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INTRODUCTION: We used clinical assessment records to provide pan-Canadian estimates of the prevalence and risks associated with recent (within the last 3 days) critical wandering among home care clients, with and without dementia. METHODS: The data source is interRAI Home Care (interRAI HC) assessments. The population was all long-stay home care clients assessed between 2004 and 2021 in seven Canadian provinces and territories (N = 1,598,191). We tested associations between wandering and cognition and dementia diagnoses using chi-square tests and logistic regression. RESULTS: Approximately 84% of the sample was over the age of 65. The overall rate of recent wandering was 3.0%. Dementia diagnosis was strongly associated with two to four times higher rates in the prevalence of recent critical wandering. DISCUSSION: InterRAI HC offers insights into the wandering risk of home care clients. This information should be used to manage risks in the community and could be shared with first responders. HIGHLIGHTS: In all the study regions combined, the rate of recent wandering is 3.0%. Dementia was associated with 18 times greater prevalence of recent critical wandering. Home care clients at risk of wandering have complex clinical profiles that pose important risks for their health and well-being. Collaboration and information sharing between search and rescue and health professions is essential for managing risks related to critical wandering.
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BACKGROUND: Functional Capacity Evaluation (FCE) is a crucial component within return-to-work decision making. However, clinician-based physical FCE interpretation may introduce variability and biases. The rise of technological applications such as machine learning and artificial intelligence, could ensure consistent and precise results. OBJECTIVE: This review investigates the application of information and communication technologies (ICT) in physical FCEs specific for return-to-work assessments. METHODS: Adhering to the PRISMA guidelines, a search was conducted across five databases, extracting study specifics, populations, and technological tools employed, through dual independent reviews. RESULTS: Nine studies were identified that used ICT in FCEs. These technologies included electromyography, heart rate monitors, cameras, motion detectors, and specific software. Notably, although some devices are commercially available, these technologies were at a technology readiness level of 5-6 within the field of FCE. A prevailing trend was the combined use of diverse technologies rather than a single, unified solution. Moreover, the primary emphasis was on the application of technology within study protocols, rather than a direct evaluation of the technology usability and feasibility. CONCLUSION: The literature underscores limited ICT integration in FCEs. The current landscape of FCEs, marked by a high dependence on clinician observations, presents challenges regarding consistency and cost-effectiveness. There is an evident need for a standardized technological approach that introduces objective metrics to streamline the FCE process and potentially enhance its outcomes.
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BACKGROUND: Critical wandering occurs when an individual living with dementia leaves a location and is unaware of place or time. Critical wandering incidents are expected to increase with the growing prevalence of persons living with dementia worldwide. We investigated the association between demographic, psychopathological, and environmental factors and a history of critical wandering among Medic-Alert subscribers, both with and without dementia. METHODS: Our retrospective study included data of 25,785 Canadian Medic-Alert subscribers who were aged 40 years or older. We used multivariable logistic regression analysis to examine the associations between a history of critical wandering and dementia status as psychopathological independent variable, controlled by demographic (age, ethnic background, sex at birth, Canadian languages spoken) and environmental (living arrangement, population density) factors. RESULTS: The overall study sample comprised of mainly older adults (77.4%). Medic-Alert subscribers who were older, male sex at birth, living with dementia, of a minority ethnic group and who did not have proficiency in an official Canadian language had a higher likelihood of a history of critical wandering. Residing in an urban environment, in an institution or with a family member, were environmental factors associated with a higher likelihood of a history of critical wandering. CONCLUSIONS: People living with dementia experience a higher likelihood of a history of critical wandering compared to those without dementia. Medic-Alert and similar organizations can develop algorithms based on the associated factors that can be used to flag risks of critical wandering. This can inform preventative strategies at the individual and community levels.
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Demência , Comportamento Errante , Humanos , Masculino , Feminino , Estudos Retrospectivos , Idoso , Demência/epidemiologia , Demência/etnologia , Demência/psicologia , Idoso de 80 Anos ou mais , Pessoa de Meia-Idade , Adulto , Fatores de Risco , Canadá/epidemiologiaRESUMO
BACKGROUND: The COVID-19 pandemic created many challenges for in-patient care including patient isolation and limitations on hospital visitation. Although communication technology, such as video calling or texting, can reduce social isolation, there are challenges for implementation, particularly for older adults. OBJECTIVE/METHODS: This study used a mixed methodology to understand the challenges faced by in-patients and to explore the perspectives of patients, family members, and health care providers (HCPs) regarding the use of communication technology. Surveys and focus groups were used. FINDINGS: Patients who had access to communication technology perceived the COVID-19 pandemic to have more adverse impact on their well-beings but less on hospitalization outcomes, compared to those without. Most HCPs perceived that technology could improve programs offered, connectedness of patients to others, and access to transitions of care supports. Focus groups highlighted challenges with technology infrastructure in hospitals. DISCUSSION: Our study findings may assist efforts in appropriately adopting communication technology to improve the quality of in-patient and transition care.
