The experience of homelessness is associated with strong stigmatization processes, which are often reflected in the treatment received from professionals and the healthcare system itself. This ...article aims to analyze the experiences of participants in a program for homeless individuals in Barcelona called Primer la Llar within the healthcare system, and how the stigma they suffer affects the care processes. This program follows the Housing First model, a social intervention that proposes providing housing without preconditions to individuals with long histories of street living, who suffer from severe mental disorders and/or addictions. Based on individual interviews with 20 participants conducted between 2016 and 2020, it is observed that in certain cases, entering the program, having housing availability, support from professionals, and the development of their own strategies had positive effects on improving their health, although they continue to perceive discriminatory attitudes in some medical settings. It is suggested that the transformation regarding stigmatization be understood broadly, affecting individuals, institutions, and society as a whole.The experience of homelessness is associated with strong stigmatization processes, which are often reflected in the treatment received from professionals and the healthcare system itself. This article aims to analyze the experiences of participants in a program for homeless individuals in Barcelona called Primer la Llar within the healthcare system, and how the stigma they suffer affects the care processes. This program follows the Housing First model, a social intervention that proposes providing housing without preconditions to individuals with long histories of street living, who suffer from severe mental disorders and/or addictions. Based on individual interviews with 20 participants conducted between 2016 and 2020, it is observed that in certain cases, entering the program, having housing availability, support from professionals, and the development of their own strategies had positive effects on improving their health, although they continue to perceive discriminatory attitudes in some medical settings. It is suggested that the transformation regarding stigmatization be understood broadly, affecting individuals, institutions, and society as a whole.
As a new revolution of the Internet, Internet of Things (IoT) is rapidly gaining ground as a new research topic in many academic and industrial disciplines, especially in healthcare. Remarkably, due ...to the rapid proliferation of wearable devices and smartphone, the Internet of Things enabled technology is evolving healthcare from conventional hub based system to more personalised healthcare systems (PHS). However, empowering the utility of advanced IoT technology in PHS is still significantly challenging in the area considering many issues, like shortage of cost-effective and accurate smart medical sensors, unstandardised IoT system architectures, heterogeneity of connected wearable devices, multi-dimensionality of data generated and high demand for interoperability. In an effect to understand advance of IoT technologies in PHS, this paper will give a systematic review on advanced IoT enabled PHS. It will review the current research of IoT enabled PHS, and key enabling technologies, major IoT enabled applications and successful case studies in healthcare, and finally point out future research trends and challenges.
Internet of Things (IoT) on the Wireless Body Area Network (WBAN) for healthcare applications is an operative scenario for IoT devices that has gained attention from vast research fields in recent ...years. The IoT connects all subjects and the healthcare system seamlessly. This paper describes the WBAN based IoT healthcare system and reviews the state-of-the-art of the network architecture topology and applications in the IoT based healthcare solutions. Moreover, this paper analyzes the security and the privacy features consisting of privacy, authentication, energy, power, resource management, Quality of Services and the real-time wireless health monitoring that are quite problematic in many IoT healthcare architectures. Because, system architecture is not well-defined, data restriction and its integrity preservation is still a challenge. At present 90% of the information available is acquired in the recent two years. This survey mainly aims at analyzing healthcare purpose which is based on digital healthcare system. Further, it reports many IoT and the e-healthcare policies and systems that decide how to ease all bearable development. Thus, the overall system provides large possibilities for future research based on IoT healthcare system. Finally, research gaps are reviewed and the possible future aspects have been discussed.
