Health Assurance Research Articles

CPS Modeling of CNC Machine Tool Work Processes Using an Instruction-Domain Based Approach

ABSTRACT Building cyber-physical system (CPS) models of machine tools is a key technology for intelligent manufacturing. The massive electronic data from a computer numerical control (CNC) system during the work processes of a CNC machine tool is the main source of the big data on which a CPS model is established. In this work-process model, a method based on instruction domain is applied to analyze the electronic big data, and a quantitative description of the numerical control (NC) processes is built according to the G code of the processes. Utilizing the instruction domain, a work-process CPS model is established on the basis of the accurate, real-time mapping of the manufacturing tasks, resources, and status of the CNC machine tool. Using such models, case studies are conducted on intelligent-machining applications, such as the optimization of NC processing parameters and the health assurance of CNC machine tools.

PEARL translational network: an infrastructure for person-centricity and improved clinical outcomes

Healthcare systems should be transparent and easy to use and considered a joint venture between the various stakeholders with the goal of improving the diagnosis, treatment and clinical outcomes to control nations’ rising costs of healthcare. The stakeholders are many including an educational component, practitioners, payers, government and industry providing the treatment and medications. All of these variables and more contribute to cost escalation. Within this complex framework is the nations’ abiliy to provide some level of basic care for public health assurance of its populace possibly through the concept of ‘person-centricity’. The Practitioners Engaged in Applied Learning & Research (PEARL) Network was conceived through government funding and has evolved into a not-for-profit private enterprise. The PEARL Network is a hybrid network incorporating the benefits of an academic practice based research network into a practice based translational network with the principles of conducting pharmaceutical l...

APPLICATION OF TOTAL QUALITY MANAGEMENT IN ISLAMIC EDUCATION: A Case Study of Madrasah Aliyah (MA) Al-Hikmah, Karangmojo, Gunung Kidul, Yogyakarta

This paper examines how Total Quality Management in Islamic School can fulfill market demands of quality graduates using Madrasah Aliyah (MA) Al-Hikmah Karangmojo Gunung Kidul Yogyakarta as a case study. Based on the research’s findings, it will show that: (1) in terms of service management, MA al-Hikmah provides service to the customers –the students- by not charging them any fees for educational operational costs, accommodation, health assurance, and educational facilities such as books and courses; (2) in terms of educational process management, MA Al-Hikmah’s teachers teach students using various teaching methods and strategies. Teaching processes are conducted both indoor and outdoor. MA Al-Hikmah also has a teaching team to handle the 12 th graders in extra classes so that they can pass the national examination; (3) in terms of product management, MA Al-Hikmah continuously improves its educational quality through a variety of ways. MA Al-Hikmah also has a special team to maintain students’ achievements morally and academically. MA Al-Hikmah also makes some efforts to provide its graduates with opportunities to get scholarships in the higher education and job vacancies to meet the market needs of quality graduates.

Physical Exercise as an Epigenetic Factor Determining Behavioral Outcomes

The science of behavior has been afforded much fuel for advancement of notions of lifespan development through the emerging observations of (i) physical exercise as an intervention for disease states and health assurances and (ii) epigenetics as the biological avenues determining whether or not individuals well-being or illbeing . Any bodily activity that enhances or maintains physical fitness implies the involvement of regular and frequent exercise have defined exercise as a planned, structured physical activity with the purpose of improving one or more aspects of physical fitness and functional capacity. Epigenetics may be defined as the study of heritable phenotypic expressions resulting from changes in a chromosome without alterations in the DNA sequence. It has been applied in developmental psychology to examine psychobiological development emerging from an ongoing, bi-directional interchange between heredity and the environment through mechanisms of temporal and spatial control of gene activity during the development of complex organisms thereby shaping the behavior of individuals and organisms; as an experimental aspect of psychology it investigates how the life-span of ‘nurture’ orchestrates the biological heredity of ‘nature’.

India's draft National Health Policy, 2015: Improving policy to implementation effectiveness.

As the Government of India is working on drafting a new National Health Policy, developing national health accounts, and planning for a “health assurance mission,” this opportunity has the potential to transform health status of millions of Indians and achieve universal health coverage. The draft of new National Health Policy of India was put in public domain for comments in early 2015. This editorial reviews the draft National Health Policy 2015 and proposes a few steps to improve implementation effectiveness.

HSF-1-mediated cytoskeletal integrity determines thermotolerance and life span.

