A human-factors approach to capture medical device safety, performance and usability

Advances in medical technology including computer aided and robotic surgery, digital health and increased use of portable devices have improved patient care in both hospital and home environments. These advancements have brought an increased level of complexity in patient care with new challenges to both patients and clinicians. The available performance data on medical devices (MD) is scarce and of variable quality despite work from regulatory bodies, with multiple associated challenges and lack of effective systems in place for its collection. This research used human factor methods to address i) the current state of safety and performance data availability for MDs and ii) methods of capturing safety and usability data in hospital and home environments by using human factor methods. Part A of this thesis concentrated on hospital based devices whilst Part B addressed home use MDs. End user experiences were utilised throughout to gain an understanding of the current system including its challenges and reasons leading to lack of data. Patients, clinicians, manufacturers, human factor specialists and MHRA were involved at all stages of this research. The studies led to the developments of the pathway map to reporting and information transfer in operating theatres and furthermore the development and initial evaluation of the MD-PRS concept (Medical Device Performance Reporting System) as a single dedicated method of reporting all MD malfunctions/ failures. The My-VID usability tool (My Voice in Design) was developed and evaluated as a method for collecting usability data directly from patients on home use MDs. In conclusion, this thesis used human factor methods to better understand the current system of data collection, available data sources on MDs and challenges faced prior to developing methods for improvement, based on end user experiences . Finally, methods of applying this research to clinical practice were addressed in the final chapter.Open Acces

Seguimiento de la inclusión financiera a través del análisis del déficit de presupuesto en Nagaland, India

The paper finds that, to achieve financial inclusion for the India’s unbanked poor is a pressing goal with perplexing obstacles. While states or union territories like Puducherry, Himachal Pradesh and Kerala announced 100% financial inclusion in all their districts, the level of financial inclusion in Nagaland remains very low. The paper finds that financial inclusion as earmarked in policies does not reach the common beneficiaries of Deficit Budgetary Government and conclude that Financial Inclusion strategy needs to be built.El artículo considera que lograr la inclusión financiera para los sectores pobres no bancarizados de la India es una meta urgente con desconcertantes obstáculos. Mientras los estados o territorios de la unión como Puducherry, Himachal Pradesh y Kerala anunciaron inclusión financiera del 100% en todos sus distritos, el nivel de inclusión financiera en Nagaland sigue siendo muy bajo. El artículo encuentra que la inclusión financiera previstos en las políticas no llega a los beneficiarios comunes de déficit presupuestario, y concluye que la estrategia de inclusión financiera necesita construirse

Terrorism, War and Conflict, an analysis into the Horn of Africa - Al Shabaab in Somalia; US and UN efforts to reduce violence

Somalia has been one of the UN member countries who lingers from the presence of terrorist groups in its territory, that exert tremendous influence in the daily life of its society and economy. Al Shabaab is well known in the horn of Africa, particularly in Somalia, for its terrorist training and strong affiliation with other terrorist groups in Nigeria and Al-Qaeda. The Harakat Shabaab Al Mujahidin, also known as Al-Shabaab. has completely controlled the central and southern part of Somalia including some of its important sea ports, which are vital for the country’s economy. Although Ethiopian and Somali military forces attempted to rout the group in a two week war between December 2006 and January 2007, Al Shabaab, with its 14,500 militants, still continues to maintain control over strategic locations, not only in Somalia, but also throughout the horn of Africa. The paper delves into the recent events and attacks either undertaken or influenced by Al-Shabaab, including a snap shot of its threat to humanitarian aid personnel as well as the Africa Union troops who are desperately trying to lower the intensity of conflict along the Somalia Kenya border area and Al-Shabaab’s actions to secure financial resources

Italy and Albania: The political and economic alliance and the Italian invasion of 1939