Recently, there is a tremendous rise and adoption of smart wearable devices in smart healthcare applications. Moreover, the advancement in sensors and communication technology empowers to detect and ...analyse physiological data of an individual from the wearable device. At present, the smart wearable device based on internet of things is assisting the pregnancy woman to continuously monitor their health status for avoiding the severity. The physiological data analysis of wearable device is processed with the assistance of fog computing due to limited computational and energy capability in the wearable device. Additionally, fog computing overcomes the excess latency that is created by cloud computing during physiological data analysis. In this article, a smart health monitoring IoT and fog-assisted framework are proposed for obtaining and processing the temperature, blood pressure, ECG, and pulse oximeter parameters of the pregnant woman. Based on real time series data, the rule-based algorithm logged in the wearable device with fog computing to analyse the critical health conditions of pregnant women. The proposed wearable device is validated and tested on 80 pregnant women in real time, and wearable device is delivering the 98.75% accuracy in providing health recommendations.
Currently, ECG-based authentication is considered highly promising in terms of user identification for smart healthcare systems because of its inimitability, suitability, accessibility and ...comfortability. However, it is a great challenge to improve the authentication accuracy, especially for scenarios that include a large number of users. Thus, this paper proposes a parallel ECG-based authentication called PEA. Specifically, this paper proposes a hybrid ECG feature extraction method that integrated fiducial- and non-fiducial-based features to extract more comprehensive ECG features and thereby improve the authentication stability. Furthermore, this paper proposes a parallel ECG pattern recognition framework to improve the recognition efficiency in multiple ECG feature spaces. Through the experiments, the performance of the proposed authentication is verified.
Abstract
Objective
To explore differences in position emission tomography-computed tomography (PET-CT) service provision internationally to further understand the impact variation may have upon ...cancer services. To identify areas of further exploration for researchers and policymakers to optimize PET-CT services and improve the quality of cancer services.
Design
Comparative analysis using data based on pre-defined PET-CT service metrics from PET-CT stakeholders across seven countries. This was further informed via document analysis of clinical indication guidance and expert consensus through round-table discussions of relevant PET-CT stakeholders. Descriptive comparative analyses were produced on use, capacity and indication guidance for PET-CT services between jurisdictions.
Setting
PET-CT services across 21 jurisdictions in seven countries (Australia, Denmark, Canada, Ireland, New Zealand, Norway and the UK).
Participants
None.
Intervention(s)
None.
Main Outcome Measure(s)
None.
Results
PET-CT service provision has grown over the period 2006–2017, but scale of increase in capacity and demand is variable. Clinical indication guidance varied across countries, particularly for small-cell lung cancer staging and the specific acknowledgement of gastric cancer within oesophagogastric cancers. There is limited and inconsistent data capture, coding, accessibility and availability of PET-CT activity across countries studied.
Conclusions
Variation in PET-CT scanner quantity, acquisition over time and guidance upon use exists internationally. There is a lack of routinely captured and accessible PET-CT data across the International Cancer Benchmarking Partnership countries due to inconsistent data definitions, data linkage issues, uncertain coverage of data and lack of specific coding. This is a barrier in improving the quality of PET-CT services globally. There needs to be greater, richer data capture of diagnostic and staging tools to facilitate learning of best practice and optimize cancer services.
Display omitted
•Most patients with complex epilepsy and their caregivers are unaware of the transition process.•A significant decrease in access to psychologist, dietician, speech therapist, and ...occupational therapist was found in the adult health care system.•54% of patients felt stressed during the move from pediatric to AHCS, but 85% perceived more autonomy in the adult health care system.•Epilepsy transition programs are not well developed even in academic centers.
Epilepsy is a complex condition and seizures are only one part of this disease. The move from pediatric to adult healthcare system proves difficult for many adolescents with epilepsy and their families. The challenges increase when patients have epilepsies associated with intellectual and/or developmental disabilities, autism spectrum disorder, and motor disorders. Knowledge and system gaps may exist between the two systems, adding to the challenges. The main goal of this study is to understand the perception of patients with epilepsy and their families who were preparing to move from pediatric to adult healthcare system or had already moved.