The conserved heat shock transcription factor-1 (HSF-1) is essential to cellular stress resistance and life-span determination. The canonical function of HSF-1 is to regulate a network of genes encoding molecular chaperones that protect proteins from damage caused by extrinsic environmental stress or intrinsic age-related deterioration. In Caenorhabditis elegans, we engineered a modified HSF-1 strain that increased stress resistance and longevity without enhanced chaperone induction. This health assurance acted through the regulation of the calcium-binding protein PAT-10. Loss of pat-10 caused a collapse of the actin cytoskeleton, stress resistance, and life span. Furthermore, overexpression of pat-10 increased actin filament stability, thermotolerance, and longevity, indicating that in addition to chaperone regulation, HSF-1 has a prominent role in cytoskeletal integrity, ensuring cellular function during stress and aging.

EVALUASI IMPLEMENTASI PROGRAM JAMINAN KESEHATAN MASYARAKAT (JAMKESMAS) DI KECAMATAN BATURETNO KABUPATEN WONOGIRI

One of the government’s efforts to reduce poverty in Indonesia is giving health aid for poor citizens by giving Jamkesmas (Public Health Assurance) to them. Wonogiri Regency is one of poor regencies in Indonesia, shown by increasing number of people who receive Jamkesmas. There are some aspects that have to be improved in the data collection of Jamkesmas’ beneficiaries in Baturetno District. This is according to the incompleteness of the Jamkesma coverage. Based on this condition, this research is aimed at investigating how Jamkesmas can be enjoyed by poor people listed in Jamkesmas beneficiaries and investigating the achievements of the objectives of Jamkesmas towards poor people in Baturetno District. This research uses the criteria of policy evaluation by William N. Dunn: effectiveness, efficiensy, adequacy, responsiveness, dan accuracy. This research uses qualitative descriptive method. The data were obtained by interview, observation, documentation, and literary review. By using descriptive method, the researcher studied the problem faced by describing the situation of the subjects or the objects of the research based on facts found and based on the real condition. The sources of this research were authorities of Jamkesmas and the beneficieries of Jamkesmas in Baturetno’s Health Center (puskesmas) The results of this reserach were: (1) there is no annual verification or update of the data of Jamkesmas beneficiaries that caused the incompleteness of Jamkesmas beneficiaries, (2) the objectives of Jamkesmas were achieved well in Baturetno District, (3) the acces and quality of health service for poor community were improved, (4) poor neighbourhood had more understanding about the benefits of health service, (5) Jamkesmas program positively affected poorer community in Baturetno Distict, and (6) people felt it hard to complete the requirements of the referral and felt that the registration in the hospitals were convoluted. Based on the above results, it is recommended that the data of Jamkesmas beneficiaries are verified, authorities need to improve coordination so that any information obtained by society is true and complete. The weaknesses of Jamkesmas concluded in this research are expected to improve JKN (National Health Insurance) which is now being implemented by the government.

Health system challenges in implementing universal health coverage: Asian perspectives and experiences

In line with the global trend towards providing universal health coverage (UHC) as a primary tool in achieving sustainable development in the post-2015, post-MDG era, many low- and middle-income countries in the Asian region are in the midst of developing and implementing various schemes and strategies to achieve UHC. Given the diversity in health system structures, resources and capacities, the implementation of UHC in these countries poses major challenges to health service delivery. Indonesia, the fourth largest country in the world, rolled out its UHC plan, called JKN (National Health Assurance) in early 2014 and faces formidable logistic and administrative challenges with regards to access to medicines, human resources, financing, governance and scaling up health service delivery. Key implementation challenges include those associated with issues of equity, quality and sustainability. The Indonesian experience in rolling out UHC may also be compared to other countries in the region which have implemented UHC with varying degrees of success (e.g. Thailand, Vietnam, Taiwan, India, Malaysia, etc.). In the spirit of ‘reverse innovation’, it is also hoped that lessons learnt from UHC implementation in these countries will provide valuable learning lessons for each other, and for the success of UHC more broadly.

Methodological approaches to veterinary service efficiency evaluation in livestock

This paper presents the contradiction between modern views on the role of veterinary science from the concept 'one health' position, which implies an important role in health assurance and the welfare of the whole veterinary care society, and existing methodological support of its efficiency evaluation. The analysis of existing methods of veterinary attendance efficiency evaluation was conducted on the case of Stavropol Territory and with the help of canonical correlations method their disadvantages were shown. The paper provides rationalization for the need of veterinary science external effect consideration, which operates in healthcare and environmental protection. The procedure for calculating the integral coefficient of veterinary service efficiency was proposed, which allows taking into account the complex of internal and external effects. The integral coefficient may be used in the process of comparative analysis, in the specification of strategic growth priorities, in the motivation system integration of veterinary service employees.

