scholarly journals Real-time monitoring of the rollout of pneumococcal conjugate vaccines in rural India using a digital tracking platform

2021 ◽  
Vol 5 ◽  
pp. 16
Author(s):  
Ruchit Nagar ◽  
Mohammad Sarparajul Ambiya ◽  
Saachi Dalal ◽  
Pawan Singh Bhadauriya ◽  
Hamid Abdullah ◽  
...  
Keyword(s):  
Booster Dose ◽  
Digital Health ◽  
Rural India ◽  
Geographic Variations ◽  
Immunization Program ◽  
Novel Technology ◽  
High Level ◽  
Rural Part ◽  
Maximal Benefit ◽  
Digital Tracking

Background: In 2017, the pneumococcal conjugate vaccine (PCV) was introduced into the Indian immunization program as a priority. However, monitoring the implementation of this program has been a major challenge in rural India. Novel digital health platforms, used to track vaccine delivery, can address this issue. Methods: We analyzed data collected in a rural part of the Udaipur District of India, which recently introduced PCV13 into the routine immunization program. The data were collected by Khushi Baby, a novel technology platform which facilitates tracking the vaccination status of individual children. We assessed the percent of children receiving 1, 2, or 3 doses of the vaccine at different ages and time points, as well as geographic variations in uptake. Only doses received before 12 months of age were considered for this analysis. Results: More than 96% of children captured by the database received the first dose of PCV13. Uptake of the second dose ranged from 69% to 90% across the five regions, and 44% to 76% of children received the third (booster) dose within 3 months of the recommended date. Conclusions: These data provide early evidence that the primary doses of PCV13 are being administered at a high level in rural India; however, there is considerable variability between regions. Additionally, the receipt of the booster dose may be lower than desired. Given the importance of the booster dose in reducing pneumococcal transmission, its delivery is essential to ensure maximal benefit of the vaccine program.

scholarly journals A Roadmap to Inform Development, Validation and Approval of Digital Mobility Outcomes: The Mobilise-D Approach

2020 ◽  
Vol 4 (1) ◽  
pp. 13-27 ◽  
Author(s):  
Lynn Rochester ◽  
Claudia Mazzà ◽  
Arne Mueller ◽  
Brian Caulfield ◽  
Marie McCarthy ◽  
...  
Keyword(s):  
Health Care ◽  
Clinical Trials ◽  
Health Care Professionals ◽  
Digital Health ◽  
Disease Status ◽  
Proximal Femoral Fracture ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Physical Mobility ◽  
High Level

Health care has had to adapt rapidly to COVID-19, and this in turn has highlighted a pressing need for tools to facilitate remote visits and monitoring. Digital health technology, including body-worn devices, offers a solution using digital outcomes to measure and monitor disease status and provide outcomes meaningful to both patients and health care professionals. Remote monitoring of physical mobility is a prime example, because mobility is among the most advanced modalities that can be assessed digitally and remotely. Loss of mobility is also an important feature of many health conditions, providing a read-out of health as well as a target for intervention. Real-world, continuous digital measures of mobility (digital mobility outcomes or DMOs) provide an opportunity for novel insights into health care conditions complementing existing mobility measures. Accepted and approved DMOs are not yet widely available. The need for large collaborative efforts to tackle the critical steps to adoption is widely recognised. Mobilise-D is an example. It is a multidisciplinary consortium of 34 institutions from academia and industry funded through the European Innovative Medicines Initiative 2 Joint Undertaking. Members of Mobilise-D are collaborating to address the critical steps for DMOs to be adopted in clinical trials and ultimately health care. To achieve this, the consortium has developed a roadmap to inform the development, validation and approval of DMOs in Parkinson’s disease, multiple sclerosis, chronic obstructive pulmonary disease and recovery from proximal femoral fracture. Here we aim to describe the proposed approach and provide a high-level view of the ongoing and planned work of the Mobilise-D consortium. Ultimately, Mobilise-D aims to stimulate widespread adoption of DMOs through the provision of device agnostic software, standards and robust validation in order to bring digital outcomes from concept to use in clinical trials and health care.