A survey was distributed to patients/caregivers of patients with epilepsy through patient support groups in North America and in-person through the 2019 Epilepsy Awareness Day at Disneyland. Patients were required to be 12 years or older at the time of the survey and were divided into two groups: those between 12 and 17 years and those 18 years or older. Caregivers answered on behalf of patients who were unable to respond (e.g., intellectual disability). Major components of the survey included demographics, epilepsy details, quality and access to care received in pediatric and adult years, and questions regarding transition and readiness.
Responses were received from 58 patients/caregivers of patients with epilepsy from Canada and the United States. In group A (patients between 12 and 17 years), none of the 17-year-old patients were spoken to about transition. Patients (caregivers) with epilepsy and intellectual and/or developmental disabilities (IDD) had less time to discuss important things during the transition/transfer phase than patients with normal intelligence. Finally, there was a statistically significant difference observed in access to specialty care reported in the adult years, compared to the years in the pediatric system.
In the group B (patients 18 years and older) a) 35 % still visit their family doctor for epilepsy related treatment despite the majority being on 2 or more antiseizure medications (ASMs); b) 27 % of patients in this group were still being followed by their pediatric neurologist; c) one patient received care only through visits to the emergency department; d) only 4 % felt that they received clear instructions during transfer of care such as knowing the name of the adult healthcare practitioner and/or the name of the care institution they were being transferred to.
This study highlights the lack of appropriate transition to adult healthcare system (AHCS) amongst an unselected group of patients with epilepsy in Canada and United States. An overwhelming majority of patients followed in the community and in academy centers were simply “transferred” to an adult health practitioner, or they remained under the care of pediatricians. Finally, most patients lack access to significant social and medical support after moving to the AHCS.
I will never shake the memory of one of the first patients I worked with during clinical rotations. I was excited to begin my internal medicine rotation in my third year, marking my initiation into ...the world of inpatient care. On my first day, the residents on my team introduced themselves and discussed which patients would provide the best learning opportunities for students. That's how I ended up caring for John Doe.
•The BSM-Ether combines selfish mining and bribery attacks in Ethereum.•We analyze the mining rewards and the impact of bribes on the rewards for parties.•The simulation of BSM-Ether is performed and ...results are analyzed.
Blockchain-enabled distributed networks present a new infrastructure for building reliable and privacy-preserving healthcare utilities. Among them, Ethereum networks have gained specialized attention for their high usability and security. In this paper, we raise the awareness of Ethereum’s vulnerability due to selfish mining, in which ill-disposed miners are feasible to receive more rewards than honest ones. To demonstrate this, we compose a new bribery selfish mining scheme, the BSM-Ether, targeted to Ethereum. The BSM-Ether attack can be easily conducted and has higher rewards than other existing malicious attacks. Besides, we present a formal and rigorous analysis of multiple kinds of rewards from the BSM-Ether attack. Simulation experiments show the high effectiveness of BSM-Ether – the attacker can get a higher revenue with few efforts. To tackle this variability, we present some implementation level proposals and suggestions for building healthcare systems on top of Ethereum to minimize the negative effect of the security deficiency of underlying systems.
In extreme circumstances such as pandemics, the presence of patients in hospital emergency departments becomes untenable. Healthcare professionals and organizations worldwide are leaning on ...technology as a crucial ally to deal with the COVID-19 outbreak. This article focuses on the positive impact of telemedicine for helping service provision, from enabling virtual triage to mitigating the negative psychological effects of social isolation. The authors discuss the challenges and opportunities to telemedicine practices.
This article explains how telemedicine and other e-healthcare technologies can benefit people, medical staff and healthcare systems. One of the main challenges for telemedicine in many countries is the lack of regulations. The authors call on policy-makers to facilitate wider implementation of e-healthcare technologies, while considering issues of inclusiveness, privacy and data protection. The article informs managers about the use of new technologies. Examples are provided of e-healthcare technologies implemented during the COVID-19 pandemic, for example in terms of healthcare capacity and providing support to people affected by quarantine.
PDF