As the successful coup d’etat of Rome in October 27 – 29, 1922, successfully unfolded and Benito Mussolini emerged into power, the threat of invasion and spread of fascism was looming over southeastern Europe and North African countries of Ethiopia, Libya and Somalia. Mussolini’s intentions would not be perceptible until October, 1935, the invasion of Ethiopia and consequently almost four years later with the invasion of Albania in April 7th, 1939, which is considered by many as the prelude to World War II. Italy’s role and support towards the implementation of infrastructure projects and economic development initiatives in Albania proved to be essential. The fascist regime of Benito Mussolini was also a strategic ally for King Zog I who was in a desperate need to establish a stable government and secure his monarchy. Although King Zog I came to power with the immense help of Yugoslavia, months later he established strong ties with Italy and worked tirelessly to foster strategic bilateral relations with Mussolini’s administration. Italo-Yugoslav Relations improved greatly after the signing of a bilateral agreement in March 25, 1937, therefore Benito Mussolini had the green light from the Yugoslav government – which brought King Zog I into power in December, 1924 – to storm with loans, equipment and human assets the newly created Albanian government which later would become a Kingdom under the rule of Zog I. The focus of this Essay will be the impact of Italian – Albanian Strategic Alliance, a detailed analysis on the pact of Tirana (1926), the Italian Strategic Interests on western Balkans and its subsequent invasion in April, 1939

General Objectives and Methods in HIV/AIDS Surveillance

Preventing transmission of virus is still the single intervention known as effective in limiting the spread of HIV infection. So, the epidemiological surveillance of HIV/AIDS is an important tool used by public health specialists in controlling epidemics. Epidemiological surveillance is a continuous process of collecting, analysing, interpreting and disseminating data in order to plan, implement and assess public health interventions. The objectives of HIV/AIDS surveillance should be specific, measurable, transformed into actions, realistic, planned to be done in due time. The main methods used by HIV/AIDS surveillance in collecting the data are biological surveillance, behavioural surveillance, other sources of information. The main indicators recommended for any HIV/AIDS programme components include the fields of politics, condoms availability and quality, social stigmatus & discrimination, knowledge, vertical transmission, sex negotiation and attitude, sexual behaviour, especially in youngsters, injection with drugs, safe blood and derivatives, STI treatment and prevention, care and social support, social & health impact. Data collected by public health surveillance systems guide the responses to the events, measure and monitor the burden of the disease, assess public health politics, etc.. Integrated approach in epidemiological surveillance takes into account, generally, the integration of all activities that have to do with epidemiological surveillance into a single service with multiple functions using the same structures, procedures and personnel. Second generation HIV/AIDS surveillance is a WHO concept developped on modular systems. The metodology in risk behaviour surveillance studies includes: justifying, behavioural risk, methods for collecting data, behavioural data value, steps in organizing behavioural surveillance studies

The Effect of Abscisic Acid on the Freezing Tolerance in Lolium Temulentum L.

This study was conducted to clarify the effect of abscisic acid (ABA) on the development of freezing tolerance in Lolium temulentum L. We compared the changes of freezing tolerance and endogenous ABA content by the ABA treatment with those by the hardening treatment. Exogenous ABA applications (7.5 x 10-5 M) increased freezing tolerance, but did not completely substitute for the hardening process. This treatment resulted in great increase in endogenous ABA content, as compared with the control or the hardening treatment. Since the relationship between endogenous ABA content and freezing tolerance was not parallel, it is considered that freezing tolerance is not dependent on endogenous ABA level alone in seedling

The Development of Higher Education in Albania, Problems and Challenges

Education is considered as one of the main pillars of society. An educated society leads the development of a nation. Education is also one of the areas which is also strongly influenced by it and social change. The fact that the educational systems are in permanent change does not show instability. But rather on the other side, they serve to better adapt the society which is changing. Starting from the beginning the education system in Albania has experienced changes after the collapse of the communist system and the approach of society to these changes has been a sensitive issue. These changes were not very studied, since they were in a very unfavorable environments, in which our education system came from a widespread politicization, and they did not always have the right fruits which was often perceived by us as experiments. These changes have not passed without debate, not only by academics, but also by students and civil society. Methodology: The work is based on a comparative analysis over these three decades, relying also on INSTAT’s statistical data.Main results: In this paper, I will show the transformation of the higher education system and how today the Law on Higher Education after three years of implementation has encountered a number of problems where the state and universities are moving from one to the other and finally that those who suffer the consequences of this law are the Albanian young who are not finding themselves in the Albanian market