Regulatory Issues in Telehealth

2021 ◽  
pp. 19-28
Author(s):  
Alison Hardacre ◽  
Lachlan Wheeler
Keyword(s):  
Data Storage ◽  
Digital Health ◽  
Patient Identification ◽  
Regulatory Issues ◽  
The World ◽  
Clinical Benefits ◽  
Catch Up ◽  
Funding Mechanisms ◽  
High Level ◽  
Everyday Reality

Telehealth and digital health more broadly have become two of the fastest growing IT sectors in the world. They have the potential to transform lives everywhere, often before regulation has had the chance to catch up to everyday reality in healthcare. This chapter is grounded in clinical practice occurring at the time of writing and discusses at a high level regulatory issues in telehealth. This chapter argues that complexities regarding regulation over clinical applicability, patient identification, bandwidth, and funding mechanisms, as well as data storage, jurisdiction, and usage should not prevent uptake of telehealth and digital health given the clinical benefits of telehealth in countries such as Australia and internationally.

Queensland Digital Health Clinical Charter: a clinical consensus statement on priorities for digital health in hospitals

2020 ◽  
Vol 44 (5) ◽  
pp. 661
Author(s):  
Clair Sullivan ◽  
Andrew Staib ◽  
Keith McNeil ◽  
David Rosengren ◽  
Ian Johnson
Keyword(s):  
Decision Making ◽  
Digital Health ◽  
Digital Technologies ◽  
Executive Leadership ◽  
Digital Transformation ◽  
Decision Making Process ◽  
Health Technologies ◽  
Clinical Community ◽  
Expected Benefits ◽  
High Level

Digital transformation of Australian hospitals is occurring rapidly. Although the clinical community has had limited ability to influence high-level decision making and investments into digital health technologies, as these technologies increasingly transform the way patients are cared for, the clinical community must influence the digital health agenda and be an integral part of the decision-making process. This case study details the process and lessons learnt during the development of the state-wide consensus statement detailing the clinical requirements for digital health initiatives to form the Queensland Digital Health Clinical Charter. To the best of our knowledge, Queensland is the first Australian jurisdiction to create a Digital Clinical Charter to be specifically referenced in the investment in and governance of digital health in hospitals. By developing this clinical charter for digital health, and in articulating the needs of clinicians, a clinical framework will be added to both the decision-making process around the investments in digital health and the definition and realisation of the expected benefits from these sizable investments. What is known about the topic? Digital transformation of healthcare is occurring rapidly. The clinical community has had limited ability to influence high-level decision making and investments into these digital health technologies. Tension currently exists between the clinical community who must use the new digital technologies and the technical groups that govern the introduction of the new technologies. This tension can be manifest as clinicians refusing to adopt new systems, safety concerns and an inability to reach consensus on direction. There are few peer reviewed publications addressing this tension between the clinical community and technical providers. What does this paper add? This paper is the first attempt to create a list of clinical requirements for digital transformation that crosses professional streams and is endorsed by the state-wide executive leadership team to inform the acquisition and governance of digital health technologies. What are the implications for practitioners? Clinicians can feel excluded and marginalised during the decision-making process for new digital technologies, despite the fact that they are often using these technologies to deliver hands-on care to patients. This charter clearly articulates the requirements of clinicians for digital transformation and has been endorsed by the executive leadership team of Queensland Health. The charter adds a clinical framework to be referenced during the decision-making process around the investments in digital health, and the definition and realisation of the expected benefits from these sizable investments. As the digital landscape in public hospitals evolves, clinicians are becoming increasingly reliant upon digital technologies. It is critical that clinicians have a strong effect on technology acquisition and governance to maximise the quality and efficiency of the care they provide.

scholarly journals Expedited Biodegradation of Organic Pollutants and Refractory Compounds Using Bio-Electrochemical Systems

2021 ◽  
Author(s):  
Eustace Fernando ◽  
Godfrey Kyazze ◽  
Ahmed Ahsan ◽  
Pavithra Fernando
Keyword(s):  
Difficult Problem ◽  
The Novel ◽  
Alternative Technologies ◽  
Electrochemical Systems ◽  
Novel Technology ◽  
Refractory Compounds ◽  
Slow Kinetics ◽  
Rapid Removal ◽  
High Level ◽  
Kinetics Of

Biodegradation of xenobiotics is often considered to be a slow process. This is especially true if the xenobiotic in question is polymeric in nature, contains many chemical substituent groups or generally exhibits high level of toxicity to environmental microbiota. Due to this observed slow kinetics of degradation, removal of many xenobiotics from contaminated environments using conventional bioremediation technologies is a difficult problem. To alleviate this, alternative technologies showing improved kinetics of biodegradation are sought by the scientific community. One such promising approach is the usage of the novel technology of bio-electrochemical systems for improved degradation of xenobiotics. Due to the newness of this technology and affiliated methods, not much information about its usage for biodegradation of xenobiotics is available in literature. Therefore, this chapter aims to address that gap and bring about a comprehensive analysis on the usage of bio-electrochemical systems for rapid removal of xenobiotic contaminants from the environment.

