language version questionnaires. Fear of exercise was measured using the Tampa Scale for Kinesiophobia, Dutch version and the Fear Avoidance Beliefs Questionnaire, Dutch version. Association between outcome variables was analysed by linear regression analyses. Study results show that the HR-QoL of patients with ICDs in our study population is significantly worse than that of normal healthy people. Furthermore, fear of exercise is negatively associated with HR-QoL corrected for sex, age and number of years living with an ICD. After implantation of the ICD, patients with a clear fear of exercise should be identified and interventions should be considered in order to increase their HR-QoL

New version of the Pediatric Evaluation of Disability Inventory (PEDI-CAT): translation, cultural adaptation to Brazil and analyses of psychometric properties

BACKGROUND: The Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT), developed with innovative measurement methodologies, evaluates functioning of children and youth, from 0 to 21 years, with different health conditions. It is a revision of an earlier instrument (PEDI) that has been used in national and international clinical practice and research. It was felt to be necessary to make this new version (PEDI-CAT) available in Brazil. OBJECTIVES: Translate and culturally adapt the PEDI-CAT to the Brazilian-Portuguese language and test its psychometric properties. METHOD: This methodological study was developed through the following stages: (1) translation, (2) synthesis, (3) back-translation, (4) revision by an expert committee, (5) testing of the pre-final version, and (6) evaluation of the psychometric properties. The 276 translated PEDI-CAT items were divided into three age groups (0-7, 8-14, and 15-21 years). RESULTS: The PEDI-CAT translation followed all six stages. The adaptations incorporated cultural and socioeconomic class specificities. The PEDI-CAT/Brazil showed good indices of inter-examiner (intraclass correlation coefficient-ICC=0.83-0.89) and test-retest (ICC=0.96-0.97) reliability, good internal consistency (0.99) and small standard error of measurement in all three age groups (0.12-0.17). Factor analyses grouped the items from the three functional skills domains into one factor, and items from the responsibility scale into three factors, supporting the adequacy of these factor solutions to the conceptual structure of the instrument and the developmental model. CONCLUSION: The PEDI-CAT/Brazil is a theoretically consistent, culturally appropriate, and reliable instrument. Its availability in Brazil will contribute to the evaluation and measurement of functional outcomes from clinical interventions, longitudinal follow-up, and rehabilitation research

A framework for collaborative innovation to facilitate E-health systems adoption

The promise of telemedicine is great as observed in developed countries. However, its adoption in developing countries has been very slow. Extant literature on healthcare technological innovation indicates that organization collaboration can expedite the adoption of telemedicine especially in developing countries. The Kenyan government approved telemedicine (use of ICT to overcome geographical barriers and increase access to health care services) as a strategic approach of improving healthcare delivery especially in the marginalized areas of the country. However, the adoption of telemedicine is further hindered in developing countries by the fact that the cost of implementing telemedicine technology is deemed to be high and the resources needed are scarce especially in the public sector. This study employed a conceptual research framework to examine organizational factors that may influence organization collaboration in facilitating telemedicine adoption in developing countries. A questionnaire survey was conducted in 50 hospitals located in Eastern Kenya. The findings of this research revealed that Kenyan hospitals may enhance their ability to adopt telemedicine by affiliating with other organizations. Organization affiliation was found to significantly influence organizational resources, organization innovation acceptance, organization innovation capacity, organization agility and collaborative innovation aspects

Static and dynamic characterization of pull-in protected CMOS compatible poly-SiGe grating light valves

status: publishe

8x14Gb/s ring WDM modulator array with integrated tungsten heaters and Ge monitor photodetectors

An 8x14Gb/s wavelength-division multiplexed Si ring modulator array is presented with uniform channel performance. Tungsten heaters and Ge monitor photodetectors at the ring modulator drop ports are co-integrated to track and control the modulation quality