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1
Maclean, John Ross. "Telemedicine in remote health care". Thesis, University of Aberdeen, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.264331.
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This thesis offers a review of the historical development of telemedicine services in remote health care. It addresses the professional concerns in practising medicine in isolated conditions, and the advances in telecommunications technology since the telephone was invented. It also examines the application of telemedicine in remote environments across the world, such as in indigenous communities, remote industrial work sites and at scientific bases in Antarctica. At its most exotic, a review is offered of the health care for space crews. The literature review highlights a number of concerns about the state of the art knowledge on remote health care services. These concerns are the minimal training requirements of individuals who act as health care practitioners in the remote environment, the additional training requirement upon the advising medical practitioner, and the design of a system for the collection of clinical information from the patient. In response to the above a two year study was conducted. Quantitative and qualitative observation of remote health care consultations was undertaken. The environments studied were simulation cases occurring in the UK and Antarctica, and real cases presenting on oil installations in the North Sea. The study results answer the original concerns about the training levels, data collection and communications components of a remote health care service. In addition, they offer valuable input towards the design of a telemedicine model for remote health care. The telemedicine model is presented as a framework upon which future developments in the field of telemedicine may be approached.
2
Morris, Scott Edward Washer Glenn A. "Remote health monitoring for asset management". Diss., Columbia, Mo. : University of Missouri--Columbia, 2009. http://hdl.handle.net/10355/6556.
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The entire thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file; a non-technical public abstract appears in the public.pdf file. Title from PDF of title page (University of Missouri--Columbia, viewed on November 19, 2009). Thesis advisor: Dr. Glenn Washer. Includes bibliographical references.
3
Al-Ahwal, Saleh Abdullah Hussain. "The health care of remote industrial communities". Thesis, University of Aberdeen, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.248244.
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The main part of the introduction illustrates the health care provision made in the past for workforces of the oil and gas industries functioning in remote places usually associated with an environmental hazard. Much of the past work has been carried out in the North Sea and the provision made there has been reviewed in some detail together with the gradual development of health care in the United Arab Emirates for both the offshore and the onshore oil-related workforces. There follows a short review of the provision made for two analogous situations - Newfoundland and Labrador and the British Antarctic Territories - since the developments there are of direct relevance to the Middle East situation. The main environmental hazard in the Middle East is heat and so the physiology and pathology of thermal balance in man are addressed in some detail. The first study is on the identification of the particular thermal problem which occurs in the offshore workings on the Abu Dhabi oil and gas companies, namely heat cramps. This problems had not been previously identified and the work done in determining its presence and its management is duly reported, indicating the problems of accepting health education material designed for one environment by another. In the development of systems of health care for both oil and non-oil related remote populations, the importance of training of the population at risk has been repeatedly emphasised. The perceived problems in that area are skill retention by laymen and the acceptance of the guidelines of the European and US Resuscitation Councils. A second study was therefore carried out to examine skill retention in laymen together with the feasibility of carrying out resuscitation manoeuvres in high temperatures.
4
Jasti, Madhu Narasimha Rao. "IoT based remote patient health monitoring system". Kansas State University, 2017. http://hdl.handle.net/2097/38268.
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Master of ScienceDepartment of Computer Science
Daniel A. Andresen
With an improvement in technology and miniaturization of sensors, there have been attempts to utilize the new technology in various areas to improve the quality of human life. One main area of research that has seen an adoption of the technology is the healthcare sector. The people in need of healthcare services find it very expensive this is particularly true in developing countries. As a result, this project is an attempt to solve a healthcare problem currently society is facing. The main objective of the project was to design a remote healthcare system. It’s comprised of three main parts. The first part being, detection of patient’s vitals using sensors, second for sending data to cloud storage and the last part was providing the detected data for remote viewing. Remote viewing of the data enables a doctor or guardian to monitor a patient’s health progress away from hospital premises. The Internet of Things (IoT) concepts have been widely used to interconnect the available medical resources and offer smart, reliable, and effective healthcare service to the patients. Health monitoring for active and assisted living is one of the paradigms that can use the IoT advantages to improve the patient’s lifestyle. In this project, I have presented an IoT architecture customized for healthcare applications. The aim of the project was to come up with a Remote Health Monitoring System that can be made with locally available sensors with a view to making it affordable if it were to be mass produced. Hence the proposed architecture collects the sensor data through Arduino microcontroller and relays it to the cloud where it is processed and analyzed for remote viewing. Feedback actions based on the analyzed data can be sent back to the doctor or guardian through Email and/or SMS alerts in case of any emergencies.
5
Yang, Cheng. "Multimedia motion analysis for remote health monitoring". Thesis, University of Strathclyde, 2017. http://digitool.lib.strath.ac.uk:80/R/?func=dbin-jump-full&object_id=27952.
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Substantial amount of research in home-use health monitoring techniques has emerged given growing global health awareness and ageing population in recent decades. These sensor-driven home-use healthcare applications encourage patient involvement at home during daytime activities and nighttime sleep, effectively help assess patients conditions away from clinics and hospitals, and significantly reduce the number of infirmary visits. However, there are two main issues in current wearable/remote sensor-based home-use health monitoring applications: 1) portable human motion analysis systems that are commercially available still require substantial amount of manual effort to process the measurements, which is time consuming and thus impractical for long-term home-use health monitoring, and 2) current sleep-related health monitoring applications are intrusive to the body, limited to measuring the respiration rate and sleep duration, or not clinically validated to demonstrate their efficacy. In this dissertation, we overcome the drawbacks of current health monitoring systems as follows. For lower limb motion analysis, we propose an alternative to state of the art optical motion analysis systems, cost-effective and portable, single-camera system. For upper limb motion analysis, we track all relevant body joints simultaneously, and classify the post-stroke recovery levels based on features extracted from the tracked body-joint trajectories. For abnormal respiratory event detection during sleep, we propose to record video and audio of a patient using a depth camera during his/her sleep, and extract relevant features to train a classifier for detection of the abnormal respiratory events scored manually by a scientific officer based on data collected by a clinical-use sleeping device The main contribution of this dissertation lies in proposing new application-driven algorithms for advancing cost-effective human limb motion analysis and sleep monitoring healthcare techniques, including an autonomous detection scheme for finding the initial and final frames that are of interest for video analysis, a single marker tracking scheme that is based on the Kalman filter and Structural Similarity image quality assessment,an autonomous gait event detection scheme that is based on the features of the relative positions of the markers, a scheme classification of the post-stroke recovery level by minimization of graph total variation with graph-based signal processing, an alternating-frame depth video coding scheme, a depth video temporal denoising scheme using a motion vector graph smoothness prior, and a dual-ellipse model that can efficiently track the torso motion during a person is sleeping. Experimental results show that, both the autonomous frame-of-interest detection and gait event detection show high detections rates. The validation of tracking in terms of the knee angle, shoulder movement, trunk tilt and elbow movement with a gold standard optical motion analysis system shows R-squared value larger than 0.95. The graph-based classification scheme has the potential to accurately classify participants into different stroke groups. Our depth video coding scheme outperforms a competitor that records only the 8 most significant bits. Our temporal denoising scheme reduces the flickering effect without ever-smoothing. Finally, our trained classifiers can deduce respiratory events with high accuracy. Overall, our proposed limb motion analysis system offers an alternative,inexpensive and convenient solution for clinical gait and upper limb motion analysis,and our proposed sleep monitoring system can reliably detect abnormal respiratory events using our extracted video and audio features.
6
Collins, Jonathan D. "Remote monitoring systems for substructural health monitoring". [Tampa, Fla] : University of South Florida, 2008. http://purl.fcla.edu/usf/dc/et/SFE0002605.
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Khorakhun, Chonlatee. "Using quantified-self for future remote health monitoring". Thesis, University of St Andrews, 2015. http://hdl.handle.net/10023/9460.
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Remote monitoring is an essential part of future mHealth systems for the delivery of personal and pervasive healthcare, especially to allow the collection of personal bio-data outside clinical environments. mHealth involves the use of mobile technologies including sensors and smart phones with Internet connectivity to collect personal bio-data. Yet, by its very nature, it presents considerable challenges: (1) it will be a highly distributed task, (2) requiring collection of bio-data from a myriad of sources, (3) to be gathered at the clinical site, (4) and via secure communication channels. To address these challenges, we propose the use of an online social network (OSN) based on the quantified-self, i.e. the use of wearable sensors to monitor, collect and distribute personal bio-data, as a key component of a near-future remote health monitoring system. Additionally, the use of a social media context allows existing social interactions within the healthcare regime to be modeled within a carer network, working in harmony with, and providing support for, existing relationships and interactions between patients and healthcare professionals. We focus on the use of an online social media platform (OSMP) to enable two primitive functions of quantified-self which we consider essential for mHealth, and on which larger personal healthcare services could be built: remote health monitoring of personal bio-data, and an alert system for asynchronous notifications. We analyse the general requirements in a carer network for these two primitive functions, in terms of four different viewpoints within the carer network: the patient, the doctor in charge, a professional carer, and a family member (or friend) of the patient. We propose that a wellbeing remote monitoring scenario can act as a suitable proxy for mHealth monitoring by the use of an OSN. To allow rapid design, experimentation and evaluation of mHealth systems, we describe our experience of creating an mHealth system based on a wellbeing scenario, exploiting the quantified-self approach of measurement and monitoring. The use of wellbeing data in this manner is particularly valuable to researchers and systems developers, as key development work can be completed within a realistic scenario, but without risk to sensitive patient medical data. We discuss the suitability of using wellbeing monitoring as a proxy for mHealth monitoring with OSMPs in terms of functionality, performance and the key challenge in ensuring appropriate levels of security and privacy. We find that OSMPs based on quantified-self offer great potential for enabling personal and pervasive healthcare in an mHealth scenario.