scholarly journals Novel technology concepts and architecture for on-board condition-based monitoring of railway running gear: The RUN2Rail vision

2020 ◽  
pp. 095440972095140
Author(s):  
Julián Martín Jarillo ◽  
Juan Moreno ◽  
Stefano Alfi ◽  
Sylvain Barcet ◽  
Pascal Bouvet ◽  
...  
Keyword(s):  
Condition Monitoring ◽  
Fault Classification ◽  
Rolling Stock ◽  
Novel Technology ◽  
New Concepts ◽  
Wear Damage ◽  
High Level ◽  
Railway Operation ◽  
Condition Based Monitoring ◽  
Monitoring Application

Bogies are key subsystems for rolling stock safety and, therefore, meaningful and objective data concerning their condition is of paramount importance for railway operation. These subsystems experience severe service conditions causing wear, damage and degradation of components and affecting the vibrations to which the passengers are exposed. As such, safe and reliable operation, together with a high level of comfort for the passengers, can only be assured by an in-depth, data-based and comprehensive maintenance of the bogie components. In this perspective, advanced health monitoring of the running gear plays a fundamental role as the enabler for condition-based maintenance strategies. This paper reports about work performed in the RUN2Rail project aimed at formulating new concepts for the condition monitoring of the running gear. Three case studies are addressed: wheelsets, powertrain and suspension components. For these cases, the suitable choice and location of sensors is investigated and innovative fault detection and fault classification methods are proposed and preliminarily validated by means of numerical experiments and laboratory tests. A concise outline of the impacts and benefits of each proposed condition monitoring application is also provided.

scholarly journals Geographical variations in access to expert centers for multiple sclerosis in France

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
E Leray ◽  
F Mamadou ◽  
A Guilleux ◽  
J Roux ◽  
O Grimaud
Keyword(s):  
Multiple Sclerosis ◽  
Health Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Social Deprivation ◽  
Care Providers ◽  
Geographic Variations ◽  
Geographical Variations ◽  
Set Up ◽  
High Level

Abstract Background Multiple sclerosis (MS) is a chronic neurological disease affecting about 100,000 persons in France. Disease management is mainly supervised by the neurologist, supported by the general practitioner (GP). The complexity of the disease, due to the variety of symptoms as well as the recent changes in the therapeutic arsenal, requires both a high level of expertise and coordination between the different health care providers. To face this challenge, integrated and coordinated network of services “MS expert centers” have been progressively set up from 2000 onwards. Our objectives are to describe referrals to MS expert centers over the 2010-2015 period, to look for geographic variations and if any, to identify potential determinants of access. Methods The analysis is performed on the French health insurance database which covers 97% of the French population. Geographic variations of access are explored, as well as association with the following parameters: demographics (age, sex), socio-economic characteristics (social deprivation index at residence, degree of urbanization), and density of health care services (GPs, neurologists, hospital beds). Results Overall, 112,415 people with MS (70% women, mean age 46 years) were included. Initial results show that over the study period, 98% of patient had at least one visit to GP, 87% to neurologist, and 36% in a CRC SEP. Conclusions The present study will assess to what extent MS patients have been able to take full advantage of an innovative organization of specialized care which was recently deployed in France. This model of care has been generalized by the French Ministry of Health in 2016 and 23 ‘competence and resource centers’ for MS (CRC SEP) are now covering the whole national territory. Further research will be performed to identify whether and how this has modified access to specialized coordinated MS care.

Examining the Relationship Between Incarceration and Population Health: The Roles of Region and Urbanicity

2020 ◽  
pp. 088740342091690
Author(s):  
Robert R. Weidner ◽  
Jennifer Schultz
Keyword(s):  
United States ◽  
Health Outcomes ◽  
Population Health ◽  
Premature Death ◽  
The United States ◽  
National Sample ◽  
Geographic Variations ◽  
Collateral Consequences ◽  
High Level ◽  
The Relationship

Among the myriad collateral consequences of the high level of incarceration in the United States is its detrimental effects on public health. Just as there are geographic variations in level of incarceration within the United States, so too are there variations in health outcomes. This study examines the relationship between incarceration rates and population health for a national sample of counties from 2015, with a focus on how this relationship is influenced by both region (South vs. non-South) and whether a jurisdiction is rural. To obtain unbiased estimates of the effect of incarceration rates on two alternate health outcomes, it employs two-stage least-squares modeling, which accounts for the endogeneity of incarceration rates when determining their effect on population health. Results indicate that level of incarceration has a detrimental effect on both mortality (i.e., premature death) and morbidity (i.e., self-reported health), and that these effects are more pronounced in rural and Southern counties. Implications of these findings for both policy and research are considered.

