Business Ethics for Mobile Network Operators.

The letter is highlighting a case of Business Ethics for Mobile Network Operators based on the recent news.

A Prospective Pilot Study of the Use of Telemedicine During Pediatric Transport: A High-Quality, Low-Cost Alternative to Conventional Telemedicine Systems.

OBJECTIVE: Few trials address the use of telemedicine during pediatric transport. We believe that video conferencing has equivalent quality, connectivity, and ease of operation, can be done economically, and will improve evaluation. METHODS: Prospective randomized pilot study was used to examine video versus cellular communication between the medical command officer (MCO) and pediatric transport team (TT) for children with moderate to severe illness undergoing interhospital transport. Twenty-five patients were randomized to cellular communication, and 25 patients were randomized to video. The MCO completed a Likert scale to evaluate connection, quality, and ease of operation. Call durations were recorded. A Likert scale to evaluate the communication mode on patient care was completed. RESULTS: Connection and audio quality were equivalent and there were no dropped calls. Average call duration in the phone group was 186 versus 139 seconds in the video group (P = 0.055). The MCO survey results were the following: 100% found video intuitive, 92% felt that disposition based on phone report was difficult, 80% felt that video provided better understanding of patient condition, 70% felt that video assisted disposition, and 80% believe that video should be used for transport. The iPad system offers a significant savings when compared with conventional telemedicine. CONCLUSIONS: Video conferencing seems as easy to complete as phone with equivalent quality and connectivity. Duration of video was equivalent to phone conferencing. Surveyed MCOs believed that video conferencing improved assessment and disposition. The iPad-based conferencing provided significant savings when compared with conventional cart-based or robotic units. Further evaluation of video conferencing during interhospital transport is warranted.

An investigation into the use of 3G mobile communications to provide telehealth services in rural KwaZulu-Natal.

BACKGROUND: We investigated the use of third-generation (3G) mobile communications to provide telehealth services in remote health clinics in rural KwaZulu-Natal, South Africa. MATERIALS AND METHODS: We specified a minimal set of services as our use case that would be representative of typical activity and to provide a baseline for analysis of network performance. Services included database access to manage chronic disease, local support and management of patients (to reduce unnecessary travel to the hospital), emergency care (up to 8 h for an ambulance to arrive), e-mail, access to up-to-date information (Web), and teleclinics. We made site measurements at a representative set of health clinics to determine the type of coverage (general packet radio service [GPRS]/3G), its capabilities to support videoconferencing (H323 and Skype™ [Microsoft, Redmond, WA]) and audio (Skype), and throughput for transmission control protocol (TCP) to gain a measure of application performance. RESULTS: We found that none of the remote health clinics had 3G service. The GPRS service provided typical upload speed of 44 kilobits per second (Kbps) and download speed of 64 Kbps. This was not sufficient to support any form of videoconferencing. We also observed that GPRS had significant round trip time (RTT), in some cases in excess of 750 ms, and this led to slow start-up for TCP applications. CONCLUSIONS: We found audio was always so broken as to be unusable and further observed that many applications such as Web access would fail under conditions of very high RTT. We found some health clinics were so remote that they had no mobile service. 3G, where available, had measured upload speed of 331 Kbps and download speed of 446 Kbps and supported videoconferencing and audio at all sites, but we frequently experienced 3G changing to GPRS. We conclude that mobile communications currently provide insufficient coverage and capability to provide reliable clinical services and would advocate dedicated wireless services where reliable communication is essential and use of store and forward for mobile applications.

Assessment of renewable energy technology and a case of sustainable energy in mobile telecommunication sector.

The rapid growth of the mobile telecommunication sectors of many emerging countries creates a number of problems such as network congestion and poor service delivery for network operators. This results primarily from the lack of a reliable and cost-effective power solution within such regions. This study presents a comprehensive review of the underlying principles of the renewable energy technology (RET) with the objective of ensuring a reliable and cost-effective energy solution for a sustainable development in the emerging world. The grid-connected hybrid renewable energy system incorporating a power conversion and battery storage unit has been proposed based on the availability, dynamism, and technoeconomic viability of energy resources within the region. The proposed system's performance validation applied a simulation model developed in MATLAB, using a practical load data for different locations with varying climatic conditions in Nigeria. Results indicate that, apart from being environmentally friendly, the increase in the overall energy throughput of about 4 kWh/$ of the proposed system would not only improve the quality of mobile services, by making the operations of GSM base stations more reliable and cost effective, but also better the living standards of the host communities.

Rural health care support mechanism. Final rule.

In this document, the Federal Communications Commission reforms its universal service support program for health care, transitioning its existing Internet Access and Rural Health Care Pilot programs into a new, efficient Healthcare Connect Fund. This Fund will expand health care provider access to broadband, especially in rural areas, and encourage the creation of state and regional broadband health care networks. Access to broadband for medical providers saves lives while lowering health care costs and improving patient experiences.