8
Spark, Ross L. "Developing health promotion methods in remote Aboriginal communities". Thesis, Curtin University, 1999. http://hdl.handle.net/20.500.11937/969.
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This thesis investigates the development and implementation of health promotion strategies and methods in remote Aboriginal communities via the Kimberley Aboriginal Health Promotion Project (KAHPP), a project funded under a grant from the Commonwealth Department of Health and Family Services and conducted by the School of Public Health at Curtin University of Technology. The aim of the project was to investigate the effectiveness of health promotion strategies and methods in remote Aboriginal communities and to develop structures for implementing effective Aboriginal health promotion programs.There were three main research components in this study: an assessment of health indicators; an assessment of the intervention impact; and an assessment of the media component of the intervention. The research methodology included the development of a culturally appropriate survey instrument and the conduct of cross-sectional surveys of three remote Aboriginal communities with differing historical circumstances in the Kimberley region. The questionnaire and field study methods were piloted in 1990 and the main study conducted in 1991 1[superscript].A health promotion intervention was conducted based on an approach originally developed in the Northern Territory 2[superscript]. The intervention employed community development and mass media strategies. Community members nominated health issues that they wished to address, from which 'storyboards' were created for health promotion advertisements to appear on remote television on a paid schedule 3[superscript]. Representative random samples of adult males and females from three remote Aboriginal communities were surveyed according to a range of attitudinal and behavioural health indicators. A post-test survey assessed media reach and impact and pre-post surveys assessed relevant changes in the communities.The cross-sectional survey of health indicators found differences between communities in terms of self-assessed health and risk behaviours. These are discussed in terms of the historical differences between communities and with respect to each community's current situation. Respondents from all communities rated environmental factors as important in their contribution to health, and generally more so than individual lifestyle behaviours.The study demonstrated that television has the potential to reach the vast majority of Aboriginal people in remote communities in the Kimberley. There was some indication that participation in the development of advertisements was associated with higher recognition and more positive assessments of that advertisement. No significant differences in selected indicators of community 'empowerment' were detected following the intervention.The thesis methodology has contributed to the development of a set of guidelines for the conduct of survey research in remote Aboriginal communities, 4[superscript] and has guided the formation of Aboriginal health promotion units in Western Australia and elsewhere.1. Spark R, Binns C, Laughlin D, Spooner C, Donovan RJ. Aboriginal people's perceptions of their own and their community's health: results of a pilot study. Health Promotion Journal of Australia 1992; 2(2):60-61.2. Spark R, Mills P. Promoting Aboriginal health on television in the Northern Territory: a bicultural approach. Drug Education Journal of Australia 1988; 2 (3):191-198.3. Spark R, Donovan RJ, Howat P. Promoting health and preventing injury in remote Aboriginal communities: a case study. Health Promotion Journal of Australia 1991; 1(2):10-16.4. Donovan RJ, Spark. R. Towards guidelines for conducting survey research in remote Aboriginal communities. Australian and New Zealand Journal of Public Health 1997; 21:89-94.
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Spark, Ross L. "Developing health promotion methods in remote Aboriginal communities". Curtin University of Technology, School of Public Health, 1999. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=9501.
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This thesis investigates the development and implementation of health promotion strategies and methods in remote Aboriginal communities via the Kimberley Aboriginal Health Promotion Project (KAHPP), a project funded under a grant from the Commonwealth Department of Health and Family Services and conducted by the School of Public Health at Curtin University of Technology. The aim of the project was to investigate the effectiveness of health promotion strategies and methods in remote Aboriginal communities and to develop structures for implementing effective Aboriginal health promotion programs.There were three main research components in this study: an assessment of health indicators; an assessment of the intervention impact; and an assessment of the media component of the intervention. The research methodology included the development of a culturally appropriate survey instrument and the conduct of cross-sectional surveys of three remote Aboriginal communities with differing historical circumstances in the Kimberley region. The questionnaire and field study methods were piloted in 1990 and the main study conducted in 1991 1[superscript].A health promotion intervention was conducted based on an approach originally developed in the Northern Territory 2[superscript]. The intervention employed community development and mass media strategies. Community members nominated health issues that they wished to address, from which 'storyboards' were created for health promotion advertisements to appear on remote television on a paid schedule 3[superscript]. Representative random samples of adult males and females from three remote Aboriginal communities were surveyed according to a range of attitudinal and behavioural health indicators. A post-test survey assessed media reach and impact and pre-post surveys assessed relevant changes in the communities.The cross-sectional survey ++of health indicators found differences between communities in terms of self-assessed health and risk behaviours. These are discussed in terms of the historical differences between communities and with respect to each community's current situation. Respondents from all communities rated environmental factors as important in their contribution to health, and generally more so than individual lifestyle behaviours.The study demonstrated that television has the potential to reach the vast majority of Aboriginal people in remote communities in the Kimberley. There was some indication that participation in the development of advertisements was associated with higher recognition and more positive assessments of that advertisement. No significant differences in selected indicators of community 'empowerment' were detected following the intervention.The thesis methodology has contributed to the development of a set of guidelines for the conduct of survey research in remote Aboriginal communities, 4[superscript] and has guided the formation of Aboriginal health promotion units in Western Australia and elsewhere.1. Spark R, Binns C, Laughlin D, Spooner C, Donovan RJ. Aboriginal people's perceptions of their own and their community's health: results of a pilot study. Health Promotion Journal of Australia 1992; 2(2):60-61.2. Spark R, Mills P. Promoting Aboriginal health on television in the Northern Territory: a bicultural approach. Drug Education Journal of Australia 1988; 2 (3):191-198.3. Spark R, Donovan RJ, Howat P. Promoting health and preventing injury in remote Aboriginal communities: a case study. Health Promotion Journal of Australia 1991; 1(2):10-16.4. Donovan RJ, Spark. R. Towards guidelines for conducting survey research in remote Aboriginal communities. Australian and New Zealand Journal of Public Health 1997; 21:89-94.
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Weyant, Emily, Nakia J. Woodward, Rachel R. Walden, Rick L. Wallace i Kelly R. Loyd. "Promoting Consumer Health Materials at Remote Area Medical Clinics". Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/8823.
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Brebner, John Alexander. "The provision of health care in remote hostile environments". Thesis, Robert Gordon University, 1990. http://hdl.handle.net/10059/2192.
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The health care of those who work in remote places associated with hostile environments is reviewed, concentrating on the offshore oil industry and Antarctic populations. An understanding of associated environmental hazards is essential for adequate health care and particular attention is paid to the hyperbaric environment and to environmental heat and cold. The basic medical problems in remote health care are evaluated in three related studies. The first examines 2,162 personnel who required medical evacuations from the offshore structures of four North Sea operating companies, the second with 5,894 presentations from offshore at the A&E department of Aberdeen Royal Infirmary, while the third examines 100 annual medical reports from British Antarctic Survey stations.
12
Williams, Cynthia. "Home Care Quality Effects of Remote Monitoring". Doctoral diss., University of Central Florida, 2014. http://digital.library.ucf.edu/cdm/ref/collection/ETD/id/6383.
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Despite concerted efforts to decrease costs and increase public health, the embattled U.S. health care system continues to struggle to alleviate these widespread issues. Because the problem of hospital utilizations among patients with heart failure is posited to increase as the population ages, innovative methodologies need to be explored to mitigate adverse events. Remote monitoring harnesses the strength of advanced information and communication technology to affect positive changes in health care quality and cost. By reaching across geographical boundaries, remote monitoring may support increased access to less costly services and improve the quality of home health care.
The purpose of the study was to examine the home care quality effects of remote monitoring technology in patients with heart failure and to provide an economic justification for its adoption and diffusion. It compared remote monitoring as a potential intervention strategy to a standard no-intervention group (without remote monitoring). Specifically, it analyzed remote monitoring as a viable strategy to decrease hospital readmissions and emergency department visits. It also compared the cost of remote monitoring against the current standard-of-care.
The theoretical framework of Donabedian's Quality Model was used in the evaluation of remote monitoring. A retrospective posttest only, case control study design was used to test the degree which remote monitoring was effective in promoting health care quality (hospital readmissions and decreased emergency department visits). Retrospective chart reviews were performed using electronic medical records (EMR). Analysis of Variance, Path Analysis, Automatic Interaction Detector Analysis (Dtreg), and Cost Outcomes Ratio were used to test the hypotheses and validate the proposed theoretical model.