The report from the Health Service Ombudsman: Time for review?

British Journal of MidwiferyVol. 22, No. 1 CommentThe report from the Health Service Ombudsman: Time for review?Cathy RogersCathy RogersSearch for more papers by this authorCathy RogersPublished Online:3 Apr 2014https://doi.org/10.12968/bjom.2014.22.1.56AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Burden B, Jones T (1999) Midwives' perceptions of supervisors and managers. British Journal of Midwifery 7(9): 547–52 Link, Google ScholarBurden B, Jones T (2001) Improvements to supervision are essential for best practice. British Journal of Midwifery 9(4): 220–6 Link, Google ScholarCare Quality Commission (2013) Maternity services survey 2013. Care Quality Commission, London Google ScholarDepartment of Health (2007) Trust, Assurance and Safety – The Regulation of Health Professionals in the 21st Century. The Stationery Office, London Google ScholarDuerden J (2000) Audit of Supervision of Midwives. England 1996–1997. In: Kirkham, M (ed.) Developments in the Supervision of Midwives. Books for Midwives, Oxford Google ScholarFrancis R (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. The Stationery Office, London Google ScholarGaffney E (1998) What do midwives want from their supervision? Results of a small survey in Yorkshire. The Practising Midwife 1(10): 24–6 Google ScholarHalksworth G, Bale B, James C (2000) Evaluation of the supervision of midwives; Wales. In: Kirkham, M (ed.) Developments in the Supervision of Midwives. Books for Midwives, Oxford: 1–32 Google ScholarHenshaw AM, Clarke D, Long AF (2013) Midwives and supervisors of midwives' perceptions of the statutory supervision of midwifery within the United Kingdom: A systematic review. Midwifery 29(1): 75–85 Crossref, Google ScholarHome Office, Department of Health (2003) The Shipman Inquiry. Third Report. Death Certification and the Investigation of Deaths by Coroners. Her Majesty's Stationery Office, London Google ScholarKirkham M, Morgan RK (2006) Why midwives return and their subsequent experience. Department of Health and Bedfordshire and Hertfordshire Workforce Development Confederation, University of Sheffield Women's Informed Childbearing and Health Research Group Google ScholarKirkham M, Morgan RK, Davies C (2006) Why do midwives stay? Department of Health and Bedfordshire and Hertfordshire Workforce Development Confederation, University of Sheffield Women's Informed Childbearing and Health Research Group Google ScholarMcDaid C, Stewart Moore J (2006) Supervision: How can the gap be bridged? RCM Midwives 9(5): 180–3 Google ScholarMead M, Kirby J (2006) An evaluation of the time spent by midwives on supervisory activities. British Journal of Midwifery 14(2): 76–81 Link, Google ScholarNational Audit Office (2013) Maternity Services in England. National Audit Office, London Google ScholarParliamentary and Health Service Ombudsman (2013) Midwifery supervision and regulation: Recommendations for change. tinyurl.com/negso38 (accessed 16 December 2013) Google ScholarRogers C, Yearley C (2013) National survey of supervision of midwives: Time for reflection? British Journal of Midwifery 21(5): 356–63 Link, Google ScholarShennan C (1996) Midwives perceptions of the role of a supervisor of midwives. In: Kirkham M (ed.) Supervision of Midwives. Midwives Press, Oxford: 163–82 Google ScholarStapleton H, Duerden J, Kirkham M (1998) Evaluation of the Impact of Supervision of Midwives on Midwifery Practice and the Quality of Midwifery Care. ENB, London Google ScholarWarwick C (2009) Statutory supervision of midwives: Adding value to the profession. British Journal of Midwifery 17(11): 686 Link, Google Scholar FiguresReferencesRelatedDetails 1 January 2014Volume 22Issue 1ISSN (print): 0969-4900ISSN (online): 2052-4307 Metrics History Published online 3 April 2014 Published in print 1 January 2014 Information© MA Healthcare LimitedPDF download

Universal health coverage: the way forward.

