Tinnitus is a conscious perception of phantom sounds in the absence of external acoustic stimuli, and masking is one of the popular ways to treat it. Due to the variation in the perceived tinnitus sound from patient to patient, the usefulness of masking therapy cannot be generalized. Thus, it is important to first determine the feasibility of masking therapy on a particular patient, by quantifying the tinnitus sound, and then generate an appropriate masking signal. This paper aims to achieve this kind of individual profiling by developing interactive software -Tinnitus Analyzer, based on clinical approach. The developed software has been proposed to be used in place of traditional clinical methods and this software (as a part of the future work) will be implemented in the practical scenario involving real tinnitus patients. / by Bashali Chaudbury. / Thesis (M.S.C.S.)--Florida Atlantic University, 2010. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2010. Mode of access: World Wide Web.

Internet use is considered a lever for empowering patients, levelling inequalities and reducing healthcare expenditure. However, with digital inclusion, health provision quality and health system efficiency high on the UK and EU policy agendas, we need to better understand the relationship between Internet use and health outcomes to assess potential benefits and adverse effects. This research addresses the question of how Internet use influences individuals' health service use and their perceived health in the context of England. Focusing on health information-seeking, it analyses variations across different kinds of users, mechanisms between Internet use and both health outcomes, and the role of individual and contextual factors in this relationship. To answer this question, this research uses a mixed methods approach. Quantitative data from the Oxford Internet Surveys (OxIS), the English census and Hospital Episode Statistics (HES) was connected through spatial microsimulation based on output areas. Qualitative data was collected through semi-structured, face-to-face interviews, primarily with former OxIS participants from output areas in the quantitative strand. The quantitative data was revisited based on emerging interview themes. The results indicate that Internet use influences perceived health and health service use via various mechanisms based on the Internet's content, mediation and connection affordances. However, the boundaries between users and non-users are blurry and outcomes vary for different types of individuals, classified here as learners, pragmatists, sceptics, worriers, delegators and adigitals. Age, education, socioeconomic status, long-term health conditions, and geographic context influence Internet use and health outcomes separately, while the social context shapes their relationship too. These findings advance the theoretical understanding of Internet-based health outcomes, and provide practical implications for health professionals and policymakers with insights down to the local level. Moreover, this research demonstrates how novel insights for public wellbeing can be derived from qualitatively enriched secondary data in privacy-preserving and cost-effective ways.

A Dissertation in fulfillment of the requirements for the Degree of Master of Commerce by Research in Information Systems / Electronic Medical Records (EMR) systems aim to provide an integrated solution to a number of hospital processes, including supporting administrative functions such as patient billing, providing clinical guidelines, and allowing clinicians to order and view lab reports. Yet with all these possible benefits, like many other types of information systems and technologies, their impact on hospital performance has been a key area of interest and a source of debate. This study examines the extent to which EMR systems are available across South African hospitals as well as how well they have been integrated into the processes of the said hospitals. The diffusion of EMR systems means they are available in the relevant clinical units whilst their infusion suggests they are comprehensively embedded into the processes that they are meant to support. The most important question answered in this study was whether the diffusion and infusion of these systems had any impact on the performance of hospitals. Answering this question would aid decision makers on whether more effort is indeed needed to ensure their availability across units and their embedding into hospital processes. The study collected data from a number of hospitals in the private and public sector with multiple informants providing data on diffusion and infusion of these systems as well as on hospital performance. Performance measures included the hospitals’ economic efficiency, their clinical effectiveness, patient safety, and patient satisfaction. Key findings were that while there are performance benefits in the diffusion of EMR systems across units, the impacts are not always positive for some hospitals. Large hospitals were less likely to benefit from the diffusion of these systems. However the comprehensive use of these systems provided benefits for all types of hospitals, suggesting that while availability may be important, it is the comprehensive embedding of the EMR system into the hospital’s processes that is more beneficial to all types of hospitals. These results present further opportunity for research into why the impact of EMR systems is not always positive for some hospitals. / MT2017