Structure and practices of the video relay service program; telecommunications relay services and speech-to-speech services for individuals with hearing and speech disabilities. Final rule.

In this document, the Commission adopts further measures to improve the structure, efficiency, and quality of the video relay service (VRS) program, reducing the inefficiencies in the program, as well as reducing the risk of waste, fraud, and abuse, and ensuring that the program makes full use of advances in commercially-available technology. These measures involve a fundamental restructuring of the program to support innovation and competition, drive down ratepayer and provider costs, eliminate incentives for waste that have burdened the Telecommunications Relay Services (TRS) Fund in the past, and further protect consumers. The Commission adopts several measures in order to: ensure that VRS users can easily select their provider of choice by promoting the development of interoperability and portability standards; enable consumers to use off-the-shelf devices and deploying a VRS application to work with these devices; create a centralized TRS User Registration Database to ensure VRS user eligibility; encourage competition and innovation in VRS call handling services; spur research and development on VRS services by entering into a Memorandum of Understanding with the National Science Foundation; and pilot a National Outreach Program to educate the general public about relay services. In this document, the Commission also adopts new VRS compensation rates that move these rates toward actual costs over the next four years which will better approximate the actual, reasonable costs of providing VRS, and will reduce the costs of operating the program. The Commission takes these steps to ensure the integrity of the TRS Fund while providing stability and certainty to providers.

Novel optical fiber design for low-cost optical interconnects in consumer applications.

We propose a novel fiber design optimized for short-reach interconnects in consumer applications. A detailed analysis of the optical and mechanical properties of this fiber design is presented. Results are presented demonstrating (i) low bend loss and enhanced mechanical reliability in bends as small as 3 mm diameter; (ii) high power budget margin to enable relaxed mechanical tolerances on transmitter, receiver, and expanded-beam connectors for low-cost connectivity; and (iii) high bandwidth capability and system testing results at 10 Gb/s.

Digital technology use among disadvantaged Australians: implications for equitable consumer participation in digitally-mediated communication and information exchange with health services.

OBJECTIVE: To present research findings on access to, and use of, digital information and communication technologies (ICTs) by Australians from lower income and disadvantaged backgrounds to determine implications for equitable consumer access to digitally-mediated health services and information. METHODS: Focus groups were held in 2008-09 with 80 residents from lower income and disadvantaged backgrounds in South Australia, predominantly of working- and family-formation age (25 to 55 years). Qualitative analysis was conducted on a-priori and emergent themes to describe dominant categories. RESULTS: Access to, and use of, computers, the Internet and mobile phones varied considerably in extent, frequency and quality within and across groups due to differences in abilities, resources and life experience. Barriers and facilitators included English literacy (including for native speakers), technological literacy, education, income, housing situation, social connection, health status, employment status, and trust. Many people gained ICT skills by trial and error or help from friends, and only a few from formal programs, resulting in varied skills. CONCLUSION: The considerable variation in ICT access and use within lower income and disadvantaged groups must be acknowledged and accommodated by health initiatives and services when delivering digitally-mediated consumer-provider interaction, online health information, or online self-management of health conditions. If services require consumers to participate in a digitally-mediated communication exchange, then we suggest they might support skills and technology acquisition, or provide non-ICT alternatives, in order to avoid exacerbating health inequities.

Health care and TEM managing costs of fixed and mobile communications.

Steps to implementing an outsourced telecom or wireless expense management (TEM or WEM) solutions should include: Review of the organization's prior experience with these solutions. Promotion of the approach across the organization. Assignment of an internal owner of the TEM or WEM functions. The decision as to which activities to outsource. Due diligence in sourcing the TEM or WEM solution.

Electronic consultations between primary and specialty care clinicians: early insights.

Electronic consultation (e-consultation) is an emerging tool that primary care clinicians can use to communicate with specialists about patients asynchronously--that is, at different times that are convenient for each physician. To conduct an e-consultation, clinicians use either a Web-based program or a shared electronic medical record. Early adopters of e-consultation describe positive experiences for patients, clinicians, and health systems, including improved continuity of care, access to specialists, convenience, and information transfer. E-consultation presents opportunities to improve health care quality and reduce specialty care costs, but dissemination will be limited unless incentives are created and clinicians are encouraged to use e-consultation through financial reimbursement.

The impact of financial contagion on real economy-An empirical research based on combination of complex network technology and spatial econometrics model.