Universal health coverage (UHC) is the means to provide accessible and appropriate health services to all citizens without financial hardships. India, an emerging economy with demographic window of opportunity has been facing dual burden of diseases in midst of multiple transitions. Health situation in the country despite quantum improvements in recent past has enormous challenges with urban-rural and interstate differentials. Successful national programs exists, but lack ability to provide and sustain UHC. Achieving UHC require sustained mechanisms for health financing and to provide financial protection through national health packages. There is a need to ensure universal access to medicines, vaccines and emerging technologies along with development of Human Resources for Health (HRH). Health service, management, and institutional reforms are required along with enhanced focus on social determinants of health and citizen engagement. UHC is the way for providing health assurance and enlarging scope of primary health care to nook and corners of the country.

Improving immunization rates of underserved children: a historical study of 10 health departments.

Despite high immunization rates, hundreds of thousands of poor and underserved children continue to lack their necessary immunizations and are at risk of acquiring a vaccine-preventable disease. Local Health Departments (LHDs) and public health clinicians figure prominently in efforts to address this problem. This exploratory research compared ten (10) North Carolina LHDs with respect to immunization delivery factors. The study sample was identified based on urban designation as well as county demographic and socio-economic indicators that identified predicted "pockets" of underimmunization. Survey instruments were used to identify specific LHD immunization delivery factors. It was found that hours of operation, appointment policies, use and type of tracking systems, and wait times influence a health department's ability to immunize underserved children. This exploratory research is of particular importance, because it suggests that the implementation of specific policy interventions may reduce the morbidity and mortality related to vaccine-preventable diseases in poor and underserved children. This research also highlights the significance of the nurses' role in the policy making process in this important area of community health assurance. To improve childhood immunization rates, policy-makers should encourage adequate and appropriate funding for LHDs to adopt service delivery factors that are associated with higher-performing local health departments. LHDs should study the population they serve to further refine service delivery factors to meet the population's needs.

Essential elements of personalized medicine

Genomic information has been promoted as the basis for "personalized" health care. We considered the benefits provided by genomic testing in context of the concept of personalized medicine. We evaluated current and potential uses of genomic testing in health care, using prostate cancer as an example, and considered their implications for individualizing or otherwise improving health care. Personalized medicine is most accurately seen as a comprehensive effort to tailor health care to the individual, spanning multiple dimensions. While genomic tests will offer many potential opportunities to improve the delivery of care, including the potential for genomic research to offer opportunities to improve prostate cancer screening and treatment, such advances do not in themselves constitute a paradigm shift in the delivery of health care. Rather, personalized medicine is based on a partnership between clinician and patient that utilizes shared decision making to determine the best health care options among the available choices, weighing the patient's personal values and preferences together with clinical findings. This approach is particularly important for difficult clinical decisions involving uncertainty and trade-offs, such as those involved in prostate cancer screening and management. The delivery of personalized medicine also requires adequate health care access and assurance that basic health needs have been met. Substantial research investment will be needed to identify how genomic tests can contribute to this effort.

A Literature Review on Social and Economic Factors Related to Access to Dental Care for Pregnant Women

Background: The early detection of oral pathology in the pregnant woman can contribute to reduction in childbirth-related complications and consequences of low birth weight. The purpose of this review was to identify and analyze main social and economic factors related to access to dental care of pregnant women. Methods: The Guide on implementation of the narrative synthesis was used systematic reviews of research evidence Popay et al. 2006. The review process included identification of the approach to review, search and allocation of the available evidence, review question was specified, identified studies for inclusion in the review, extracted data and evaluation of the quality of the study. The search was about pregnant women and dental services. Qualitative and quantitative studies in a period from 1990 to 2013 were included. Publications included are in English, Portuguese and Spanish. Age was women over the age of 13 and under 45 years of age. Results: Of 120 relevant items found in electronic databases used as PubMed, library virtual em Saúde, ISI Web of Knowledge, Scielo, The Anthropological Index Online, PsycInfo, The Psychology & Behavioral Sciences Collection, SocINDEX, ProQuest, network of scientific journals of Latin America and the Caribbean, Spain and Portugal, EBSCO, Google school. Only thirty-three articles satisfied the quality criteria to be included in the review. The most frequently identified relating to access to dentistry-related factors were: age of the pregnant woman, schooling level, ethnicity, marital status, income, occupation, socioeconomic level and attention-related social dynamics as access to information, health assurance and use of dental service according to trimester of gestation. This review found that the level of schooling achieved, family income, the marital status and having health insurance were important predictors of attending for dental care. Only three articles were qualitative research. Conclusions: The existence of published reports on the topic of search suggests the need for more qualitative and quantitative research. Actions to improve the coverage and dental care of pregnant women should consider social and economic factors and not just the change in user behavior.