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Background App-based strategies are a promising solution to deliver nutrition and exercise interventions during social distancing. With limited RCT data in individuals with chronic disease, further information is required both to determine impact, and to guide delivery. The Heal-Me app is an evidence-based, theoretically informed nutrition and exercise solution that can be tailored for use across a range of individuals with chronic disease. As compared to controls receiving educational material, the aim of this study is to assess the acceptability, effectiveness, and cost of Heal-Me app programming delivered alongside two levels of dietitian and exercise-specialist support. Methods Heal-Me PiONEer is a 12-week, 3-arm RCT with randomization to one of three study groups (n=72 per group, 216 total). Group 1 (control: educational material), Group 2 (Heal-Me app + virtual group dietitian/exercise-specialist sessions), Group 3 (Heal-Me app + virtual group and 1-to-1 dietitian/exercise-specialist sessions). Inclusion criteria: adults with cancer, chronic lung disease or status post-transplantation from liver or lung transplant; previous completion of an exercise rehabilitation program; access to an internet-connected device. Study outcomes measured at study weeks 0 and 12 include: Primary - Lower Extremity Functional Scale; Secondary - virtual physical function tests, loneliness, resilience, anxiety, well-being and health-related quality of life; Exploratory outcomes - protein intake, behavioral beliefs around exercise and nutrition, adherence, adverse events, acceptability, and cost-utility. Conclusions The Heal-Me PiONEer RCT holds promise to provide a comprehensive understanding of the delivery and impact of app-based nutrition and exercise programming in a diverse group of participants with chronic disease.
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Aplicativos Móveis , Qualidade de Vida , Adulto , Doença Crônica , Exercício Físico , Terapia por Exercício , HumanosRESUMO
The textile and clothing industry sector has today a big environmental impact, not only due to the consumption of water and the use of toxic chemicals but also due to the increasing levels of textile waste. One way to reduce the problem is to circularise the, currently linear, textile and clothing value chain, by using discarded clothes as raw material for the production of new clothes, transforming it into a model of circular economy. This way, while reducing the need to produce new raw materials (e.g. cotton), the problem of textile waste produced is also reduced, thus contributing to a more sustainable industry. In this article, we review the current approaches for traceability in the textile and clothing value chain, and study a set of technologies we deem essential for promoting the circular economy in this value chain - namely, the blockchain technology - for registering activities on traceable items through the value chain, and the Internet of Things (IoT) technology, for easily identifying the traceable items' digital twins.
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Blockchain , Internet das Coisas , Indústrias , Tecnologia , TêxteisRESUMO
Frailty is a prevalent condition among Canadians; over one million are diagnosed as medically frail, and in the next ten years this number will double. Information and telecommunication technologies can provide a low-cost method for managing frailty more proactively. This study aims to examine the range and extent of information and telecommunication technologies for managing frailty in older adults, their technology readiness level, the evidence, and the associated outcomes. A systematic literature review was conducted. Four databases were searched for studies: Medline, EMBASE, CINAHL, and Web of Science. In total, we included 19 studies (out of 9,930) for the data abstraction. Overall, our findings indicate that (1) the proposed frailty phenotype is the most common ground truth to be used for assessing frailty; (2) the most common uses of information and telecommunication technologies for managing frailty are detection, and monitoring and detection, while interventional studies on frailty are very rare; (3) the five main types of information and telecommunication technologies for managing frailty in older adults are information and telecommunication technology-based platforms, smartphones, telemonitoring (home monitoring), wearable sensors and devices (commercial off-the-shelf), and multimedia formats for online access; (4) the technology readiness level of information and telecommunication technologies for managing frailty in older adults is the "Technology Demonstration" level, i.e., not yet ready to be operated in an actual operating environment; and (5) the level of evidence is still low for information and telecommunication technology studies that manage frailty in older adults. In conclusion, information and telecommunication technologies for managing frailty in the older adult population are not yet ready to be full-fledged technologies for this purpose.