No significant difference was noted in remote monitoring and usual care groups. Results suggested that remote monitoring does not statistically lead to a decrease in heart failure-related hospital readmissions and all-cause emergency department visits. Results of the cost ratio analysis suggested that there was no statistically significant difference in the net income between usual care and remote monitoring; however, data suggest that there were significant increases in cost and intensity of nursing utilization for the remote monitoring intervention. The Automatic Interaction Detector Analysis showed that the unfavorable results in hospital readmissions were due to a decrease in collaborative care and patient education prior to the recommendation for hospitalization.
The role of nursing care, whether in hospital or community-based care, in heart failure management is critical to quality outcomes. As the field continues to consider the use of technology in health care, decision makers should think through the process of patient care such that preventable hospital readmissions are decreased and patients received quality care.Ph.D.
Doctorate
Health and Public Affairs
Public Affairs; Health Services Management and Research Track
13
Patra, Harisadhan. "Mechanisms of remote masking". Columbus, Ohio : Ohio State University, 2008. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1199309775.
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Liu, Y. "Wireless remote patient monitoring on general hospital wards". Thesis, Bournemouth University, 2010. http://eprints.bournemouth.ac.uk/17508/.
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A novel approach which has potential to improve quality of patient care on general hospital wards is proposed. Patient care is a labour-intensive task that requires high input of human resources. A Remote Patient Monitoring (RPM) system is proposed which can go some way towards improving patient monitoring on general hospital wards. In this system vital signs are gathered from patients and sent to a control unit for centralized monitoring. The RPM system can complement the role of nurses in monitoring patients’ vital signs. They will be able to focus on holistic needs of patients thereby providing better personal care. Wireless network technologies, ZigBee and Wi-Fi, are utilized for transmission of vital signs in the proposed RPM system. They provide flexibility and mobility to patients. A prototype system for RPM is designed and simulated. The results illustrated the capability, suitability and limitation of the chosen technology.
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Hsieh, Sheau-Ling 1952. "Distributed multimedia collaborative system framework for tele-healthcare remote consultation systems". Diss., The University of Arizona, 1998. http://hdl.handle.net/10150/284034.
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The Remote Consultation and Diagnosis (RCD) in Global Picture Archiving and Communication System (Global PACS) is a unique suite of multimedia telemedicine applications developed at the University of Arizona. The applications support real-time patients' data, image files, audio and video consultation and diagnosis annotation exchanges. The RCD enables joint collaboration between pathologists, radiologists, or physicians while they are at distant geographical locations. This project provides four RCD scenarios, i.e., Case Review, Case Acquire, Store and Forward Analysis, as well as Interactive Diagnosis and Consultation. The RCD Global PACS environment consists of heterogeneous, autonomous, and legacy resources. The Common Object Request Broker Architecture (CORBA), Java Database Connectivity (JDBC), and Java language provide the capability to combine the RCD Global PACS resources into an integrated, interoperable, and scalable system. The underneath technology, including IDL, ORB, Event Service, IIOP, JDBC/ODBC, legacy system wrapping and Java implementation are explored. This distributed collaborative CORBA/JDBC based framework will challenge the advanced, medical information management requirements. It also makes the RCD Global PACS both hardware and software technologically independent. As our research and development extend, we will continue to incorporate the latest advances in computer technology. RCD Global PACS is not another new tool in telemedicine, but rather a new paradigm for the delivery of health services that requires process reengineering, cultural changes, as well as organizational changes. It is a whole new way of practicing in telemedicine. We ensure that the RCD Global PACS project has long-term, comprehensive solutions for today and tomorrow's healthcare needs.
16
Gogineni, Jyothsna. "An ingenious decision support system for remote health monitoring of pregnant women". Thesis, Queensland University of Technology, 2012. https://eprints.qut.edu.au/52831/1/Jyothsna_Gogineni_Thesis.pdf.
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Maternal deaths have been a critical issue for women living in rural and remote areas. The need to travel long distances, the shortage of primary care providers such as physicians, specialists and nurses, and the closing of small hospitals have been problems identified in many rural areas. Some research work has been undertaken and a few techniques have been developed to remotely measure the physiological condition of pregnant women through sophisticated ultrasound equipment. There are numerous ways to reduce maternal deaths, and an important step is to select the right approaches to achieving this reduction. One such approach is the provision of decision support systems in rural and remote areas. Decision support systems (DSSs) have already shown a great potential in many health fields.
This thesis proposes an ingenious decision support system (iDSS) based on the methodology of survey instruments and identification of significant variables to be used in iDSS using statistical analysis. A survey was undertaken with pregnant women and factorial experimental design was chosen to acquire sample size. Variables with good reliability in any one of the statistical techniques such as Chi-square, Cronbach’s á and Classification Tree were incorporated in the iDSS. The decision support system was developed with significant variables such as: Place of residence, Seeing the same doctor, Education, Tetanus injection, Baby weight, Previous baby born, Place of birth, Assisted delivery, Pregnancy parity, Doctor visits and Occupation.
The ingenious decision support system was implemented with Visual Basic as front end and Microsoft SQL server management as backend. Outcomes of the ingenious decision support system include advice on Symptoms, Diet and Exercise to pregnant women. On conditional system was sent and validated by the gynaecologist. Another outcome of ingenious decision support system was to provide better pregnancy health awareness and reduce long distance travel, especially for women in rural areas. The proposed system has qualities such as usefulness, accuracy and accessibility.
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Porter, Suzette Adela Tindal. "Dental effectiveness in rural and remote Queensland". Thesis, Queensland University of Technology, 2000. https://eprints.qut.edu.au/35843/1/35843_Digitised%20Thesis.pdf.
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This research was stimulated by the knowledge that dental services to rural and remote consumers in Australia are unpredictable and will remain so into the future. Rural and remote consumers are disadvantaged in their access to dental services due to distance, scarcity of dentists, lack of choice· and variable quality of treatment and facilities. Nonetheless, it is clear that some rural and remote consumers are able to achieve sound oral health. This study examined these dental consumers in order to identify characteristics which may contribute to their success.
Providing appropriate and adequate dental services to rural and remote towns is predicted to become more difficult and require greater travel due to both a reduction in the number of dentists and a smaller population base. Encouraging rural residents to become more effective as dental consumers may result in improved preventive practices, more positive attitudes to oral health and better dental status. Dental effectiveness is improved when the dentist-patient relationship is sound and when there is a source of routine and continuing dental care, features which should form part of public health policies and training of rural dentists.
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Waddel, Matt Burns 1960. "Real time remote microscope control over the Internet". Thesis, The University of Arizona, 1992. http://hdl.handle.net/10150/291659.
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Telepathology systems were developed to allow pathologists to perform remote diagnosis and consultations. These systems have the following essential components; a remote controlled microscope, a video processing system, a communication link, and a user interface and display. This thesis defines a telepathology communication system based on the Internet network. The basic telepathology system problems were addressed: (1) Determining available network bandwidth, (2) Investigating video image compression, (3) Developing a user interface and display. A software model of the telepathology system was tested. Results demonstrated that, depending on the location on the Internet, only about 40 Kbps and 1.1 Mbps of bandwidth can be obtained. Using an image compression algorithm that reduces images to one twentieth their original size does not reduce bandwidth requirements enough to have real-time video image updates. Current capabilities are about 5 frames per second. A 5 Mbps network is required for full motion video.
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Jones, Lisa Julienne. "Issues of representation within the Health Advisory Council of a remote NSW community /". Title page, table of contents and summary only, 1998. http://web4.library.adelaide.edu.au/theses/09MPM/09mpmj77.pdf.
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Nawyn, Jason Paul. "A persuasive television remote control for the promotion of health and well-being". Thesis, Massachusetts Institute of Technology, 2005. http://hdl.handle.net/1721.1/34185.
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Thesis (S.M.)--Massachusetts Institute of Technology, School of Architecture and Planning, Program in Media Arts and Sciences, February 2006.Includes bibliographical references (leaves 128-132).
New forms of media technology that enter the home often fundamentally transform the way that people spend their time. In the present day, daily "screen time" with televisions and other entertainment systems continues to rise [1]. Within this climate of escalating media consumption, experts in the medical community have repeatedly voiced concerns about the public health crisis that looms over a largely sedentary U.S. population. Principal among these concerns is the continuing upward trend in lifestyle-related disorders such as obesity and Type 2 diabetes. Within the last two decades, substantial epidemiological research has linked excessive television viewing with both obesity [2] and Type 2 diabetes [3, 4]. This work describes the design, implementation, and evaluation of a ubiquitous computing system intended to simultaneously decrease a user's television viewing while increasing his or her frequency and quantity of non-sedentary activities. This system, called VizTo, employs a residential sensing infrastructure to recognize an individual's television viewing and uses wearable accelerometers to detect physical movement. The primary user interface consists of a handheld computing device that serves as a wireless remote control for a television and home theatre system, as well as an interface for planning and reviewing daily activity.
(cont.) This device tracks daily activity patterns and uses theories of behavior modification to non-intrusively persuade users to decrease their daily television use while increasing physical activity. Results from a 14-day case study evaluation revealed examples of how persuasive interface design elements might influence user behavior without inducing a burden of annoyance.
by Jason Paul Nawyn.
