Trends and correlates of the public’s perception of the healthcare system in the European Union: a multi-level analysis of Eurobarometer survey data from 2009 to 2013

Objective The aim of the study is to assess trends in public perceptions of health systems in 27 European Union (EU) member states following the financial crisis (2009–2013), in order to discuss observed changes in the context of the financial crisis. Design Repeated cross-sectional studies. Setting 27 EU countries. Participants EU citizens aged 15 years and older. Methods The study mainly uses the Eurobarometer Social Climate Survey, conducted annually between 2009 and 2013, thereby analysing 116 706 observations. A multilevel logistic regression was carried out to analyse trends over time and the factors associated with citizens’ perceptions of their healthcare systems. Results Europeans generally exhibit positive perceptions of their national healthcare systems, 64.0% (95% CI 63.6% to 64.4%). However, we observed a significant drop in positive perceptions in the years following the crisis, especially within countries most affected by the crisis. Concerning fiscal characteristics, wealthier countries and those dedicating higher proportion of their national income to health were more likely to maintain positive perceptions. At the individual level, perceptions of healthcare systems were significantly associated with respondents’ self-perceptions of their social status, financial capacity and overall satisfaction in life. Conclusions Our finding confirms previous observations that citizens’ perceptions of their healthcare systems may reflect their overall prospects within the broader socioeconomic systems they live in; which have in turn been affected by the financial crisis and the policy measures instituted in response

European Union citizens’ views on development assistance for developing countries, during the recent migrant crisis in Europe

Background: Development assistance from governments of high income countries represents the vast majority of international funding for global health. Recent stagnation of this important source of funding may affect attainment of major global health goals. The financial crisis is widely accredited as denting governments’ outlay for development aid, as well as citizen’s support for aid. Europe has also recently experienced record levels of migration; the so called ‘European migration crisis’. This study aims to analyse trends in public attitudes towards development aid in European Union (EU) countries, in the context of the European migrant crisis. Methods: Eurobarometer survey data from 2011 (prior to the migrant crisis) and 2015 (at the peak of the crisis) was analysed for 27 EU countries. The outcome variables related to people’s levels of support to three statements around the importance of supporting people in developing countries, increasing countries’ commitments to aid and willingness to pay extra for products from developing countries. EU Member States were categorised as ‘arrival’ or ‘destination’ countries in view of migration routes and numbers of asylum applications per 100,000 population, respectively. Multiple linear regression analysis was performed, adjusting for countries’ economic status (gross domestic product per capita). Results: In general, support for development aid has increased from 2011 to 2015, but was largely unaffected by migration status when applying the regression model. In 2015, the belief that development assistance is ‘very important’ was significantly higher in countries where migrants first arrived compared to other EU Member States, with a trend towards this association also apparent in 2011. Conclusions: The positive trends in public support for development aid are encouraging in an age where economic hardships at home, as well as the tone of national political discourses and rising right wing populism appear to suggest otherwise

Closed Loop Control of a Tethered Magnetic Capsule Endoscope

Magnetic field gradients have repeatedly been shown to be the most feasible mechanism for gastrointestinal capsule endoscope actuation. An inverse quartic magnetic force variation with distance results in large force gradients induced by small movements of a driving magnet; this necessitates robotic actuation of magnets to implement stable control of the device. A typical system consists of a serial robot with a permanent magnet at its end effector that actuates a capsule with an embedded permanent magnet. We present a tethered capsule system where a capsule with an embedded magnet is closed loop controlled in 2 degree-of-freedom in position and 2 degree-offreedom in orientation. Capitalizing on the magnetic field of the external driving permanent magnet, the capsule is localized in 6- D allowing for both position and orientation feedback to be used in a control scheme. We developed a relationship between the serial robot’s joint parameters and the magnetic force and torque that is exerted onto the capsule. Our methodology was validated both in a dynamic simulation environment where a custom plug-in for magnetic interaction was written, as well as on an experimental platform. The tethered capsule was demonstrated to follow desired trajectories in both position and orientation with accuracy that is acceptable for colonoscopy