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The aims of this paper are (1) to identify the characteristics of maintenance service providers that directly impact maintenance service quality, using 18 independent covariables; (2) to quantify the change in risk these covariables present to service quality, measured in terms of equipment turnaround time (TAT). A survey was applied to every maintenance service provider (n = 19) for characterization purposes. The equipment inventory was characterized, and the TAT variable recorded and monitored for every work order of each service provider (N = 1,025). Finally, the research team conducted a statistical analysis to accomplish the research objectives. The results of this study offer strong empirical evidence that the most influential variables affecting the quality of maintenance service performance are the following: type of maintenance, availability of spare parts in the country, user training, technological complexity of the equipment, distance between the company and the hospital, and the number of maintenance visits performed by the company. The strength of the results obtained by the Cox model built are supported by the measure of the Rp,e(2) = 0.57 with a value of Rp,e= 0.75. Thus, the model explained 57% of the variation in equipment TAT, with moderate high positive correlation between the dependent variable (TAT) and independent variables.
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Engenharia Biomédica/organização & administração , Engenharia Biomédica/normas , Manutenção/métodos , Manutenção/normas , Serviços Terceirizados , Equipamentos e Provisões Hospitalares , Departamentos Hospitalares , Humanos , Modelos Estatísticos , Avaliação de Programas e Projetos de SaúdeRESUMO
El proceso de publicar una investigación como un trabajo científico es el último eslabón de la cadena de investigación. Intentar publicar es un proceso largo y desgastante, que en muchas ocasiones no termina en éxito. En revistas de alto impacto en el área de gerencia, donde se publican trabajos originales relacionados con el área de la salud, solo pasan a primera ronda de revisión de pares el 10% de los artículos y logran ser publicados apenas el 5% del total de trabajos sometidos a revisión. En el siguiente trabajo se exponen algunos consejos útiles, que pueden contribuir a que sus trabajos se encuentren en ese selecto 5% . Si bien (se dará cuenta) es difícil, no es imposible.
Publishing scientific papers is the last process in the research chain. Publishing is a long and exhausting process, which, in many cases, does not have a happy end. In high-impact management journals publishing original works in the health area,, only about 10% of the articles passed to the first round of peer review, and only 5% of all papers subject to review are eventually published. My paper discusses some useful tips that can help your papers to belong to that 5%-elite. Even if you find it is difficult, it is not impossible.
O processo de publicar uma pesquisa como um trabalho científico é o último processo da cadeia de pesquisa. Tentar publicar é um processo longo e desgastante, que em muitas ocasiões não termina em sucesso. Em revistas de alto impacto de management onde se publicam trabalhos originais relacionados com a área da saúde, só passam a primeira ronda de revisão de pares o 10% dos artigos e conseguem ser publicados a penas o 5% do total de trabalhos submetidos à revisão. No seguinte trabalho expõem-se alguns conselhos úteis, que podem contribuir a que seus trabalhos se encontrem nesse seleto 5%. Se bem que (será evidente) é difícil, não é impossível.
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Humanos , Publicações Científicas e Técnicas , Pesquisa , Publicações Seriadas , Efetividade , Sistemas de Avaliação das PublicaçõesRESUMO
Todos hemos sometido algún artículo científico a revisión con la idea de que sea publicado en cierta revista. Frecuentemente, los autores experimentan muchas barreras para alcanzar el éxito (lograr la publicación) cuando someten artículos a revisión. Estas barreras dependen de la escritura del artículo en sí mismo, de los sesgos de los pares revisores, de la forma en que se escribe la carta de presentación (cover letter), y de la manera en la cual se implementa una estrategia para abordar y responder a las observaciones (erradas o no) que emiten los pares revisores y el editor de la revista. El propósito de este artículo vivencial es el de brindar consejos útiles a autores que investigan en el área de la ingeniería clínica, sobre cómo publicar artículos que aborden temas en el área de la salud en revistas de alto impacto en el área del operations research & management sciences.
All of us have at some point submitted a scientific paper for review with the idea of being published in a given journal. Often, the authors experience many barriers to success (achieving publication) when they submit articles for publication. These barriers depend on the quality of the writing itself, on the biases of the peer reviewers, the way you write your cover letter, and the way in which you address and respond to the observations (erroneous or not) emitted by peer reviewers and the editor of the journal. The purpose of this paper is to provide useful pieces of advice on how to publish articles that tackle issues in the health area in high impact journals in the area of Operations Research & Management Sciences.