S.M.
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Schlaerth, Hannah L. "Remote Sensing of Water Quality Parameters Influencing Coral Reef Health, U.S. Virgin Islands". Kent State University Honors College / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ksuhonors1525710103251186.
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Olson, Michael G. "Remote Sensing of Forest Health Trends in the Northern Green Mountains of Vermont". ScholarWorks @ UVM, 2012. http://scholarworks.uvm.edu/graddis/172.
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Northeastern forests are being impacted by unprecedented environmental stressors, including acid deposition, invasive pests, and climate change. Forest health monitoring at a landscape scale is necessary to evaluate the changing condition of forest resources and to inform management of forest stressors. Traditional forest health monitoring is often limited to specific sites experiencing catastrophic decline or widespread mortality. Satellite remote sensing can complement these efforts by providing comprehensive forest health assessments over broad regions. Subtle changes in canopy health can be monitored over time by applying spectral vegetation indices to multitemporal satellite imagery. This project used historical archives of Landsat-5 TM imagery and geographic information systems to examine forest health trends in the northern Green Mountains of Vermont from 1984 to 2009. Results indicate that canopy health has remained relatively stable across most of the landscape, although decline was present in localized areas. Significant but weak relationships were discovered between declining forest health and spruce-fir-paper birch forests at high elevations. Possible causes of decline include the interacting effects of acid deposition, windthrow, and stressful growing environments typical of montane forests.
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Hubbard, Joyce 1934. "A descriptive study of the developing role of village health workers in a remote Tarahumara pueblo". Thesis, The University of Arizona, 1990. http://hdl.handle.net/10150/277794.
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Six young women from a remote Tarahumara pueblo are functioning as village health workers. Through qualitative research techniques informed by symbolic interactionism, the investigator has sought to determine what it is like for these women living in a pre-Columbian society to develop this new role. Some issues guiding the research were; education, families' reactions to the new role, perceived changes in the health status of the pueblo and current attitudes of village health workers toward their new role. Although it was difficult for these women to respond to abstract questions regarding their feelings and emotions, rich descriptive data emerged outlining the women's perceptions of the village health worker role and its effects on their families and the community. The major themes that emerged during this research were; "wanting to learn more;" "less sickness and death among children;" "personal hygiene has changed lives;" and "medicine is gaining acceptance."
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Mikulski, Heather Ann. "Utilizing Connected Health Applications in Diabetes Care: Implications for Public Health and Policy in the U.S". Kent State University / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=kent1619799550674987.
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Sabharwal, Yashvinder Singh 1970. "Remote-access slit-scanning confocal microscope for in vivo tumor diagnosis". Diss., The University of Arizona, 1998. http://hdl.handle.net/10150/284035.
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Microscopic fluorescence imaging of thick biological tissue has been successfully demonstrated with a fiber-based, slit-scanning, confocal microscope. The system developed under this research consists of an illumination arm, a fiber-optic imaging system, and a detection arm. The illumination arm is an anamorphic optical system that converts a circular, laser beam into a cylindrical beam forming a line image at the proximal face of the fiber-optic relay. This relay system is comprised of a fiber-optic imaging bundle, a miniature objective lens, and a miniature hydraulic positioning mechanism. It delivers illumination to a remote sample and simultaneously collects the fluorescence from the sample. The miniature objective lens and positioning mechanism were specially designed and fabricated for this system, allowing for high resolution imaging and optical sectioning in-vivo. The detection arm relays the fluorescence image at the proximal face of the fiber-optic relay with magnification onto a two-dimensional CCD. Characterization of the system has demonstrated a lateral resolution of three microns. The axial resolution when imaging a point object is 10 microns. When imaging a planar object, the axial resolution is 25 microns. Images are acquired at a rate of 2-4 frames per second and the imaging performance has been evaluated with different biological models including animal peritoneal tissue and human prostate tissue in-vitro. In-vivo images of human skin and rat peritoneum have also been acquired to demonstrate that patient motion does not adversely affect the performance of the system. These in-vitro and in vivo images demonstrate the capability of the system to resolve cell nuclear morphology, to visualize cell density and organization, and to image at selected depths below the tissue surface.
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Prior, Maria E. "Added-value roles and remote communities an exploration of the contribution of health services to remote communities and of a method for measuring the contribution of institutions and individuals to community stocks of capital /". Thesis, Available from the University of Aberdeen Library and Historic Collections Digital Resources, 2009. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?application=DIGITOOL-3&owner=resourcediscovery&custom_att_2=simple_viewer&pid=33408.
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Clarke, Kaila-Lea. "Climate-related Stresses on Human Health in a Remote and Rural Region of Ontario, Canada". Thèse, Université d'Ottawa / University of Ottawa, 2012. http://hdl.handle.net/10393/23296.
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This thesis examines the susceptibility of human health to climate-related stresses in the rural municipality of Addington Highlands, Ontario. Human health is sensitive to climatic variations and change, and public health systems play a role in managing climate-related risks. Canada is generally deemed to have considerable capacity to adapt to vulnerabilities associated with climate change, yet there is variability among communities in their exposure and ability to manage health risks. This thesis examines the health-related vulnerability of the community of Addington Highlands. Drawing upon data gained from key informant interviews and newspaper articles, as well as other secondary data sources, the thesis documents climate-related health risks, outlines the programs and services available to deal with those risks, and assesses the capacity of the community to adapt to future climate conditions and risks. Conditions such as storms, heat stress and forest fires currently present health risks in the area, and they are expected to become more prevalent with climate change. The health risks of Lyme disease, West Nile virus and algal blooms are likely to increase in the future as the climate continues to change. Adaptation to these risks is evident in several of Addington Highlands public health and emergency management programs. The community’s adaptive capacity is strengthened by its social networks and institutional flexibility, but it is constrained by its aging population, limits to the availability and access to health care services, and challenges relating to the retention of service providers. An important strategy to assist adaptation to climate change risks to health is the promotion of public awareness, a strategy to which this research contributes. This thesis research serves to identify and better understand vulnerabilities, and help stimulate actions toward preparing Addington Highlands for possible future climate-related risks.
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Zhang, Feng. "Cyanobacterial blooms: causes, innovative monitoring and human health impact". The Ohio State University, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=osu1405800137.
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Weyant, Emily C., Nakia J. Woodward, Rachel R. Walden i Rick L. Wallace. "Reflections on a Decade of Promoting Consumer Health Resources at Remote Area Medical Clinics". Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/8675.
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Librarians at the East Tennessee State University (ETSU) Quillen College of Medicine Library have provided consumer health outreach services to rural and underserved populations at Remote Area Medical (RAM) clinics since 2009. These outreach services heavily depend upon and promote consumer health websites and National Library of Medicine (NLM) resources in order to reach the largest number of people at the lowest possible cost. This article will provide a brief overview of RAM clinics in Wise, VA, and Gray, TN, served by ETSU librarians for years. Additionally, this article will discuss the evolution of ETSU QCoM librarian outreach initiatives relating to these clinics over the past decade. This article includes a list of online consumer health resources used to support these initiatives as well as a list of most commonly addressed consumer health topics.
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Whitehurst, Daniel Scott. "Techniques for Processing Airborne Imagery for Multimodal Crop Health Monitoring and Early Insect Detection". Thesis, Virginia Tech, 2016. http://hdl.handle.net/10919/73048.
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During their growth, crops may experience a variety of health issues, which often lead to a reduction in crop yield. In order to avoid financial loss and sustain crop survival, it is imperative for farmers to detect and treat crop health issues. Interest in the use of unmanned aerial vehicles (UAVs) for precision agriculture has continued to grow as the cost of these platforms and sensing payloads has decreased. The increase in availability of this technology may enable farmers to scout their fields and react to issues more quickly and inexpensively than current satellite and other airborne methods. In the work of this thesis, methods have been developed for applications of UAV remote sensing using visible spectrum and multispectral imagery. An algorithm has been developed to work on a server for the remote processing of images acquired of a crop field with a UAV. This algorithm first enhances the images to adjust the contrast and then classifies areas of the image based upon the vigor and greenness of the crop. The classification is performed using a support vector machine with a Gaussian kernel, which achieved a classification accuracy of 86.4%. Additionally, an analysis of multispectral imagery was performed to determine indices which correlate with the health of corn crops. Through this process, a method for correcting hyperspectral images for lighting issues was developed. The Normalized Difference Vegetation Index values did not show a significant correlation with the health, but several indices were created from the hyperspectral data. Optimal correlation was achieved by using the reflectance values for 740 nm and 760 nm wavelengths, which produced a correlation coefficient of 0.84 with the yield of corn. In addition to this, two algorithms were created to detect stink bugs on crops with aerial visible spectrum images. The first method used a superpixel segmentation approach and achieved a recognition rate of 93.9%, although the processing time was high. The second method used an approach based upon texture and color and achieved a recognition rate of 95.2% while improving upon the processing speed of the first method. While both methods achieved similar accuracy, the superpixel approach allows for detection from higher altitudes, but this comes at the cost of extra processing time.Master of Science
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Vinh, Sean, Rebecca Maloney, Addison Lawson i Emily K. Flores. "Impact of Interprofessional Healthcare Student Teams at a Remote Area Medical Event in Rural Appalachia". Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/asrf/2019/schedule/79.
