ANALISIS PERAN AKTOR DALAM IMPLEMENTASI KEBIJAKAN PEMBERIAN INSENTIF BAGI TENAGA KESEHATAN DAERAH YANG MENANGANI COVID-19

Background: In the policy of incentives for health workers in the regions that handle COVID-19 (Innakesda) is part of the health budget for handling COVID-19 which must be budgeted by the local government sourced from Refocusing funds of 8% DAU/DBH in 2021. There is differences in the results of the implementation of the Innakesda policy carried out by the Regional Government where there are local governments that have succeeded in implementing this policy and there are also local governments that have not succeeded in doing so Purpose: The success in thisimplementation can be seen from the availability of budgets in the regions and the realization of incentive budgets for health workers in these areas.Therefore, it is interesting to know the factors that influence a region's success in implementing this policy from the actor dimension in regional financial management. Method: This research was conducted using a qualitative approach using in-depth interviews with several key informants and a literature review. Walt and Gilson's policy triangle is used in analyzing policies. The analysis was conducted to see the successful implementation of the Innakesda policy from the actor dimension in regional financial management. The location of the research was carried out in one of the areas that have successfully implemented the Innakesda policy, namely the City of South Tangerang. Conclusion: The conclusion of the research illustrates that the involvement of actors at both the Central Government and Regional Government levels of South Tangerang City with their respective authorities and roles issues policies that are mutually synergistic and responsive to efforts to encourage the successful implementation of Innakesda policies, in the regional financial management process there is the Political will of the Mayor of Tangerang South in the form of alignments to prioritize the successful implementation of Innakesda in the 2021 APBD policy. (English) [ FROM AUTHOR] Latar Belakang : Dalam kebijakan insentif bagi tenaga kesehatan di daerah yang menangani COVID-19 (Innakesda) merupakan bagian dari anggaran kesehatan untuk penanganan COVID-19 yang harus dianggarkan oleh pemerintah daerah yang bersumber dari dana Refocusing 8% DAU/DBH pada Tahun 2021. Terdapat perbedaan hasil implementasi dari kebijakan Innakesda yang dilakukan oleh Pemerinah Daerah dimana terdapat pemerintah daerah yang berhasil melakukan implementasi kebijakan ini dan ada pula pemerintah daerah yang tidak berhasil melakukannya Tujuan : Keberhasilan dalam implementasi ini dilihat dari adanya ketersediaan anggaran di daerah serta terlaksananya realisasi anggaran insentif bagi tenaga kesehatan di daerah tersebut. Oleh karena itu, menjadi hal yang menarik untuk mengetahui faktorfaktor yang mempengaruhi suatu daerah berhasil mengimplentasikan kebijakan ini dari dimensi aktor dalam pengelolaan keuangan daerah. Metode : Penelitian ini dilakukan dengan pendekatan kualitatif menggunakan metode wawancara mendalam dengan beberapa informan kunci serta kajian literatur. Segitiga kebijakan Walt dan Gilson digunakan dalam menganalisis kebijakan Analisis dilakukan untuk melihat keberhasilan implementasi kebijakan Innakesda dari dimensi aktor dalam pengelolaan keuangan daerah. Lokasi penelitian dilakukan pada salah satu daerah yang berhasil melaksanakan implementasi kebijakan Innakesda yaitu Kota Tangerang Selatan. Kesimpulan: Kesimpulan penelitian memberikan gambaran bahwa Keterlibatan aktor baik di level Pemerintah Pusat dan Pemerintah Daerah Kota Tangerang Selatan dengan masing-masing kewenangan serta perannya mengeluarkan kebijakan yang saling sinergi dan responsif terhadap upaya mendorong keberhasilan implementasi kebijakan Innakesda, dalam proses pengelolaan keuangan daerah terdapat Political will Walikota Tangerang Selatan berupa keberpihakan untuk memprioritaskan keberhasilan implementasi Innakesda dalam kebijakan APBD tahun 2021. (Indonesian) [ FROM AUTHOR] Copyright of Jurnal Sosial dan Sains (SOSAINS) is the property of Green Publisher and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Creating a new sovereign debt reconstruction mechanism: why incentives, risk sharing, and CACs will all matter

This paper argues that the Covid recession, and aggressive monetary tightening in the US accompanying the post-Covid recovery, are likely to cause a sovereign debt overhang in emerging market economies—i.e. debt which is unlikely to be fully repaid. A sovereign debt reconstruction mechanism (SDRM) seems necessary to avoid widespread disorderly debt write-downs. We discuss a range of procedures that are available, building upon Anne Krueger's proposal for an SDRM in 2002 (Krueger, 2002a,b). At that time Krugman (1988) had already argued that any SDRM should incentivize debtors so that they put in effort to clear their debts (a Krugman contract). Menzies (2004) went further than this to show that these effects should be further sharpened, creating what he called ‘hyper-incentive effects' (a Menzies contract). The International Monetary Fund has argued that risk-sharing between debtors and creditors will also be important (IMF, 2020). But we show that risk-sharing will—in general—pull in the opposite direction to incentive effects, and we doubt the extent to which the IMF has recognized this trade-off. Finally, we argue that collective action clauses (CACs) increase the probability of achieving any agreement, whatever it might be. They will help avoid the alternative of disorderly debt write-downs, outcomes which will deliver neither incentive effects nor risk-sharing. © The Author(s) 2023. Published by Oxford University Press.

