The Impact of eHealth and mHealth on doctor behavior and patient involvement: an Israeli and Portuguese comparative approach

Based on the experience of a Short Term Scientific Mission (STSM) promoted by COST Net and developed in CIES/ISCTE-IUL (Portugal), this paper presents a reflection about the implementation of Information & Communication Technologies (ICT) in the healthcare sector in Israel and Portugal. Specifically, we focus on the impacts of ICT or eHealth on patient empowerment, as perceived by doctors and managers in order to better comprehend the role of national policy and explore the options for building a national strategy regarding ICT in healthcare. The experience of the Portuguese healthcare system was selected and compared to the results found in a similar research in Israel. Methodologically, in-depth interviews with the Ministry of Health, the private sector, patients associations and researches were used to collect data. Purposeful sampling was used to select respondents, and secondary sources were used for triangulation. The findings of the research work show that the increased deployment of ICT has furthered patient empowerment (1). From the doctors' perspective, while ICT has provided more information in the long-run, changes of these magnitudes were not easy in the beginning. These findings were similar in both countries. The work concludes that ICT tools were successfully implemented and the general perception is that they have been beneficial. The work provides information in order to understand and improve ICT services. Additionally, the results suggest alternatives for future investments in these technologies.info:eu-repo/semantics/publishedVersio

Health information technology implementation - Impacts and policy considerations: a comparison between Israel and Portugal

The use of Information and Communications Technology (ICT) in health systems is increasing worldwide. While it is assumed that ICT holds great potential to make health services more efficient and grant patients more empowerment, research on these trends is at an early stage. Building on a study of the impact of ICT on physicians and patients in Israel, a Short Term Scientific Mission (STSM) sponsored by COST Net in conjunction with CIES/ISCTE IUL (Portugal) facilitated a comparison of ICT in health in Israel and Portugal. The comparison focused on patient empowerment, physician behavior and the role of government in implementing ICT. The research in both countries was qualitative in nature. In-depth interviews with the Ministry of Health (MOH), the private sector, patients associations, health plans and researchers were used to collect data. Purposeful sampling was used to select respondents, and secondary sources were used for triangulation. The findings indicate that respondents in both countries feel that patient empowerment has indeed been furthered by introduction of ICT. Regarding physicians, in both countries ICT is seen as providing more information that can be used in medical decision making. Increased access of patients to web-based medical information can strengthen the role of patients in decision making and improve the physician-patient relationship, but also shift the latter in ways that may require adjustments in physician orientation. Physician uptake of ICT in both countries involves overcoming certain barriers, such as resistance to change. At the national level, important differences were found between the two countries. While in Israel, ICT was promoted and adopted by the meso level of the health system, in particular the health plans and government intervention can be found in a later stage, in Portugal the government was the main developer and national strategies were built from the beginning. These two approaches present different advantages and disadvantages. Government involvement in earlier stages could provide benefit in terms of interoperability of systems between different healthcare organizations. However, innovation could be slowed down due to government bureaucracy or lack of leadership. The work provides information in order to understand and improve ICT services. Additionally, it provides input regarding impact of ICT on the physician/patient relationship and national policies in the area.info:eu-repo/semantics/publishedVersio

Contestable adulthood: variability and disparity in markers for negotiating the transition to adulthood

Recent research has identified a discreet set of subjective markers that are seen as characterizing the transition to adulthood. The current study challenges this coherence by examining the disparity and variability in young people’s selection of such criteria. Four sentence-completion cues corresponding to four differentcontexts in which adult status might be contested were given to 156 British 16- to 17-year-olds. Their qualitative responses were analyzed to explore patterns whilst capturing some of their richness and diversity. An astonishing amount of variability emerged, both within and between cued contexts.The implications of this variability for how the transition to adulthood is experienced are explored. The argument is made that markers of the transition to adulthood are not merely reflective of the bio–psycho–social development of young people. Rather, adulthood here is seen as an essentially contested concept,located within the discursive interactional environment in which young people participate