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Interprofessional collaboration in healthcare is vital to the nation’s health and interprofessional education is of significant interest in the current academic climate and practice environment. Remote Area Medical is a non-profit healthcare organization that partners with community hosts to provide dental, vision, and medical services to medically underserved patients in remote areas of the United States and abroad. RAM mobile clinics have served over 785,000 people since their founding in 1985, providing vital healthcare services free of charge through the volunteer services of healthcare professionals. RAM mobile clinics provide an excellent opportunity for interprofessional collaboration and interprofessional education as learners partner with volunteer professionals to serve the community. The RAM mobile clinic in Gray, Tennessee was first established in 2017 and implemented the innovate utilization of undergraduate and graduate health professional students from the East Tennessee State University Academic Health Sciences Center in student teams. Interprofessional student teams along with precepting faculty are flexible in location and services offered to best serve the needs of the mobile clinic at any given time. Interprofessional student teams work to improve patient utilization of services offered at the event and assist with medication histories and health screens while growing student interprofessional patient care skills in the process. The objective of this research is to describe the impact of interprofessional student teams on patient care at the Gray, Tennessee RAM mobile clinic during the first two years. Data was collected from the years 2017 and 2018 by the student volunteer coordinator then analyzed by student researchers. The interprofessional student teams consisted of 87 student volunteers that were training in Clinical and Rehabilitative Sciences, Medicine, Nursing, Public Health, or Pharmacy over the course of the three-day mobile clinic in 2017 and 109 different student volunteers in 2018. Student teams were precepted by interprofessional faculty and logged 2,332 interventions in 2017 and 1,130 interventions in 2018. The top two interventions in 2017 were Medication Histories and Blood Glucose Screens while the top two interventions in 2018 were Medication Histories and Health Screens. Variation in number of interventions logged and type of interventions logged can be explained by event characteristics that differed between the two years. Student participants commented positively on their engagement with one another and discussions they had to better understand each other’s professions between patient encounters. This research attempts to demonstrate that the impact of interprofessional student teams at a RAM mobile clinic is worth the investment of faculty resources in planning and execution to engage student learning while benefitting the patient population being served. This research also provided a hypothesis for additional research to be conducted around the 2019 Gray, Tennessee RAM mobile clinic.
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Heaney, David. "Organisational change and remote and rural health care delivery : identifying the attributes of successful innovation". Thesis, University of Aberdeen, 2013. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=211425.
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Aims To investigate the impact of organisational change on the delivery of health services in remote and rural Scotland using, as an example, changes in the organisation of out of hours primary care, and to identify the attributes of successful innovation in remote and rural health provision. Methods The thesis comprised a thematic literature review; in depth interviews with key stakeholders, and case studies based in remote communities. Results The literature review identified recurring attributes of successful innovation. Interviews with remote and rural GPs showed that working out of hours had been, or still was, an integral part of life as a GP. Most agreed there had been an impact on family life. Advantages and challenges of remote and rural working were identified; many GPs could not envisage a better way of delivering services. This was contested by managers. There were divergent views of the 2004 GMS contract. The GPs who opted out of 24 hour responsibility experienced a transformational change in working life. All in all, there was a lack of understanding, and trust, between organisations. NHS 24 and Scottish Ambulance Service were criticised. There had been little change in out of hours service delivery since 2005, and the present configuration was seen as expensive and unsustainable. Despite these acknowledged difficulties, the view was that difficult decisions had been avoided, and a long-term solution that fits the area was required. The case studies added detail and contextual understanding of delivery of services. This could vary even within a practice area. Service delivery on islands was different, with a stronger tie between community and practice, governed by transport logistics, and difficult to understand from an outside perspective. Conclusions. The delivery of out of hours services in remote and rural Scotland has been a difficult and contested issue. Context can have different impacts, even within a very small area. Failure to innovate was associated with lack of collaboration, lack of strategy, lack of understanding of local context, and avoidance of difficult decisions. The organisational change literature demonstrated that receptive contexts for change were not present.
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Lawford, Karen. "First Nations Women's Evacuation During Pregnancy from Rural and Remote Reserves". Thèse, Université d'Ottawa / University of Ottawa, 2011. http://hdl.handle.net/10393/20356.
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Pregnant First Nations women who live on reserves in rural and remote regions of Canada are routinely evacuated to urban cities to await labour and birth; this is commonly referred to as Health Canada’s evacuation policy. I produced two stand alone papers to investigate this policy. In the first, I investigated the development and implementation of the Canadian government’s evacuation policy. Archival research showed that the evacuation policy began to take shape in 1892 and was founded on Canada’s goals to assimilate and civilize First Nations. My second paper employed First Nations feminist theory to understand why the evacuation policy does not result in good health, especially for First Nations women. Because the evacuation policy is incongruent with First Nations’ epistemologies, it compromises First Nations’ health. I offer policy recommendations to promote First Nations health in a way that is consistent with First Nations’ epistemologies and goals towards self-determination and self-governance.
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Donovan, Anne, i n/a. "In a nutshell, it's the very basics: remote area nurses' constructions of primary health care". Griffith University. School of Nursing and Midwifery, 1997. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20050901.104302.
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This study explores the constructions of primary health care held by remote area nurses working in indigenous communities without resident medical practitioners, in the Northern Territory. Primary health care is increasingly permeating health policy in Australia, and nurses in remote areas are responsible for its implementation. The study investigates past and present discussions of the meaning of the concept of primary health care to begin to identify the major forces which have problematically impacted on its evolution and interpretation. It traces the threads which emerge from these forces through the more recent developments of health promotion and new pubflc health to explore the discourses and strategies they have produced, and which overtly and covertly influence the implementation of primary health care. Remote area nurses are individually interviewed and their discussions analysed to explore the constructions of primary health care which they hold. The analysis also explores some of the ways in which these constructions may have come to exist, the evident impact of current discourses, and the absence of effective support in the further development of these constructions. The remote area nurses' discussions display a view of primary health care as the most basic of health services, focussed on personal hygiene and the individual's responsibility in prevention of illness, operated through encounters which offer opportunities for education and basic curative care. While several of the nurses indicate discomfort with the paternalistic nature of such a service, none are aware of ways in which they might resolve their concerns about it. The study briefly explores positive approaches towards the democratization of health care, and examines the support needed by remote area nurses if primary health care is to be effectively implemented by them.
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Armstrong, Iain. "Application and evaluation of high speed data transfer for decision support in remote health care". Thesis, Robert Gordon University, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.342743.
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Kentoffio, Katherine. "Health Systems Reconstruction Among Remote Populations: Trends From Rural Liberia Prior to the Ebola Epidemic". Thesis, Harvard University, 2015. http://nrs.harvard.edu/urn-3:HUL.InstRepos:17295911.
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Background:
The weak health network in post-war Liberia is likely a primary contributor to the unprecedented 2014 Ebola outbreak in West Africa. This paper seeks to assess gaps in the health system prior to the epidemic by evaluating changes in access to maternal and child health services in a remote region compared to rural averages from 2007-2013.
Methods:
We conducted a two-staged cluster survey in 2012 in the remote district of Konobo, Liberia. Our primary outcomes of interest were access to prenatal, peri-natal and postnatal care, and access to sick child services. We compared results from our survey to the rural sub-samples from the Demographic and Health Survey (DHS) in 2007 and 2013 to assess for differential service utilization in remote regions.
Results:
Although most child and maternal health indicators improved in the DHS rural sub-sample from 2007 to 2013, this progress was not reflected in the remote Konobo population. Fewer women received 4+ antenatal care visits (OR 0.28, P< 0.001) and any postnatal care (OR 0.25, P<0.001) in Konobo as compared to the 2013 DHS. Similarly, fewer children received professional care for common childhood illnesses, including acute respiratory infection (9% vs 52%, P<0.001) and diarrhea (11% vs. 46%, P< 0.001).
Conclusions:
Even before the Ebola epidemic, residents in remote areas of Liberia had severely limited access to basic services. Most indicators remain below 2013 levels, despite the overall progress seen elsewhere in rural Liberia from 2007-2013. As attention turns to rebuilding the healthcare infrastructure in Liberia, a specific focus on remote areas will be crucial.
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Chaiyakae, Sonngan, Nobuyuki Hamajima, Pajjuban Hemhongsa, Yoshitoku Yoshida i Tawatchai Yingtaweesak. "ACCESSIBILITY OF HEALTH CARE SERVICE IN THASONGYANG, TAK PROVINCE, THAILAND". Nagoya University School of Medicine, 2013. http://hdl.handle.net/2237/18473.
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Nimegeer, Amy. "Considering community engagement for remote and rural healthcare design in Scotland : exploring the journey from rhetoric to reality". Thesis, University of the Highlands and Islands, 2013. https://pure.uhi.ac.uk/portal/en/studentthesis/considering-community-engagement-for-remote-and-rural-healthcare-design-in-scotland(9418ba56-720c-41b6-b97f-f345cfad0ffa).html.