Characterization of impact damage in composite laminates using guided wavefield imaging and local wavenumber domain analysis

Delaminations in composite laminates resulting from impact events may be accompanied by minimal indication of damage at the surface. As such, inspections are required to ensure defects are within allowable limits. Conventional ultrasonic scanning techniques have been shown to effectively characterize the size and depth of delaminations but require physical contact with the structure and considerable setup time. Alternatively, a non-contact scanning laser vibrometer may be used to measure guided wave propagation in the laminate structure generated by permanently bonded transducers. A local Fourier domain analysis method is presented for processing guided wavefield data to estimate spatially dependent wavenumber values, which can be used to determine delamination depth. The technique is applied to simulated wavefields and results are analyzed to determine limitations of the technique with regards to determining defect size and depth. Based on simulation results, guidelines for application of the technique are developed. Finally, experimental wavefield data is obtained in quasi-isotropic carbon fiber reinforced polymer (CFRP) laminates with impact damage. The recorded wavefields are analyzed and wavenumber is measured to an accuracy of up to 8.5% in the region of shallow delaminations. These results show the promise of local wavenumber domain analysis to characterize the depth of delamination damage in composite laminates. The technique can find application in automated vehicle health assurance systems with potential for high detection rates and greatly reduced operator effort and setup time.

There are Doctors and there are Doctors : Creating a Dichotomy between Physicians’ Roles = طبيب و دكتور : إختلاف أوجد إنقساما في أدوار الأطب

There are Doctors and there are Doctors : Creating a Dichotomy between Physicians’ Roles = طبيب و دكتور : إختلاف أوجد إنقساما في أدوار الأطب

Human Factors and IT Medical Device Standards at AAMI

Human Factors and IT Medical Device Standards at AAMI

Report of the 2011-2012 Standing Committee on Advocacy: The Relevance of Excellent Research: Strategies for Impacting Public Policy

Report of the 2011-2012 Standing Committee on Advocacy: The Relevance of Excellent Research: Strategies for Impacting Public Policy

Local Public Health System Performance and Community Health Outcomes

Public health systems are charged with protecting the health and well-being of the communities they serve. Higher-performing public health systems should be associated with improved community health status. Currently, little research examines the impact of variations in public health system performance on community health outcomes. The current study seeks to provide local public health system partners with evidence regarding the impact of their efforts. It does so through examining the relationship between variations in local public health system performance in providing the core functions of public health (assessment, assurance, and policy development) and community health outcomes. Measures of community health status (dependent variables) and community demographic characteristics, collected from 1994 to 2003, were merged with measures of public health system performance collected from 2002 to 2007 (independent variables). For each dependent variable, Pearson correlations were calculated with all of the independent variables. Multivariate linear regression models were developed for each health outcome. Analysis was completed in 2010. Bivariate analysis found nine associations between local public health system performance and health outcomes. Linear regression models found associations between performance and three of the six outcomes measured. The outcomes associated with performance are those that would seem to be most sensitive to variations in practice. Poverty is significantly associated with all the health outcomes measured. These associations between performance and health outcomes suggest that improving performance of the core functions of public health may improve health.

Safety Management in Catalonia's Schools

The management of safety in schools is an essential aspect to guarantee the protection of all the students, teachers and other staff from the risk and hazards of the school environment. The whole school community plays an important role in school safety assurance, but it is the headmasters who are in charge of protection. Spain's school legislation establishes this responsibility, but no general function directly refers to the safety management. The purpose of this study is to identify and analyse the functions that the headmasters develop to guarantee the integrity of all users, in the context of the Catalan schools (Spain). The approach takes the shape of descriptive-inductive study, using data from documentary analysis, interviews with headmasters (n=14) and teachers (n=12) of fourteen public schools, and one focus group with experts (n=7) to discuss provisional findings. The outcomes show that all the headmasters recognise their responsibility and obligation in the assurance of safety and health to all the members of the school, but in opinion of some experts the responsibility is not fully assumed. The study concludes that, for an adequate safety management in schools, the following factors are absolutely necessary: enough administration support, increasing time and resources and improving the level staff training.