scholarly journals Prevalence of moderate penicillin resistant invasive Neisseria meningitidis infection in Scotland, 1994–9

2001 ◽  
Vol 128 (2) ◽  
pp. 149-156 ◽  
Author(s):  
M. H. KYAW ◽  
J. C. BRAMLEY ◽  
S. CLARKE ◽  
P. CHRISTIE ◽  
I. G. JONES ◽  
...  
Keyword(s):  
Antimicrobial Agents ◽  
Health Interventions ◽  
Penicillin Resistance ◽  
Drug Resistant ◽  
Geographic Variations ◽  
Resistance To Penicillin ◽  
Low Incidence ◽  
High Level ◽  
B 52 ◽  
Level Resistance

We examined the serological characteristics of 774 invasive meningococcal isolates collected through an active laboratory-based surveillance system in Scotland from 1994 to 1999. Of these, 72–73% of isolates were tested for susceptibility to several antimicrobial agents. Meningococci with high-level resistance to sulphadiazine had a prevalence of 10% and incidence of 0·22 per 100000 population. High-level resistance to penicillin and other antibiotics was not detected. The prevalence of moderate penicillin resistant meningococci was 8·3%. There was no increase in moderate penicillin resistant meningococcal isolates during the study period, but there were temporal and geographic variations. The estimated incidence of moderate penicillin resistant meningococci was 0·15 per 100000 population. High and low incidence of moderate penicillin resistant meningococci appeared to correlate with the number of doses of penicillin prescribed in some geographic locations. The majority of moderate penicillin resistant isolates belonged to serogroups B (52·2%) and C (39·2%). However, the prevalence of moderate penicillin resistance in serogroup W135 was substantially higher (51·7%) than serogroups B (7·8%) and C (7·6%). Serogroup W135 accounted for a higher proportion of moderate penicillin resistance (8·7%) than disease (1%). There was no predominant penicillin resistant serotype/subtype within any serogroup. Constant surveillance is necessary to monitor the emergence and spread of resistance and to guide appropriate public health interventions in preventing drug resistant meningococci.

scholarly journals COVID-19 awareness, knowledge and perception towards digital health in an urban multi-ethnic Asian population

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Cong Ling Teo ◽  
Miao Li Chee ◽  
Kai Hui Koh ◽  
Rachel Marjorie Wei Wen Tseng ◽  
Shivani Majithia ◽  
...  
Keyword(s):  
Health Service ◽  
Health Services ◽  
Digital Health ◽  
Asian Population ◽  
Well Being ◽  
Daily Routine ◽  
Logistic Regression Models ◽  
Systemic Factors ◽  
High Level ◽  
Prevention Methods

AbstractThis study aimed to determine COVID-19-related awareness, knowledge, impact and preparedness among elderly Asians; and to evaluate their acceptance towards digital health services amidst the pandemic. 523 participants (177 Malays, 171 Indians, 175 Chinese) were recruited and underwent standardised phone interview during Singapore’s lockdown period (07 April till 01 June 2020). Multivariable logistic regression models were performed to evaluate the associations between demographic, socio-economic, lifestyle, and systemic factors, with COVID-19 awareness, knowledge, preparedness, well-being and digital health service acceptance. The average perception score on the seriousness of COVID-19 was 7.6 ± 2.4 (out of 10). 75.5% of participants were aware that COVID-19 carriers can be asymptomatic. Nearly all (≥ 90%) were aware of major prevention methods for COVID-19 (i.e. wearing of mask, social distancing). 66.2% felt prepared for the pandemic, and 86.8% felt confident with government’s handling and measures. 78.4% felt their daily routine was impacted. 98.1% reported no prior experience in using digital health services, but 52.2% felt these services would be helpful to reduce non-essential contact. 77.8% were uncomfortable with artificial intelligence software interpreting their medical results. In multivariable analyses, Chinese participants felt less prepared, and more likely felt impacted by COVID-19. Older and lower income participants were less likely to use digital health services. In conclusion, we observed a high level of awareness and knowledge on COVID-19. However, acceptance towards digital health service was low. These findings are valuable for examining the effectiveness of COVID-19 communication in Singapore, and the remaining gaps in digital health adoption among elderly.

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