Web-based Integrated Development Environment for Event-Driven Applications

Event-driven programming is a popular methodology for the development of resource-constrained embedded systems. While it is a natural abstraction for applications that interface with the physical world, the disadvantage is that the control flow of a program is hidden in the maze of event handlers and call-back functions. TinyOS is a representative event-driven operating system, designed for wireless sensor networks, featuring a component-based architecture that promotes code reuse. In this paper, we present a web-based model-driven graphical design environment for TinyOS that visualizes the component hierarchy of an application, and captures its eventbased scheduling mechanism. In contrast with existing visual environments, our representation explicitly captures the control flow of the application through events and commands, which makes it easier to understand the program logic than studying the source code. The design environment supports two-way code generation: mapping the visual representation to TinyOS source code, as well as building visual models from existing sources

Toward Rapid Prototyping of Miniature Capsule Robots

Minimally invasive robotic surgery techniques are becoming popular thanks to their enhanced patient benefits, including shorter recovery time, better cosmetic results and reduced discomforts. Less invasive procedures would be achieved with the use of Medical Capsule Robots (MCRs). These devices are characterized by low power requirements and small dimensions as well as uncompromising safety. MCRs operate wirelessly in abdominal Minimally Invasive Surgery (MIS) and Natural Orifice Transluminal Endoscopic Surgery (NOTES) or in the Gastrointestinal (GI) tract. The design process of MCRs, however, is expensive and time consuming. A platform for rapid prototyping MCRs is needed so that MCR researchers can reduce development costs and spend more time in studying innovative MCR applications. In this work, we introduce an open source modular platform geared toward rapid prototyping MCRs. To speed up the prototyping process, the MCR is programmed using TinyOS instead of bare-bone C. We present the hardware architecture of the platform, and the motivation for using TinyOS. To show the viability of TinyOS, we present results from an experiment involving sensing, actuation and wireless communication. This work lays the foundation for our future goal of building an integrated design environment for the design, analysis and simulation of MCRs

Structure and functional motifs of GCR1, the only plant protein with a GPCR fold?

Whether GPCRs exist in plants is a fundamental biological question. Interest in deorphanizing new G protein coupled receptors (GPCRs), arises because of their importance in signaling. Within plants, this is controversial as genome analysis has identified 56 putative GPCRs, including GCR1 which is reportedly a remote homologue to class A, B and E GPCRs. Of these, GCR2, is not a GPCR; more recently it has been proposed that none are, not even GCR1. We have addressed this disparity between genome analysis and biological evidence through a structural bioinformatics study, involving fold recognition methods, from which only GCR1 emerges as a strong candidate. To further probe GCR1, we have developed a novel helix alignment method, which has been benchmarked against the the class A – class B - class F GPCR alignments. In addition, we have presented a mutually consistent set of alignments of GCR1 homologues to class A, class B and class F GPCRs, and shown that GCR1 is closer to class A and /or class B GPCRs than class A, class B or class F GPCRs are to each other. To further probe GCR1, we have aligned transmembrane helix 3 of GCR1 to each of the 6 GPCR classes. Variability comparisons provide additional evidence that GCR1 homologues have the GPCR fold. From the alignments and a GCR1 comparative model we have identified motifs that are common to GCR1, class A, B and E GPCRs. We discuss the possibilities that emerge from this controversial evidence that GCR1 has a GPCR fol

Systematic Design of edical Capsule Robots

Medical capsule robots that navigate inside the body as diagnostic and interventional tools are an emerging and challenging research area within medical CPSs. These robots must provide locomotion, sensing, actuation, and communication within severe size, power, and computational constraints. This paper presents the first effort for an open architecture, platform design, software infrastructure, and a supporting modular design environment for medical capsule robots to further this research area

The role of ECL2 in CGRP receptor activation: a combined modelling and experimental approach

The calcitonin gene-related peptide (CGRP) receptor is a complex of a calcitonin receptor-like receptor (CLR), which is a family B G-protein-coupled receptor (GPCR) and receptor activity modifying protein 1. The role of the second extracellular loop (ECL2) of CLR in binding CGRP and coupling to Gs was investigated using a combination of mutagenesis and modelling. An alanine scan of residues 271–294 of CLR showed that the ability of CGRP to produce cAMP was impaired by point mutations at 13 residues; most of these also impaired the response to adrenomedullin (AM). These data were used to select probable ECL2-modelled conformations that are involved in agonist binding, allowing the identification of the likely contacts between the peptide and receptor. The implications of the most likely structures for receptor activation are discussed.</jats:p