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The way healthcare services are delivered in remote and rural Scottish communities is in a state of reconfiguration. At the same time the NHS faces pressure to plan these new services in partnership with communities themselves. Evidence, however, suggests that this is not necessarily being done well. This study considered the contextual aspects of remote and rural Scottish communities that may impact on healthcare-related engagement, and examined current understanding of what constitutes a ‘good’ engagement process. It then went on to consider a two-year action research project (RSF) that took place in four remote and rural Scottish communities to engage local residents in an anticipatory process co-designing their own future healthcare services. Finally, this study examined ways in which individuals were able to wield power within the engagement described in the RSF project, by using a combination of participant observation and Foucauldian Discourse Analysis. As well as making a number of practical recommendations for future engagement practice in a remote and rural context, this study makes three key contributions. Firstly, it contributes further contextual knowledge about the challenges of engaging with remote and rural Scottish communities for local healthcare service design; a topic about which little has been written. Secondly, it contributes a novel method for anticipatory healthcare budgeting aimed at a remote and rural Scottish context, namely the RSF Game. Thirdly, it draws the conclusion that individual (non-elite) community members have the ability to use French and Raven’s bases of social power to impact the engagement process at all stages, and also posits that discourse can be used within rural engagement as a new ‘base of power’, which contributes to the debate around individual power and agency within remote and rural community engagement for healthcare, which few studies have examined.
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Gibson, Smith Kathrine Lesley. "Promoting and implementing self care : a mixed methods study of offshore workers and remote healthcare practitioners". Thesis, Robert Gordon University, 2016. http://hdl.handle.net/10059/2127.
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The oil and gas industry is a vital contributor to the global economy and a key source of employment within oil-producing countries. Oil production is largely dependent on a skilled population who are adept in coping with the demands of an offshore environment. Due to the high risk nature of work offshore, it is a requisite that personnel engage in health promoting behaviours. The research aimed to identify aspects of offshore workers self care which required behaviour change and the behavioural determinants which were associated with engagement in self care. A mixed methods design was utilised to generate novel data and original findings. Phase 1 used a quantitative cross-sectional online survey to assess offshore workers’ (n=352, 53.6% response rate) health, quality of life, mental wellbeing and self care status. The findings highlighted key areas of concern, as indicated by negative scoring across measures, relating to: overweight/obesity; medication adherence; absenteeism (with regard to travelling offshore); medical evacuation; lack of adherence to 5-a-day fruit and vegetable guidelines; physical activity; smoking; hazardous alcohol use, and insomnia. Phase 2 used qualitative theory-based telephone interviews to explore self care behaviours from the perspective of offshore workers (n=16). Offshore workers who had completed a survey and indicated they would like to receive further information on the interviews were invited to participate. Both the interview schedule and data analysis were informed by the Theoretical Domains Framework (TDF). Healthy eating and physical activity were the behaviours most frequently discussed by offshore workers and identified as areas requiring behaviour change. TDF domains representing both behaviours included: beliefs about capabilities; beliefs about consequences; intentions; goals; memory, attention and decision processes; environmental context and resources; social influences; emotion, and behavioural regulation. Phase 3 used qualitative theory-based telephone interviews to explore offshore workers’ (n=13) self care behaviours from the perspective of remote healthcare practitioners. Both the interview schedule and data analysis were informed by TDF. Healthy eating and harmful/hazardous alcohol use were the behaviours most frequently discussed by remote healthcare practitioners and identified as areas requiring behaviour change. TDF domains representing both behaviours included: knowledge; environmental context and resources; social influences; emotion, and behavioural regulation. The findings, when triangulated suggest that offshore workers may benefit from the implementation of a self care intervention which targets healthy eating, physical activity and alcohol consumption. It is advised that the intervention target multiple self care behaviours and that development is underpinned by behaviour change theory to ensure effectiveness. The intervention may be tailored in accordance with the TDF domains identified in this research as determinants of healthy eating, physical activity and alcohol use behaviours.
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Krause, Jennifer M., Scott Douglas i Kason M. O'Neil. "University Supervisor Perceptions of Live Remote Supervision in Pete Training". Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/4027.
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Barker, McKayla, Angela Chrisman, Mason Johnson, Matthew Gouge i Emily K. Flores. "I.M.P.A.C.T. of Interprofessional Student Teams at a Remote Area Medical Clinic in Rural Appalachia". Digital Commons @ East Tennessee State University, 2021. https://dc.etsu.edu/asrf/2021/presentations/26.
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Introduction: Remote Area Medical (RAM), a non-profit organization serving underserved populations, partnered with East Tennessee State University to provide a unique learning opportunity for student volunteers at a clinic in rural Appalachia. Interprofessional student teams were established with undergraduate and graduate students in multiple professions. This study examined the impact on attitudes of students who participated and the impact of student teams on the event, hypothesizing that a positive impact would be seen on both. COVID-19 adjustments made were also evaluated.
Methods: Surveys of student participants were conducted electronically utilizing REDCap before and after participation in the event. Surveys included demographic questions, validated surveys, and open-ended questions. Demographic questions gauged personal background, level of education, and history of interprofessional education or events. The previously validated surveys utilized were the Interprofessional Collaborative Competency Attainment Scale-Revised (ICAAS-R) and the Student Perceptions of Interprofessional Clinical Education-Revised Instrument Version 2 (SPICE-R2). Quantitative data was analyzed with SPSS version 25. Qualitative data was analyzed with deductive coding. Interventions were tallied by student teams during the event.
Results: Eighty-nine students participated logging 1,213 interventions and 84 completed portions of the survey (94% response rate). ICAAS-R (n=79) displayed mean increases from 4.19 out of 5 in the pre-survey to 4.58 in the post-survey (p
Conclusion: Statistically significant quantitative findings and qualitative themes supported the hypothesis that working in interprofessional teams at a RAM event would positively impact student attitudes towards interprofessional practice, and that student teams would have a positive impact on the event. COVID-19 adjustments made were well perceived. Findings can be summarized with the I.M.P.A.C.T. neumonic.
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Muriti, Andrew John Safety Science Faculty of Science UNSW. "A biomechanical analysis of patient handling techniques and equipment in a remote setting". Awarded by:University of New South Wales. Safety Science, 2005. http://handle.unsw.edu.au/1959.4/22002.
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Remote area staff performing manual patient handling tasks in the absence of patient lifting hoists available in most health care settings are at an elevated risk of musculoskeletal injuries. The objective of this project was to identify the patient handling methods that have the lowest risk of injury. The patient handling task of lifting a patient from floor to a chair or wheelchair is a common task performed in a remote health care setting. The task was performed utilising three methods, these being: (1) heads/tails lift, (2) use of two Blue MEDesign?? slings and (3) use of a drawsheet. The task of the heads/tails lift was broken down into two distinctly separate subtasks: lifting from the (1) head and (2) tail ends of the patient load. These techniques were selected based on criteria including current practice, durability, portability, accessibility, ease of storage and cost to supply. Postural data were obtained using a Vicon 370 three - dimensional motion measurement and analysis system in the Biomechanics & Gait laboratory at the University of New South Wales. Forty reflective markers were placed on the subject to obtain the following joint angles: ankle, knee, hip, torso, shoulder, elbow, and wrist. The raw data were converted into the respective joint angles (Y, X, Z) for further analysis. The postural data was analysed using the University of Michigan???s Three-Dimensional Static Strength Prediction Program (3D SSPP) and the relative risk of injury was based on the following three values: (1) a threshold value of 3,400 N for compression force, (2) a threshold value of 500 N for shear force, and (3) population strength capability data. The effects on changes to the anthropometric data was estimated and analysed using the in-built anthropometric data contained within the 3D SSPP program for 6 separate lifter scenarios, these being male and female 5th, 50th and 95th percentiles. Changes to the patient load were estimated and analysed using the same computer software. Estimated compressive and shear forces were found to be lower with the drawsheet and tail component of the heads/tails lift in comparison to the use of the Blue MEDesign?? straps and head component of the heads/tails lift. The results obtained for the strength capability aspect of each of the lifts indicated a higher percentage of the population capable of both the drawsheet and tail end of the heads/tails lift. The relative risk of back injury for the lifters is distributed more evenly with the drawsheet lift as opposed to the heads/tails (tail) lift where risk is disproportionate with the heavier end being lifted. The use of lifter anthropometrics does not appear to be a realistic variable to base assumptions on which group of the population are capable of safely performing this task in a remote setting. This study advocates the use of the drawsheet lift in a remote setting based on the author???s experience and the biomechanical results obtained in this study. The drawsheet lift is both more accessible and provides a more acceptable risk when more than two patient handlers are involved, in comparison to the other lifts utilised lifting patients from floor to a chair.
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Lamb, Maxwell, Sean Vinh, Chandler Parris, Emily K. Flores i KariLynn Dowling-McClay. "Impact on Student Attitudes through Participation in Interprofessional Student Teams at a Remote Area Medical Event in Rural Appalachia". Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/asrf/2020/presentations/18.