Factors such as poverty, ethnicity, socio-economic status, poor infrastructure and governance, etc., are some of the reasons that effective and proven prevention and treatment interventions for most of the major causes of mortality and morbidity in the developing world continue to fail. Chronic diseases require complex interventions that these countries simply cannot maintain. Diabetes mellitus (DM) is a chronic disease that is on the rise worldwide. This disease is a lifestyle disease, which means, that it is brought on by poor health habits. Statistics show that 285 million (6.4%) people aged between 20 and 79 years will be affected by Diabetes in 2010 and a staggering 439 million (7.7%) by 2030. This is a projected growth of 69% in developing countries and 20% in developed countries. The findings from studies conducted from 1993 to 2003 in Sub-Saharan Africa, particularly in South Africa, around the health care services for diabetes highlights many challenges. Sadly, the challenges 10 years after that study, are very similar. The conditions of people with Diabetes can be improved through regular monitoring of patients, improvement and monitoring of health care provided, education on healthy lifestyle, as well as education on the importance of adherence to treatment plans for the successful management of the condition. The diabetes endemic in South Africa is exacerbated by the manual functions that are performed in all aspects of monitoring and management of the disease. With the advancements that have been made in ICT and the many apps that already exist for healthcare, it is sensible to state that ICT can assist in the monitoring and management of diabetes. Another factor that is considered is that of patient-centred care. The huge number of people who need acute care and treatment in hospitals and clinics have forced a previously caring environment, to turn into a cold, almost production line affair. The sick wait in long queues and are ushered in and out of the consulting rooms as fast as possible without even as much as a “hallo”. This has left a void in the healthcare delivery to South Africans which should never have been removed in the first place, namely patient-centred care. This means that the patient is at the centre of the treatment and fully involved in the decisions about his/her health. Every patient deserves to be recognised as a human-being and treated with dignity and respect. Treatment plans for long term chronic care patients such as diabetics, should be thoroughly discussed with the patient and they should believe and comit themselves to the treatment plan. These plans are life-long and require dedication and as it is vital that patients are part of decision making and understand fully what they are expected to do. Bearing this in mind, this study has investigated the needs and care plans for people with diabetes. Specialist in the field of diabetes were interviewed and recognised care plans for diabetes such as those from WHO, IDF and SEMSDA were studied. This study also established, that by practising a patient-centred approach the adherence to a treatment plan is likely to be higher. The strategy developed involves the person with diabetes, the healthcare worker and the support structure in the care plan of the diabetic. The use of ICT as part of the solution must consider the patient-centred requirements for using IT so that the people using the strategy are comfortable and not intimidated by the technology. The need to incorporate e-health into governments’ healthcare plans has been growing over the last decade. The GSMA conducted research into mobile health opportunities in South Africa and found that SA now has a penetration of 98% and that this is the ideal medium to address the inaccessibility and inequality of healthcare in SA. The causes identified as playing a major role in the rise in diabetes were identified and it was determined that through the implementation of an ICT strategy for diabetes care, many of these can be addressed. These include the use of technology for, improved monitoring and management, increased diabetes awareness and education, and promotion of healthy lifestyle. The study focuses on the self-management aspect of diabetes and produces a strategy that incorporates various ICT solutions that would assist in the daily aspects of diabetes care, as well as follow a patient-centred approach to diabetes care. This strategy developed in this study does not need any intervention from government as it is driven by the people who have diabetes and their healthcare workers, with the aid of the technology that they currently have on hand.

Information and communication technologies hope to revolutionize the healthcare industry with innovative and affordable solutions with a focus on pervasive care. Wearable sensors products can provide monitoring in a natural environment with a constant stream of information, enriching healthcare practices and enabling better pervasive care. Wearable sensor technologies could monitor patients' mobility, gait, tremor, daily activity and other health indicators in real time that could allow for simple, non-invasive, tracking of spine care that may lead to increased patient engagement, integration, feedback, post-surgery analysis, monitoring of patient's condition, patient's data extraction and analysis and possibly aiding in better diagnosis, intervention, adherence to treatment for the betterment of quality of care. This research focuses on the assessment of technology adoption potential of medical devices particular to tracking the mobility of patients of neurosurgery and orthopedics. Wearable medical devices that track the mobility of patients after spinal procedures could help surgeons in providing post-operative care, analysis of treatment outcomes and patient mobility. The assessment of those devices by physicians is a complex process associated with various perspectives and criteria. Therefore, the objective of this research is to assess the potential for technology adoption of those wearable medical devices through development of a hierarchical decision-making model (HDM) that incorporates the relevant perspectives and criteria encompassing the needs of hospital neurological surgery and orthopedics departments. The proposed research builds on an existing body of knowledge researched through literature review and background of the field and expands the health technology assessment field by implementation of a holistic, comprehensive and multi-perspective approach to technology assessment in wearable sensor products adoption for pervasive care in neurosurgery and orthopedics. The Hierarchical Decision Model (HDM) approach is used to break the problem down into hierarchical levels and then calculate the alternatives using pairwise comparison scales and a judgment quantification technique. Inconsistencies, disagreement, sensitivity and scenario analysis are performed as well. HDM research software is created with Ruby and R to facilitate the computation of some of these important model parameters to higher precision than is available in current statistical analysis software packages or extensions targeted for decision making. Patient perspective dominates as the main perspective for the technology adoption potential of wearable devices for pervasive care in neurosurgery and orthopedics, followed by technical and financial perspectives. Valedo, a wearable device aimed to relieve back pain through exercises, motivation and mobility tracking, received the highest ranking for adoption potential, while other devices also received high relative scores. The framework could serve as a supplementary technology assessment tool and could be tested in other settings: private, small clinic etc. with the experts and special needs of physicians in particular healthcare departments.