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The aim of this paper was to characterize clinical engineering from the perspective of scientific publications. First of all, the most significant factors that influence the change in health systems are briefly exposed. Then, clinical engineering is defined and its main functions and evolution within the development of the health system is explained. Finally, the author describes the state of the field from the viewpoint of the scientific publications; an apparent lack of interest in the engineering community to publish scientific research was observed. This behavior can be seen in the clear declining tendency in the number of citations and the number of publications (in volume or quantity) in major scientific journals in the field. Finally, current challenges and future developments must be addressed to accomplish a better positioning of the specialty in the publishing world.
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Engenharia Biomédica , Editoração , Engenharia Biomédica/tendênciasRESUMO
This paper investigates the use of clustering technique to characterize the providers of maintenance services in a health-care institution according to their performance. A characterization of the inventory of equipment from seven pilot areas was carried out first (including 264 medical devices). The characterization study concluded that the inventory on a whole is old [exploitation time (ET)/useful life (UL) average is 0.78] and has high maintenance service costs relative to the original cost of acquisition (service cost /acquisition cost average 8.61%). A monitoring of the performance of maintenance service providers was then conducted. The variables monitored were response time (RT), service time (ST), availability, and turnaround time (TAT). Finally, the study grouped maintenance service providers into clusters according to performance. The study grouped maintenance service providers into the following clusters. Cluster 0: Identified with the best performance, the lowest values of TAT, RT, and ST, with an average TAT value of 1.46 days; Clusters 1 and 2: Identified with the poorest performance, highest values of TAT, RT, and ST, and an average TAT value of 9.79 days; and Cluster 3: Identified by medium-quality performance, intermediate values of TAT, RT, and ST, and an average TAT value of 2.56 days.
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Análise por Conglomerados , Serviços Contratados/estatística & dados numéricos , Manutenção/estatística & dados numéricos , Interpretação Estatística de Dados , InternacionalidadeRESUMO
El presente artículo expone el estado de la formación en Ingeniería Biomédica en Colombia a nivel de pregrado. Se revisaron programas de la Unión Europea y los Estados Unidos. A nivel nacional, se revisaron, bajo la categoría de Ingeniería Biomédica y Bioingeniería, los planes de estudio de quince instituciones de educación superior a partir de tres fuentes de información: Páginas Web de Universidades, Sistema de Información de Educación Superior y Observatorio Laboral (Ministerio de Educación Nacional). Se encontró que la oferta de los programas nacionales de Ingeniería Biomédica y Bioingeniería en su conjunto en la ciudad de Bogotá D.C. representa el 30% de la totalidad de la oferta en el país, Antioquia (Medellín) representa el 27%, Valle del Cauca (Cali) el 13% y los demás departamentos representan el 30% restante. Los programas de educación superior en Ingeniería Biomédica muestran una uniformidad en cuanto a la duración y a las competencias a desarrollar con ligeras diferencias en los énfasis y los perfiles de egreso. Actualmente existen al menos 528 Ingenieros Biomédicos y Bioingenieros graduados en el país (0,27% del total de las ingenierías). La tasa de graduados por año, entre 2001 y 2007 es en promedio de 75 Ingenieros Biomédicos y Bioingenieros. Se puede concluir que a pesar de la oferta de programas activos de Ingeniería Biomédica a nivel nacional, la tasa de graduados es baja con relación a: la población colombiana que va en aumento, el incremento de personas con discapacidad y adultos mayores y el número de graduados de otras ingenierías. Se propone la reflexión, sobre el reto que imponen los avances científicos y tecnológicos mundiales que de alguna manera se convierten en directrices de formación.