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Interprofessional teamwork is being adopted as the best way to care for patients, but it is also important to determine how future healthcare providers view this model of patient care. What are their attitudes and beliefs after having the opportunity to work in an interprofessional team? The primary objective of this study was to determine changes in health profession students’ attitudes toward interprofessional collaboration through participation in a Remote Area Medical (RAM) event in rural Appalachia. Researchers hypothesized that working in interprofessional teams positively impacts students’ attitudes toward interprofessional practice. To explore these variables, RedCap was utilized to collect demographic information, generate a pre/post survey matching code, and administer previously validated interprofessional education (IPE) questionnaires to RAM clinic student volunteers (representing five ETSU health sciences colleges and various undergraduate programs) before and after the event. Students were allowed to voluntarily complete the pre-survey online prior to participating in the event or at sign-in and the post-survey at sign-out or online after the event. The Student Perceptions of Interprofessional Clinical Education-Revised Instrument, Version 2 (SPICE-R2), which is validated for use in pre- and post-surveys, utilized 5-point Likert-type questions (strongly disagree to strongly agree) to evaluate students’ perceptions of their role on the team and the team’s impact on healthcare and patient outcomes. The Interprofessional Collaborative Competency Attainment Scale-Revised (ICCAS-R), which is only validated for use in post-surveys, required students to simultaneously evaluate their ability to perform tangible interprofessional team skills before and after the event using 5-point Likert-type questions (poor to excellent). At the event, students were placed into interprofessional teams to provide care to patients. Faculty members from a variety of professions provided leadership to the teams and guidance as needed. The pre-survey had 107 responses and the post-survey had 108 responses. However, after matching the pre- and post-surveys with student-generated codes, there were 70 valid matched responses. Data analysis was conducted using SPSS version 25. There were no statistically significant changes in SPICE-R2 IPE constructs from the pre-survey to post-survey. However, high pre-survey scores indicated that this student cohort already had a high level of appreciation for interprofessional teams, with mean scores of 4.5 out of 5 for teamwork, 4 out of 5 for roles and responsibilities, and 4.36 out of 5 for healthcare outcomes. The mean overall composite score on the ICCAS-R increased from 3.65 out of 5 on the pre-event portion to 4.03 out of 5 on the post-event portion (p < 0.001) , indicating that students increased their self-evaluated ability to perform tangible skills used in the interprofessional team through participation in the RAM clinic. Findings of this research may allow educators in both classroom and healthcare settings to better understand how hands-on IPE experiences influence students’ interprofessional attitudes and beliefs.
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Costello, Leesa. "Communicating health promotion on the web: the building, functioning and marketing of a therapeutic online community". Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2009. https://ro.ecu.edu.au/theses/1854.
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This research was motivated by several important communication and public health issues. In terms of communication, the issue at hand was whether an authentic online health-related service could be started from scratch that would exhibit the hallmarks of community. If so, could the community offer effective support to its members? Would such a community help reduce the disadvantage experienced by some people who live outside the metropolitan area and away from health-related face to face support groups? If the on line community were supported by a charity, would community members feel more inclined to support the charity themselves, through donations, for example?
In terms of the public health agenda, heart-related diseases are a national concern in Australia and throughout many (predominantly) westernised countries. While preventing heart disease, in particular, must remain the primary focus for public health initiatives; for those already affected, the National Heart Foundation (WA) has recognised that social support is a significant protective factor along with other healthy lifestyle behaviours. Social support or access to support programs has been positioned as particularly lacking for those who reside in rural or remote areas of Australia. Therefore, finding ways to provide mechanisms and avenues for the delivery of support and rehabilitation have been identified as critical if the secondary prevention (i.e., recovery) of heart disease is to be achieved. An online community is one response to this challenge.
Given that the prevalence of heart disease increases with age, Australia's baby boomer generation is moving into a vulnerable life stage. If this large cohort is not provided for, a myriad of social and economic ramifications will follow. The National Heart Foundation has also expressed concern that baby boomers are less concerned about making donations to support their work than predecessor generations; and this may ultimately reduce the types of public health programs which are made available as more of this generation encounters heart conditions.
This research, funded by an ARC Linkage grant with the National Heart Foundation (WA) as the Industry Partner, set out to respond to these challenges through the provision of a best practice website to support heart patients in Western Australia. My role, as the PhD Candidate, was to oversee all aspects of the project's design, implementation and evaluation in order to achieve the research goals. Although I was supported by specialist supervisors and technicians, all aspects of the research were undertaken as part of my PhD journey.
The website that was developed, HeartNET, provided the mechanism to determine if a sense of community among heart patients could be fostered online, not only to produce therapeutic outcomes but to support the healthy behaviours which reduce the recurrence of heart disease or illnesses. Given the challenges with rural and remote access to support services, the building of a 'community' was aptly positioned to deliver support and rehabilitation regardless of location.
The research utilised an intervention-approach which relied upon the development of a successful website from the grassroots. That is, although research into the hallmarks of what patients consider to be community was the primary research objective, this could not be undertaken unless the website were deemed successful. Achieving the 'right' website was eventually delivered after two iterations; when it had reached a critical mass of participants, having undertaken substantial marketing and public relations activities, and after interactive tools had been fine-tuned. With the website running smoothly, utilising a netnographic methodology provided the best way to investigate the notion of community. In order to ensure rigour and trustworthiness, the research utilised two groups of participants - those who accessed the website, and those who acted as comparison, and therefore did not have access. The netnography, similar to ethnography but with unique markers for online research, utilised a number of qualitative data collection techniques - a focus group, in-depth interviews, online transcripts, and other observational techniques - along with questionnaires for quantitative data collection at the commencement of the research and after 12 months of participation.
The netnography revealed that a strong sense of community developed on the HeartNET website over a 12 month duration. The community began when members started forming relationships with each other, which resulted in a sense of bonding and belonging. Members were also identified as offering mutual support as part of a 'gift economy' which led to revelations about a reduced sense of isolation or aloneness. Having identified community features, the analysis turned to issues of identity and culture which resulted in a sense of community ownership and reinforcement of community values. The analysis then revealed some positive signs of an improvement in healthy lifestyle choices for healthy diet, physical activity and smoking cessation. The questionnaire data adds some additional weight to, and provides triangulation for, what was observed online in relation to health outcomes. The final stage analysis revealed that, although methodological issues would not allow for an in-depth interrogation of philanthropic support in terms of attitudes and behaviours to do with donations, it did reveal a new philanthropic currency in that HeartNET members were willing to donate their time, stories, and experiences to support Heart Foundation events and activities.
This thesis offers an innovative application of communications theory within a health context by providing a detailed roadmap for the development of other online health-related communities.
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Mitchell, Jillian Mary Graham, i jill mitchell@health sa gov au. "A Matter of Urgency! Remote Aboriginal Womens Health. Examining the transfer, adaptation and implementation of an established holistic Aboriginal Well Womens Health program from one remote community to another with similar needs and characteristics". Flinders University. Nursing and Midwifery, 2007. http://catalogue.flinders.edu.au./local/adt/public/adt-SFU20070725.112610.
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Aim:
As a priority for Aboriginal women, in the context of worsening Aboriginal health and lack of clarity about successful strategies to address healthcare needs, this research explored successful strategies in remote Aboriginal womens health that may be transferable to another community with similar health needs.
Methodology:
Against a background of cultural and historical events, the study sought to identify existing strategies and frameworks for Aboriginal womens health. It uses Naturalistic Inquiry situated within the Interpretive paradigm and conceptualised within the philosophical approach of feminist and critical social theory It has examined Aboriginal health providers and womens priorities, practices, perceptions and expectations within the context of primary health care and community development principles by Participatory Action Research (PAR).
The successful elements of an established and effective Aboriginal Well Womens Health (AWWH) program from Central Australia (CA) were identified, transferred and adapted to meet the needs of a willing recipient remote community in South Australia (SA). Working together with healthcare providers from CA and SA, the adapted Well Womens Health program was implemented in an Aboriginal Community Controlled Health Service collaboratively with local mainstream Community Womens health services and evaluated.
Results:
Over a two year period, the research was evaluated through Critical Social Theory examining both the process of implementation and the impact on the Aboriginal community, analysing both qualitative and quantitative data. The AWWH program model and its principles were successfully transferred, adapted and implemented in this community. The AWWH program which included comprehensive health screening, health information and lifestyle sessions have become core business of the Aboriginal health service and an Aboriginal Mens Well Health program has also been established using the same model.
The women have found the AWWH program culturally acceptable and their attendance has steadily increased and the program has reached those women in the community who previously had never experienced a well health check. It has also identified an extremely high incidence and comorbidity of acute illness and chronic disease in diabetes, renal and dental disease, mental and social health problems that require address.
Conclusion:
Health programs that are well established and effective can be successfully replicated, transferred and adapted to other communities if the elements that made them successful are acknowledged and those principles are then transferred with the program to a willing community with similar needs. This program transfer has potential to save much time and developmental costs that will help to address poor Aboriginal health.
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Braun, Ashlea. "Development, Implementation, and Evaluation of Integrated Remote Motivational Interviewing Interventions for Behavior Modification". The Ohio State University, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=osu1595504093142486.
