Real-time Health Data Research Articles

WWOSC 2014: research needs for better health resilience to weather hazards.

The first World Weather Open Science Conference (WWOSC, held from 17–21 August 2014 in Montreal, Québec), provided an open forum where the experience and perspective of a variety of weather information providers and users was combined with the latest application advances in social sciences. A special session devoted to health focused on how best the most recent weather information and communication technologies (ICT) could improve the health emergency responses to disasters resulting from natural hazards. Speakers from a plenary presentation and its corresponding panel shared lessons learnt from different international multidisciplinary initiatives against weather-related epidemics, such as malaria, leptospirosis and meningitis and from public health responses to floods and heat waves such as in Ontario and Quebec, Canada. Participants could bear witness to recent progress made in the use of forecasting tools and in the application of increased spatiotemporal resolutions in the management of weather related health risks through anticipative interventions, early alert and warning and early responses especially by vulnerable groups. There was an agreement that resilience to weather hazards is best developed based on evidence of their health impact and when, at local level, there is a close interaction between health care providers, epidemiologists, climate services, public health authorities and communities. Using near real time health data (such as hospital admission, disease incidence monitoring…) combined with weather information has been recommended to appraise the relevance of decisions and the effectiveness of interventions and to make adjustments when needed. It also helps appraising how people may be more or less vulnerable to a particular hazard depending on the resilience infrastructures and services. This session was mainly attended by climate, environment and social scientists from North American and European countries. Producing a commentary appears to be an effective way to share this session’s conclusions to research institutions and public health experts worldwide. It also advocates for better linking operational research and decision making and for appraising the impact of ICT and public health interventions on health.

Climate Change Adaptation: Weighing Strategies for Heat-Related Health Challenges

Many public health impacts have been predicted for climate change, but there has been relatively little exploration of ways to minimize the risks and develop long-term adaptation strategies. A new overview outlines the critical elements needed to address one such impact: heat-related illnesses and deaths, which are expected to increase with more frequent and more intense heat waves [EHP 121(4):415–419; http://dx.doi.org/1206025]. Adapting to the anticipated weather extremes arising from climate change has two main thrusts: reducing exposure and managing health risks. Reducing heat exposure often means having access to air conditioning, but widespread use of air conditioning can overburden the electrical grid to the point of large-scale outages. It can also further pollute the atmosphere as power plants increase output to meet electricity demands. Reliance on air conditioning could be reduced through better building design and use of materials that reflect heat or insulate against it in new construction and renovations. These methods could be incorporated in urban planning that also encompasses green spaces (i.e., trees and open areas) and other measures known to mitigate the tendency for urban areas to trap and retain heat. Health risks might be mitigated to some degree through real-time health data surveillance, which would enable officials to detect crises early and warn the public accordingly. But health care facilities will need to be prepared for increased demand during heat waves. A worker applies a coating of white paint to the roof of a row home in Philadelphia, 19 Aug 2010. Reflective white roofs have been proposed as one way to reduce reliance on air conditioning, although it’s uncertain whether they are suited for ... Implementation of adaptive measures involves a separate level of challenges because policy decisions must consider cost-effectiveness. Yet there has been no thorough economic analysis of temperature-associated health costs and public health adaptation options, and policymakers hesitate to invest scarce financial resources in measures whose benefits are ambiguous. Adding to the uncertainty, the actual severity of future weather cannot be predicted—and a 4°C increase in average temperature will create a situation different from that of a 2°C increase—so precisely quantifying the expected economic strain is difficult. Finally, although adaptation costs money now, benefits may not be realized for years. Preliminary research has laid some groundwork for determining the value of adapting to a changing climate. For example, the “statistical life” concept assigns a monetary value to a year of life, which enables policymakers to better gauge whether an intervention is cost-effective. Additionally, some research has shown that measures such as heat–health warning systems can save both lives and health care costs. Public health researchers also recognize that solutions to climate-related problems may also benefit health—for instance, a community designed so that residents can safely walk and bike to shop and work not only reduces greenhouse gas emissions but offers the cardiovascular benefits of physical exercise, which in turn may further protect individuals against extreme heat. Such multibenefit solutions might ultimately prove the most cost-effective, but they need to be better understood and quantified before they can be enacted.