A Nearly Four-Year Longitudinal Study of Search-Engine Poisoning

We investigate the evolution of search-engine poisoning using data on over 5 million search results collected over nearly 4 years. We build on prior work investigating search-redirection attacks, where criminals compromise high-ranking websites and direct search traf-fic to the websites of paying customers, such as unlicensed phar-macies who lack access to traditional search-based advertisements. We overcome several obstacles to longitudinal studies by amalga-mating different resources and adapting our measurement infras-tructure to changes brought by adaptations by both legitimate op-erators and attackers. Our goal is to empirically characterize how strategies for carrying out and combating search poisoning have evolved over a relatively long time period. We investigate how the composition of search results themselves has changed. For in-stance, we find that search-redirection attacks have steadily grown to take over a larger share of results (rising from around 30 % in late 2010 to a peak of nearly 60 % in late 2012), despite efforts by search engines and browsers to combat their effectiveness. We also study the efforts of hosts to remedy search-redirection attacks. We find that the median time to clean up source infections has fallen from around 30 days in 2010 to around 15 days by late 2013, yet the number of distinct infections has increased considerably over the same period. Finally, we show that the concentration of traffic to the most successful brokers has persisted over time. Further, these brokers have been mostly hosted on a few autonomous systems, which indicates a possible intervention strategy. Categories and Subject Descriptors K.4.1 [Public Policy Issues]: Abuse and crime involving comput-er

Is the European Union ready for foreign direct investment from emerging markets?

This chapter asks whether the European Union Member States are ready for inward Foreign Direct Investment from the Emerging Markets. It concludes that European Union Member States have relatively open Foreign Direct Investment regimes in the international context, and yet instances of protectionism have been apparent in the recent period. However, protectionism has occurred both vis-a-vis Foreign Direct Investment from the Global South as well as from within the European Union, particularly in the so-called 'strategic' industries

Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic

Physical therapy vs. medical treatment of musculoskeletal disorders in dentistry - a randomised prospective study

Introduction and objective. Musculoskeletal disorders are frequently met in dentistry. Objectives. To show the efficiency of rehabilitation and to make correlations among patients’ pain levels, their overall health status, and the number of days of work absenteeism. Materials and method. A total of 390 dentists diagnosed with low back pain, scapulohumeral periarthritis, cervicobrachial neuralgia, hand osteoarthritis, tendinitis or tenosynovitis of the upper limb, carpal tunnel syndrome, spinal deformities and fibromyalgia, were followed in a 2-year prospective study. For each ailment the patients were divided into two groups. Group 1 followed both medical and rehabilitation treatment, while group 2 followed medical treatment. The patients were assessed by the visual analogue scale (VAS), the Health Assessment Questionnaire adapted for Dentists (HAQD) and the number of days of absenteeism. Results. VAS scores did not significantly differ between the two groups at the beginning of the study but were significantly lower at final assessment. HAQD scores were significantly lower at one-year and two-year assessments in Group 1. The number of days of absenteeism did not differ significantly between the two groups at the initial assessment. Nevertheless, the number of days of absenteeism was significantly higher for Group 2 patients at the end of the study. For increased values of the visual analogue scale at the beginning and at the end of the study, the significantly increased numbers of days of absenteeism and of health assessment questionnaire scores were associated. Conclusions: Improvements of functional parameters and increase in work productivity were recorded in dentists who followed physical therapy

20 YEARS OF EXPERIENCE WITH SCRAP PREHEATING TECHNOLOGY

More and more countries worldwide implement new rules and regulations to improve energy efficiency and cut CO2 and hazardous off-gas emissions. Thus electric steelmakers need technology that keeps costs low, increases productivity and helps them adhere to environmental regulations. Decades of knowledge in preheating technology, and several different innovative applications which had been solution for many unique cases have been brought together and announced in 2010. EAF Quantum was designed as a pragmatic solution that meets requirements for high energy and cost efficiency, increased productivity and lowest emissions. Whether scrap, partly hot metal or direct-reduced iron (DRI) is charged, EAF Quantum is the solution for highly productive electric steelmaking at extra low conversion costs