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Edroos, Sadat Ali. "Myocardial ischaemia-reperfusion injury and its reduction by remote ischaemic preconditioning in health and diabetes mellitus". Thesis, University of Leicester, 2014. http://hdl.handle.net/2381/31983.
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Myocardial infarction is the main cause of death in the United Kingdom. Early reperfusion of coronary artery occlusion has greatly improved mortality, though restoration of blood supply may perpetuate cell death through reperfusion injury. Preconditioning is a potent endogenous form of cardioprotection triggered through preceding brief nonperfusion of the heart’s blood supply. In remote conditioning it is triggered by intermittent tourniquet ischaemia of a limb. However a limited understanding of the mechanisms underlying transfer of a signal from the peripheries, its reception in the heart, and the impact of comorbid disease on this process hinders its application to the clinical setting of myocardial infarction. This work trials several models of reperfusion injury, and optimises a method of centrifugation of adult rat ventricular myocytes into a dense pellet to induce ischaemia, and simulate reperfusion by its dispersal. Remote preconditioning is evoked by preincubation of myocytes with serum samples taken from participants. This is used as a screening tool in order to test serum samples acquired from volunteers in control and disease states undergoing tourniquet ischaemia of a peripheral limb to reproduce the stimulus of remote preconditioning. A protective signal was seen in serum taken from healthy subjects following remote preconditioning versus baseline serum (20.5±3.3 vs 37.2±4.5 % necrosis respectively, n = 21, p < 0.001). Protection is absent in diabetes mellitus type 1 (51.5±4.6% necrosis, n = 14) and type 2 (51.3±8.2% necrosis, n = 10). The protective signal is preserved with age in healthy male participants, though appears to decline with age in a preliminary cohort of female participants. On assay of putative mechanisms of remote preconditioning, serum nitrite did not change with preconditioning in healthy volunteers, though it was found to significantly decrease in diabetes mellitus type 1. The implications for the application of this powerful yet elusive form of innate cardiac protection are considered.
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Shakespeare, Louise. "Lymphoedema in a remote and rural area : an investigation into the prevalence of lymphoedema and its effect on daily living and quality of life in a remote and rural area in the far north of Scotland". Thesis, University of the Highlands and Islands, 2012. https://pure.uhi.ac.uk/portal/en/studentthesis/lymphoedema-in-a-remote-and-rural-area(86565f97-7da4-490a-9d74-a76d3d5a64e2).html.
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Background to the study: The long term maintenance of lymphoedema depends on a daily regime of these physical therapies, which lend themselves to self-management by those with the condition (Lymphoedema Framework, 2006). It has been widely recognised in the literature for many years, e.g. Rose et al (1991) to Fu (2010), that achieving a reduction in volume of the lymphoedema and ensuring the ongoing maintenance of the condition is dependent upon knowledgeable healthcare professionals and patients, who are aware of the importance of self care and self management in the long term maintenance of the condition. The challenges for effective lymphoedema management may be exacerbated when the person lives in a very remote and rural area. It has been recognised by policymakers that sparsely populated and geographically remote areas need different healthcare solutions as many of the healthcare policies designed for urban areas are not applicable or sustainable in these areas (British Medical Association, 2005). Estimating the prevalence of the condition and considering the experience of a sample of people with lymphoedema who live in a very remote and rural area will contribute to the knowledge of the requirements for a lymphoedema service to be effective in such an area. Aims: To estimate the prevalence of lymphoedema/chronic oedema and to investigate the characteristics of the condition in a very remote and rural area of Scotland and to explore the experience of a sample of people living with the condition in that area. Methods: A mixed methods research strategy was used. An initial survey of GP practices was undertaken to estimate the prevalence of lymphoedema/chronic oedema and to generate a sample for the other two stages of the study. A postal questionnaire was used to collect quantitative and qualitative information from the initial sample, and to generate a smaller sample to participate in individual semi-structured qualitative interviews exploring the experience of living with and self-managing lymphoedema/chronic oedema in a very remote and rural area in the north of Scotland. Results: The estimated prevalence rate, based on GP report, was higher than that noted in prevalence studies in large urban areas. Based on questionnaire responses, 53% of participants stated their lymphoedema made no difference to how they felt about themselves. However, interviews revealed that frustration and anger was present despite acceptance of the situation; in particular, lack of information and effective treatment was a source of frustration. Many of the sample effectively self-managed their condition, based on their own commonsense experience. However, this resort to commonsense measures seemed to be as result of an apparent lack of awareness and intervention from health care professionals. Conclusions: The findings suggest that early recognition and even minimal support from a knowledgeable source at that early stage could help to maintain the lymphoedema and reduce the need for specialist treatments. Suggestions for the ways of improving early recognition of the condition and access to self-management support in a very remote and rural area are offered.
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Watson, James W. "Free Clinics and the Uninsured: The Need for Remote Area Medical in Central Appalachia After Health Reform". Digital Commons @ East Tennessee State University, 2011. https://dc.etsu.edu/etd/1358.
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In 2008, the election of President Barack Obama brought health care to the forefront of national discussions and led to the passage of the Patient Protection and Affordable Care Act (ACA). The legislation changed the rules of health care delivery in the United States, but the ACA did not do one fundamental thing: It did not end the need for many of the nation's most needy patients to seek free medical care from groups such as Remote Area Medical (RAM).
A mobile clinic, RAM brings together volunteer dentists, physicians, nurses, and other professionals as well as support staff for multi-day clinic events to provide free, on-site care to anyone presenting for treatment without qualification questions. This thesis looks at the ongoing need for RAM in central Appalachia after the passage of the ACA due to a continued lack of comprehensive health care coverage for all Americans.
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Holstius, David. "Monitoring Particulate Matter with Commodity Hardware". Thesis, University of California, Berkeley, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3640465.
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Health effects attributed to outdoor fine particulate matter (PM 2.5) rank it among the risk factors with the highest health burdens in the world, annually accounting for over 3.2 million premature deaths and over 76 million lost disability-adjusted life years. Existing PM2.5 monitoring infrastructure cannot, however, be used to resolve variations in ambient PM2.5 concentrations with adequate spatial and temporal density, or with adequate coverage of human time-activity patterns, such that the needs of modern exposure science and control can be met. Small, inexpensive, and portable devices, relying on newly available off-the-shelf sensors, may facilitate the creation of PM2.5 datasets with improved resolution and coverage, especially if many such devices can be deployed concurrently with low system cost.
Datasets generated with such technology could be used to overcome many important problems associated with exposure misclassification in air pollution epidemiology. Chapter 2 presents an epidemiological study of PM2.5 that used data from ambient monitoring stations in the Los Angeles basin to observe a decrease of 6.1 g (95% CI: 3.5, 8.7) in population mean birthweight following in utero exposure to the Southern California wildfires of 2003, but was otherwise limited by the sparsity of the empirical basis for exposure assessment. Chapter 3 demonstrates technical potential for remedying PM2.5 monitoring deficiencies, beginning with the generation of low-cost yet useful estimates of hourly and daily PM2.5 concentrations at a regulatory monitoring site. The context (an urban neighborhood proximate to a major goods-movement corridor) and the method (an off-the-shelf sensor costing approximately USD $10, combined with other low-cost, open-source, readily available hardware) were selected to have special significance among researchers and practitioners affiliated with contemporary communities of practice in public health and citizen science. As operationalized by correlation with 1h data from a Federal Equivalent Method (FEM) β-attenuation data, prototype instruments performed as well as commercially available equipment costing considerably more, and as well as another reference instrument under similar conditions at the same timescale (R2 = 0.6). Correlations were stronger when 24 h integrating times were used instead (R2 = 0.72).
Chapter 4 replicates and extends the results of Chapter 3, showing that similar calibrations may be reasonably exchangeable between near-roadway and background monitoring sites. Chapter 4 also employs triplicate sensors to obtain data consistent with near-field (< 50 m) observations of plumes from a major highway (I-880). At 1 minute timescales, maximum PM2.5 concentrations on the order of 100 μg m–3 to 200 μg m–3 were observed, commensurate with the magnitude of plumes from wildfires on longer timescales, as well as the magnitude of plumes that might be expected near other major highways on the same timescale. Finally, Chapter 4 quantifies variance among calibration parameters for a large sample of the sensors, as well as the error associated with the remote transfer of calibrations between two sufficiently large sets (± 10 % for n = 12). These findings suggest that datasets generated with similar sensors could also improve upstream scientific understandings of fluxes resulting from indoor and outdoor emissions, atmospheric transformations, and transport, and may also facilitate timely and empirical verification of interventions to reduce emissions and exposures, in many important contexts (e.g., the provision of improved cookstoves; congestion pricing; mitigation policies attached to infill development; etc.). They also demonstrate that calibrations against continuous reference monitoring equipment could be remotely transferred, within practical tolerances, to reasonably sized and adequately resourced participatory monitoring campaigns, with minimal risk of disruption to existing monitoring infrastructure (i.e., established monitoring sites). Given a collaborator with a short window of access to a reference monitoring site, this would overcome a nominally important barrier associated with non-gravimetric, in-situ calibration of continuous PM2.5 monitors. Progressive and disruptive prospects linked to a proliferation of comparable sensing technologies based on commodity hardware are discussed in Chapter 5.