This study presents financial network indicators that can be applied to inspect the financial contagion on real economy, as well as the spatial spillover and industry aggregation effects. We propose to design both a directed and undirected networks of financial sectors of top 20 countries in GDP based on symbolized transfer entropy and Pearson correlation coefficients. We examine the effect and usefulness of the network indicators by newly using them instead of the original Dow Jones financial sector as explanatory variables to construct the higher-order information spatial econometric models. The results demonstrate that the estimated accuracies obtained from both the two networks are improved significantly compared with the spatial econometric model using the original data. It indicates that the network indictors are more effective to capture the dynamic information of financial systems. And meanwhile, the accuracy based on the directed network is a little higher than the undirected network, which indicates the symbolized transfer entropy, i.e. the directed and weighted network, is more suitable and effective to reflect relationships in the financial field. In addition, the results also show that under the global financial crisis, the co-movement between financial sectors of a country/region and the global financial sector as well as between financial sectors and real economy sectors is increased. However, some sectors in particular Utilities and Healthcare are impacted slightly. This study tries to use the financial network indicators in modeling to study contagion channels on the real economy and the industry aggregation effects and suggest how network indicators can be practically used in financial fields.

How Has COVID-19 Affected the Costs of the Surgical Fellowship Interview Process?

OBJECTIVE: To evaluate the effect of COVID-19 on the costs of the surgical fellowship interview process. DESIGN: A literature review of the historical costs of surgical fellowship interviews and a summary of how the shift to virtual interviews has unintended positive and negative effects on costs for applicants and training programs. RESULTS: Transitioning fellowship interviews to virtual platforms affects expenditures of finances and time. Each fellowship candidate saves close to $6,000 in interview travel expenses. Applicants require less time off from their residency programs during this critical time of need for frontline healthcare workers. However, applicants miss some of the live aspects of interviewing, and training programs invest more effort upfront altering their interviews to virtual formats. CONCLUSIONS: The COVID-19 public health crisis has had a significant impact on surgical education, including how selection is conducted. Virtual recruitment has the potential for cost savings but should continue to be refined. This is an opportune time to innovate and rethink how to recruit prospective surgical residency and fellowship candidates during the current and forthcoming interview seasons.

Automated Deployment of an Internet Protocol Telephony Service on Unmanned Aerial Vehicles Using Network Functions Virtualization.

The Network Function Virtualization (NFV) paradigm is one of the key enabling technologies in the development of the 5th generation of mobile networks. This technology aims to lessen the dependence on hardware in the provision of network functions and services by using virtualization techniques that allow the softwarization of those functionalities over an abstraction layer. In this context, there is increasing interest in exploring the potential of unmanned aerial vehicles (UAVs) to offer a flexible platform capable of enabling cost-effective NFV operations over delimited geographic areas. To demonstrate the practical feasibility of utilizing NFV technologies in UAV platforms, a protocol is presented to set up a functional NFV environment based on open source technologies, in which a set of small UAVs supply the computational resources that support the deployment of moderately complex network services. Then, the protocol details the different steps needed to support the automated deployment of an internet protocol (IP) telephony service over a network of interconnected UAVs, leveraging the capacities of the configured NFV environment. Experimentation results demonstrate the proper operation of the service after its deployment. Although the protocol focuses on a specific type of network service (i.e., IP telephony), the described steps may serve as a general guide to deploy other type of network services. On the other hand, the protocol description considers concrete equipment and software to set up the NFV environment (e.g., specific single board computers and open source software). The utilization of other hardware and software platforms may be feasible, although the specific configuration aspect of the NFV environment and the service deployment may present variations with respect to those described in the protocol.

Telecommunications and health Care: an HIV/AIDS warmline for communication and consultation in Rakai, Uganda.

Hotlines and warmlines have been successfully used in the developed world to provide clinical advice; however, reports on their replicability in resource-limited settings are limited. A warmline was established in Rakai, Uganda, to support an antiretroviral therapy program. Over a 17-month period, a database was kept of who called, why they called, and the result of the call. A program evaluation was also administered to clinical staff. A total of 1303 calls (3.5 calls per weekday) were logged. The warmline was used mostly by field staff and peripherally based peer health workers. Calls addressed important clinical issues, including the need for urgent care, medication side effects, and follow-up needs. Most clinical staff felt that the warmline made their jobs easier and improved the health of patients. An HIV/AIDS warmline leveraged the skills of a limited workforce to provide increased access to HIV/AIDS care, advice, and education.

Creating telehealth networks from existing infrastructures.

Implementing a telehealth program from the technical standpoint can be an engineering and financial challenge due to associated costs such as hardware, software, networking, administration and human expertise. To maximize potential and minimize costs, it makes sense to leverage existing telecommunications infrastructures and tailor the program based on what is available. This is especially critical in developing nations where funding is often limited.

Study says heart failure program too costly. Call center-based programs put into question.

A telephonic DM program for HF patients was not cost-effective but could have saved money if targeted to the right patients.