The advances in communication technologies have resulted in a significant shift in the workplace culture. Mobile computing devices are increasingly becoming an integral part of workplace culture. Mobility has several advantages to the organisation, one such example is the “always online” workforce resulting in increased productivity hours. As a result, organisations are increasingly providing mobile computing devices to the workforce to enable remote productivity at the organisations cost. A challenge associated with mobility is that these devices are likely to connect to a variety of networks, some which may insecure, and because of their smaller form factor and perceived value, are vulnerable to loss and theft amongst other information security challenges. Increased mobility has far reaching benefits for remote and rural communities, particularly in the healthcare domain where health workers are able to provide services to previously inaccessible populations. The adverse economic and infrastructure environment means institution provided devices make up the bulk of the mobile computing devices, and taking away the ownership, the usage patterns and the susceptibility of information to adversity are similar. It is for this reason that this study focuses on information security on institution provided devices in a rural healthcare setting. This study falls into the design science paradigm and is guided by the principles of design science proposed by Hevner et al. The research process incorporates literature reviews focusing on health information systems security and identifying theoretical constructs that support the low-resource based secure deployment of health information technologies. Thereafter, the artifact is developed and evaluated through an implementation case study and expert reviews. The outcomes from the feedback are integrated into the framework.

The potential for private sector healthcare business in Africa has been forecasted to reach $35 billion by 2016, with South Africa being regarded as the most industrially advanced country on the continent. South Africa’s entry to modern biotechnology is fairly recent, though, with companies in the private sector still in a developmental phase, and most having limited bioproduct ranges. While considerable research has been conducted in the past to attempt to define the biotechnology environment of South Africa, as yet, a concise overview is lacking. In particular, a synopsis of the biomedical or commercial health technology environment has not been forthcoming for entrepreneurs to refer to as a ‘roadmap’. The purpose of this study was to perform a comprehensive study on the attributes that should be met for a successful, sustainable health technology venture (HTV) to be started in South Africa; while identifying the opportunities and threats that have existed in the South African market; thereby, affecting their success and sustainability to date. In this study, two phases of research were conducted. The first was a small-sampled mixed-methods (both qualitative and quantitative) study involving 21 medical devices, biogenerics, diagnostics, and contract services companies. The second was a quantitative study, involving 107 vaccines, biogenerics, therapeutics, nutraceuticals, reagents, diagnostics, medical devices, biotools, contract services and public services companies. Inferential statistical tests were conducted on the data, including Pearson’s Chi-Square, ANOVA, bivariate correlation, linear regression, logistic regression and multinomial logistic regression. From the study, the overall proportion of business sustainability for HTVs was found to be 66.7%, and at least 30% were unsustainable (or not yet at a level of sustainability). Variations were observed in the overall rate of sustainability for companies, based on their core functional classification, location, production type, size and start-up or R&D spending. By converting the observed frequencies of activity level, as an indication of sustainability, into a probability, it was possible to observe the company type that was most, and least likely to succeed in South Africa. Based on the statistical observations in this study, the HTV type most likely to succeed in South Africa, with a 63.7% probability of reaching sustainability, is a ‘vaccines’, ‘biotools’ or ‘public services’ company from Johannesburg with at least 20 employees; that has developed its goods or services internally, but manufactured externally and spent between R20 million–and–R30 million on its R&D or start-up. Conversely, least likely to succeed (3.2% probability) is a nutraceutical company from Cape Town with between six and 20 employees, that has developed and produced internally, and which has spent between R1 million–and–R10million on its start-up. / Life and Consumer Sciences / M.Sc (Life Sciences)