Optimization of total protein and activity assays for the detection of MMP-12 in induced human sputum

<p>Abstract</p> <p>Background</p> <p>Proteolysis of matrix components, in particular elastin, is a major contributing factor to the development of lung diseases such as emphysema and chronic obstructive pulmonary disease (COPD). MMP-12 (macrophage elastase) is a protease known to be involved in the progression of lung disease. The relatively low abundance of MMP-12 has precluded the development of quantitative assays that can accurately measure MMP-12 protein levels and activity across cohorts of healthy and diseased individuals.</p> <p>Methods</p> <p>Commercial antibodies were screened for performance in sandwich ELISA and capture FRET activity assay formats. Precision, accuracy, sensitivity, dilution linearity, and spike recovery were evaluated using sputum samples.</p> <p>Results</p> <p>Total protein and capture FRET activity assays were developed that were sensitive enough to detect MMP-12 in 37 of 38 donor sputum samples. A comparison of results between the two assays shows that a majority of sputum MMP-12 is in the active form. No differences were seen between normal, asthmatic, and COPD donors.</p> <p>Conclusion</p> <p>Sensitive and quantitative assays for both MMP-12 activity and total protein in human induced sputum have been developed. These assays can be used to evaluate MMP-12 as a biomarker for lung disease, and to monitor efficacy of potential therapeutic compounds.</p

How Ethiopia achieved Millennium Development Goal 4 through multisectoral interventions: a Countdown to 2015 case study.

BACKGROUND: 3 years before the 2015 deadline, Ethiopia achieved Millennium Development Goal 4. The under-5 mortality decreased 69%, from 205 deaths per 1000 livebirths in 1990 to 64 deaths per 1000 livebirths in 2013. To understand the underlying factors that contributed to the success in achieving MDG4, Ethiopia was selected as a Countdown to 2015 case study. METHODS: We used a set of complementary methods to analyse progress in child health in Ethiopia between 1990 and 2014. We used Demographic Health Surveys to analyse trends in coverage and equity of key reproductive, maternal health, and child health indicators. Standardised tools developed by the Countdown Health Systems and Policies working group were used to understand the timing and content of health and non-health policies. We assessed longitudinal trends in health-system investment through a financial analysis of National Health Accounts, and we used the Lives Saved Tool (LiST) to assess the contribution of interventions towards reducing under-5 mortality. FINDINGS: The annual rate of reduction in under-5 mortality increased from 3·3% in 1990-2005 to 7·8% in 2005-13. The prevalence of stunting decreased from 60% in 2000 to 40% in 2014. Overall levels of coverage of reproductive, maternal health, and child health indicators remained low, with disparities between the lowest and highest wealth quintiles despite improvement in coverage for essential health interventions. Coverage of child immunisation increased the most (21% of children in 2000 vs 80% of children in 2014), followed by coverage of satisfied demand for family planning by women of reproductive age (19% vs 63%). Provision of antenatal care increased from 10% of women in 2000 to 32% of women in 2014, but only 15% of women delivered with a skilled birth attendant by 2014. A large upturn occurred after 2005, bolstered by a rapid increase in health funding that facilitated the accelerated expansion of health infrastructure and workforce through an innovative community-based delivery system. The LiST model could explain almost 50% of the observed reduction in child mortality between 2000 and 2011; and changes in nutritional status were responsible for about 50% of the 469?000 lives saved between 2000 and 2011. These developments occurred within a multisectoral policy platform, integrating child survival and stunting goals within macro-level policies and programmes for reducing poverty and improving agricultural productivity, food security, water supply, and sanitation. INTERPRETATION: The reduction of under-5 mortality in Ethiopia was the result of combined activities in health, nutrition, and non-health sectors. However, Ethiopia still has high neonatal and maternal morbidity and mortality from preventable causes and an unfinished agenda in reducing inequalities, improving coverage of effective interventions, and strengthening multisectoral partnerships for further progress. FUNDING: Bill & Melinda Gates Foundation and Government of Canada