This academic paper presents the state of Colombia`s undergraduate education in Biomedical Engineering. Programs of the European Union and of the United States were reviewed. In the national level, fifteen programs of different higher education institutions were reviewed under the category of Biomedical Engineering and Bioengineering, based on three information sources: University official Website, Information System on higher education and work observatory of the National Education Ministry. It was found that the total offer of national undergraduate programs in Biomedical Engineering and Bioengineering in Bogota D.C represents the 30% of the total offer in the country, Antioquia (Medellín) represents the 27%, Valle del Cauca (Cali) the 13% and the other departments represent the 30% left. The undergraduate programs in Biomedical Engineering show similar standards regarding length, and professional developing competences with slight differences in the graduation profiles and the emphasis. In the present, there are at least 528 graduated Biomedical Engineering and bioengineers in the country (0,27% of all engineering graduates). The rate of graduates per year, between 2001 and 2007, is close to 75 biomedical Engineers and bioengineers. It can be concluded, that despite the offer of active programs in the national level, the rate of graduates is low in relation to: the Colombian population which is growing, the growth of the number of people with disabilities and elders, and the number of graduates from other engineering fields. A reflection is proposed, regarding the challenges that worldwide scientific and technological advances present, which in some measure become formation directives.
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Educação Profissionalizante/estatística & dados numéricos , Educação Profissionalizante/tendências , Educação/estatística & dados numéricos , Educação/tendências , Engenharia Biomédica/educação , Engenharia Biomédica/estatística & dados numéricos , Engenharia Biomédica/tendências , ColômbiaRESUMO
El objetivo de este trabajo es hacer una caracterización del estado de la ingeniería clínica desde las publicaciones científicas. En primer lugar, se exponen brevemente los factores más significativos que influyen en el cambio y en la evolución de los sistemas sanitarios. Luego, se define el concepto de ingeniería clínica, sus funciones fundamentales y su evolución dentro del desarrollo de los sistemas sanitarios. Finalmente, se expone el estado de la especialidad, dando una mirada desde las publicaciones científicas. Se puede observar una aparente falta de interés en la comunidad de ingenieros por publicar trabajos de investigación científica. Esto se puede constatar por la franca tendencia al decrecimiento del número de citaciones y el número de publicaciones (en volumen o en cantidad) en las principales revistas del gremio científico. Finalmente, se exponen, a criterio del autor, los retos actuales y los futuros desarrollos que tiene que enfrentar la especialidad para poder posicionarse en el mundo de las publicaciones.
The aim of this paper was to characterize clinical engineering from the perspective of scientific publications. First of all, the most significant factors that influence the change in health systems are briefly exposed. Then, clinical engineering is defined and its main functions and evolution within the development of the health system is explained. Finally, the author describes the state of the field from the viewpoint of the scientific publications; an apparent lack of interest in the engineering community to publish scientific research was observed. This behavior can be seen in the clear declining tendency in the number of citations and the number of publications (in volume or quantity) in major scientific journals in the field. Finally, current challenges and future developments must be addressed to accomplish a better positioning of the specialty in the publishing world.
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Engenharia Biomédica , Aplicações da Informática Médica , Publicações Científicas e Técnicas , Vigilância de Produtos ComercializadosRESUMO
With the advancement of medical technology and thus the complexity of the equipment under their care, clinical engineering departments (CEDs) must continue to make use of computerized tools in the management of departmental activities. Authors of this paper designed, installed, and implemented an application service provider (ASP) model at the laboratory level to offer value added management tools in an online format to CEDs. The project, designed to investigate how to help meet demands across multiple healthcare organizations and provide a means of access for organizations that otherwise might not be able to take advantage of the benefits of those tools, has been well received. Ten hospitals have requested the service, and five of those are ready to proceed with the implementation of the ASP. With the proposed centralized system architecture, the model has shown promise in reducing network infrastructure labor and equipment costs, benchmarking of equipment performance indicators, and developing avenues for proper and timely problem reporting. The following is a detailed description of the design process from conception to implementation of the five main software modules and supporting system architecture.
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Sistemas de Gerenciamento de Base de Dados/organização & administração , Administração de Materiais no Hospital/métodos , Design de Software , Integração de Sistemas , Engenharia Biomédica , Sistemas de Informação em Laboratório Clínico/organização & administração , Redes de Comunicação de Computadores , Atenção à Saúde/métodos , Atenção à Saúde/organização & administração , Humanos , Serviço Hospitalar de Engenharia e Manutenção/organização & administração , Administração de Materiais no Hospital/organização & administração , Modelos OrganizacionaisRESUMO
This paper puts forward a fuzzy inference system for evaluating the quality performance of service contract providers. An Application Service Provider was designed and put online, featuring surveys to establish the most useful indicators to evaluate the quality of the service. This model was implemented in 10 separate hospitals. As a result, the service cost-acquisition cost ratio in these cases was reduced from 16.14% to 6.09% in the period 2001-January 2003.