Three decades of mobile phone diffusion, thousands of mobile-phone-based health projects worldwide ("mHealth"), and tens of thousands of health applications in Apple's iTunes store, but fundamental questions about the effect of phone diffusion on people's healthcare behaviour remain unanswered. Empirical, theoretical, and methodological gaps in the study of mobile phones and health reinforce each other and lead to simplifying assumptions that mobile phones are a ubiquitous and neutral platform for interventions to improve health and healthcare. This contradicts what we know from the technology adoption literature. This thesis explores the theoretical link between mobile phone diffusion and healthcare access; develops and tests a new multidimensional indicator of mobile phone adoption; and analyses the effects of phone use on people's healthcare-seeking behaviour. My mixed methods research design - implemented in rural Rajasthan (India) and Gansu (China) - involves qualitative research with 231 participants and primary survey data from 800 persons. My research yields a qualitatively grounded framework that describes the accessibility and suitability of mobile phones in healthcare-seeking processes, the heterogeneous outcomes of phone use and non-use on healthcare access, and the uneven equity consequences in this process. Quantitative analysis based on the framework finds that mobile phone use in rural India and China increases access to healthcare, but it also invites more complex and delayed health behaviours and the over-use of scarce healthcare resources. Moreover, increasing phone-aided health action threatens to marginalise socio-economically disadvantaged groups further. I present here the first quantitative evidence on how mobile phone adoption influences healthcare-seeking behaviour. This challenges the common view that mHealth interventions operate on a neutral platform and draws attention to potential targeting, user acceptance, and sustainability problems. The framework and tools developed in this thesis can support policy considerations for health systems to evaluate and address the healthcare implications of mobile phone diffusion.

The potential for private sector healthcare business in Africa has been forecasted to reach $35 billion by 2016, with South Africa being regarded as the most industrially advanced country on the continent. South Africa’s entry to modern biotechnology is fairly recent, though, with companies in the private sector still in a developmental phase, and most having limited bioproduct ranges. While considerable research has been conducted in the past to attempt to define the biotechnology environment of South Africa, as yet, a concise overview is lacking. In particular, a synopsis of the biomedical or commercial health technology environment has not been forthcoming for entrepreneurs to refer to as a ‘roadmap’. The purpose of this study was to perform a comprehensive study on the attributes that should be met for a successful, sustainable health technology venture (HTV) to be started in South Africa; while identifying the opportunities and threats that have existed in the South African market; thereby, affecting their success and sustainability to date. In this study, two phases of research were conducted. The first was a small-sampled mixed-methods (both qualitative and quantitative) study involving 21 medical devices, biogenerics, diagnostics, and contract services companies. The second was a quantitative study, involving 107 vaccines, biogenerics, therapeutics, nutraceuticals, reagents, diagnostics, medical devices, biotools, contract services and public services companies. Inferential statistical tests were conducted on the data, including Pearson’s Chi-Square, ANOVA, bivariate correlation, linear regression, logistic regression and multinomial logistic regression. From the study, the overall proportion of business sustainability for HTVs was found to be 66.7%, and at least 30% were unsustainable (or not yet at a level of sustainability). Variations were observed in the overall rate of sustainability for companies, based on their core functional classification, location, production type, size and start-up or R&D spending. By converting the observed frequencies of activity level, as an indication of sustainability, into a probability, it was possible to observe the company type that was most, and least likely to succeed in South Africa. Based on the statistical observations in this study, the HTV type most likely to succeed in South Africa, with a 63.7% probability of reaching sustainability, is a ‘vaccines’, ‘biotools’ or ‘public services’ company from Johannesburg with at least 20 employees; that has developed its goods or services internally, but manufactured externally and spent between R20 million–and–R30 million on its R&D or start-up. Conversely, least likely to succeed (3.2% probability) is a nutraceutical company from Cape Town with between six and 20 employees, that has developed and produced internally, and which has spent between R1 million–and–R10million on its start-up. / Life and Consumer Sciences / M. Sc. (Life Sciences)

Modern implantable and body worn medical devices leverage wireless telemetry to improve patient experience and expand therapeutic options. Wireless medical devices are subject to a unique set of regulations in which monitoring of the available frequency spectrum is a requirement. To this end, implants use software protocols to assess the in-band activity to determine which channel should be used. These software protocols take valuable processing time and possibly degrade the operational lifetime of the battery. Implantable medical devices often take advantage of a single chip transceiver as the physical layer for wireless communications. Embedding the channel assessment task in the transceiver hardware would free the limited resources of the microprocessor. This thesis proposes hardware modifications to existing transceiver architectures which would provide an automated channel assessment means for implantable medical devices. The results are applicable beyond medical device applications and could be employed to benefit any low-power, wireless, battery-operated equipment.