Dissemination of health information through social networks: Twitter and antibiotics

This study reviewed Twitter status updates mentioning "antibiotic(s)" to determine overarching categories and explore evidence of misunderstanding or misuse of antibiotics. One thousand Twitter status updates mentioning antibiotic(s) were randomly selected for content analysis and categorization. To explore cases of potential misunderstanding or misuse, these status updates were mined for co-occurrence of the following terms: "cold + antibiotic(s)," "extra + antibiotic(s)," "flu + antibiotic(s)," "leftover + antibiotic(s)," and "share + antibiotic(s)" and reviewed to confirm evidence of misuse or misunderstanding. Of the 1000 status updates, 971 were categorized into 11 groups: general use (n = 289), advice/information (n = 157), side effects/negative reactions (n = 113), diagnosis (n = 102), resistance (n = 92), misunderstanding and/or misuse (n = 55), positive reactions (n = 48), animals (n = 46), other (n = 42), wanting/needing (n = 19), and cost (n = 8). Cases of misunderstanding or abuse were identified for the following combinations: "flu + antibiotic(s)" (n = 345), "cold + antibiotic(s)" (n = 302), "leftover + antibiotic(s)" (n = 23), "share + antibiotic(s)" (n = 10), and "extra + antibiotic(s)" (n = 7). Social media sites offer means of health information sharing. Further study is warranted to explore how such networks may provide a venue to identify misuse or misunderstanding of antibiotics, promote positive behavior change, disseminate valid information, and explore how such tools can be used to gather real-time health data.

Real-time public health surveillance for emergency preparedness.

Public health agencies conduct surveillance to identify and prioritize health issues and evaluate interventions. Recently, natural and deliberate epidemics have motivated supplementary approaches to traditional surveillance methods based on physician and laboratory reporting. Fueled initially by post–September 11, 2001, bioterrorism-related funding, and more recently used for detecting natural outbreaks, these systems, many of which are called “syndromic” systems because they focus on syndromes recorded before the diagnosis, capture real-time health data and scan for anomalies suggesting an outbreak. Although these systems as typically implemented have often proven unreliable for detecting natural and simulated epidemics, real-time health-related data hold promise for public health. If redesigned to reliably perform beyond outbreak detection, syndromic systems could demonstrate unprecedented capabilities in responding to public health emergencies.

EMaintenance—Information logistics for maintenance support

Today's providers of maintenance and in-service support related to modern aircraft are facing major challenges. A central problem with Maintenance, Repair and Overhaul (MRO) as well as support of aircraft and other complex technical systems, is to manage the ever-increasing information flow and system complexity. Both military and commercial operators need to reduce aircraft downtime and maintenance man hours. Increased manual information management has the opposite effect, inducing unnecessary cost and affect efficiency negatively. Organizations developing and providing maintenance support products and in-service support does also need to improve the capability to efficiently exploit the increasing amount of digital product information and design data provided together with hardware (HW) and software (SW) products from aircraft manufacturers, sub-system suppliers and Original Equipment Manufacturers (OEM). One way to increase aircraft availability and improve maintenance and support efficiency, is to speed up the turnaround time for scheduled and unscheduled maintenance. The ultimate goal is risk-based utilization and support, where true Condition-Based Maintenance (CBM) is integrated with current operational requirements and available resources in real-time. This aims at the elimination of all preventive scheduled maintenance based on fixed time intervals and execution of only corrective maintenance that has been predicted and turned into scheduled maintenance facilitated by proper support. To address the challenge of information logistics of digital product data and information within maintenance in-service support, providers need to adapt new methodologies and tools that enable full utilization of the advantages of digital product data and information in processes and business models, e.g., Service-Oriented Architecture (SOA). To implement such improved support solutions in a global-support environment, eMaintenance is seen as one important building block. eMaintenance includes monitoring, collection, recording and distribution of real-time system health data, maintenance-generated data as well as other decision and performance-support information to different stakeholders independent of organization or geographical location, 24 h a day, 7 days a week (24/7). eMaintenance has the potential to improve the management and performance of activities related to the whole maintenance process, and thereby improve the dependability, safety and Life Cycle Cost (LCC) of critical systems. This can be realized through a coordinated application of Information and Communication Technology (ICT) throughout the maintenance and support processes, thus integrating Built-in Test (BIT) systems, external tests at different maintenance echelons, technical information, diagnostics, prognostics and other sources of support information. The purpose of this paper is to present some results from a joint academic and aerospace industry research project, describing requirements and expectations that are important in a global-support environment, and also to propose some central components in an eMaintenance framework that integrates maintenance and ICT perspectives.

Multiple xanthomas in a young male with familial hypercholesterolaemia

<h3>ABSTRACT</h3> <h3>Introduction:</h3> Effective community health management information systems (C-HMIS) are important in low-resource countries that rely heavily on community-based health care providers. Zambia currently lacks a functioning C-HMIS to provide...