Neurocognitive Outcomes in Congenital Heart Defects Ethics, Evidence, and Vaccination in Pregnancy: Lessons from COVID-19

Among the longstanding problems made vivid by the COVID-19 pandemic are challenges in gathering data to inform the use of vaccines in pregnancy. Although it was known early on that pregnant persons and their offspring faced greater risks of morbidity and mortality from COVID-19 infection, they were excluded from all trials that led to authorization of vaccines. And while reassuring evidence has since been gathered, delays, as well as mixed public health messaging, have led to low uptake of vaccines among pregnant populations, as well as disproportionate burdens for pregnant persons. Dr. Lyerly will consider key ethical issues foregrounded by the COVID-19 response in pregnancy, including the distortions of risk, misaligned incentives, and regulatory challenges. Drawing on results of the NIH-funded PHASES Project, she will describe key conceptual shifts and ethical frameworks that have recently been advanced to better serve the interests of pregnant persons and their offspring facing illness in pandemic and other contexts, as well as specific recommendations for responsible and timely research with this population.

Did A Fruit and Vegetable Incentive Program Support low-income Households in North Carolina during the COVID-19 Pandemic? A Mixed Methods Assessment of the Healthy Helping Program and Other Pandemic-Related Food Assistance

In 2020, the Healthy Helping Fruit and Vegetable Program provided SNAP-eligible beneficiaries with $40/month, for up to 3 months, to purchase fruits and vegetablesata chainsupermarket inNorthCarolina.A survey to describeparticipants' experiences with the program and interviews to explore whether these experiences were shaped byparticipating inotherpandemic-related food access programs were conducted.In conjunction with other food access programs,programs that allow participants freedom to choose what they purchase mayalleviate household hardships and provide greater access tonutrient-dense foods during the COVID-19 pandemic and beyond..Copyright © 2022 Taylor & Francis Group, LLC.

The impact of digital supply chain capabilities on enterprise sustainable competitive performance: an ambidextrous view

PurposeThe construction of digital supply chains to integrate internal and external resources is becoming an important path for manufacturing enterprises to gain competitiveness. However, at present, research on the internal mechanisms of digital supply chain capabilities (DSCC) and enterprise sustainable competitive performance (ESCP) has not been sufficiently studied. Based on contextual ambidexterity theory, this study investigates whether DSCC could enable the realization of supply chain ambidexterity and further explains the mediating role of supply chain ambidexterity on DSCC and ESCP, and the boundary conditions of supply chain governance on supply chain ambidexterity and ESCP.Design/methodology/approachWith a survey data set of 232 Chinese manufacturing enterprises from different industries, the study empirically tests a moderated mediating model and conducts hierarchical linear modeling and bootstrap to test the study's hypotheses.FindingsThe results demonstrate that: (1) DSCC positively enhance ESCP;(2) supply chain ambidexterity, which can be regarded as a synergic ability of supply chain alignment and adaptability, partially mediates the positive relationship between DSCC and ESCP;and (3) supply chain governance such as incentive governance positively moderates the association between supply chain ambidexterity and ESCP, but there is no evidence that relational governance moderates their relationship.Originality/valueThis paper proposes a new interpretive perspective to understand digital supply chains. More importantly, it reveals the importance of DSCC in contributing toward supply chain ambidexterity and ESCP, and demonstrates the differential regulating action of incentive and relational governance on the association between supply chain ambidexterity and ESCP, with implications for both academics and practitioners.

The Three Dimensions of the Indian Wage Code (2019): Shifting Economic, Socio-political and Legal Values?

The value of work is intrinsically linked to its monetary equival ent expressed in wages. Changes in wage laws therefore impact a wide-ranging frontier of tensions inherent in the politics around remuneration, at the individual, the firm and the state level. In othe r words, wages do not form a single line of conflict, but in fact matters of payment unfold multiple struggles in the spheres of institutions, at the shop-floor and within the household. From thi s three-fold perspective, the paper analyses unravelling tensions in the economic, legal and sociopolitical constitution of wages in the Indian Wage Code of 2019. This evaluation shows the importance of strengthening need-based approaches to wages such as minimum wage pol i ci e s, not just to facilitate decent working standards, but also to guarantee adequate social safety nets, particularly in times of crisis such as the COVID-19 pandemic.

A virtual pilot optimization trial for African American/Black and Latino persons with non-suppressed HIV viral load grounded in motivational interviewing and behavioral economics.

Introduction: Virtual and low-touch behavioral interventions are needed for African American/Black and Latino persons living with HIV (PLWH) with barriers to HIV viral suppression, particularly during COVID-19. Guided by the multiphase optimization strategy, we explored three components for PLWH without viral suppression, grounded in motivational interviewing and behavioral economics: (1) motivational interviewing counseling, (2) 21-weeks of automated text messages and quiz questions about HIV management, and (3) financial rewards for viral suppression (lottery prize vs. fixed compensation). Methods: This pilot optimization trial used sequential explanatory mixed methods to explore the components' feasibility, acceptability, and preliminary evidence of effects using an efficient factorial design. The primary outcome was viral suppression. Participants engaged in baseline and two structured follow-up assessments over an 8-month period, and provided laboratory reports to document HIV viral load. A subset engaged in qualitative interviews. We carried out descriptive quantitative analyses. Then, qualitative data were analyzed using directed content analysis. Data integration used the joint display method. Results: Participants (N = 80) were 49 years old, on average (SD = 9), and 75% were assigned male sex at birth. Most (79%) were African American/Black, and the remainder were Latino. Participants were diagnosed with HIV 20 years previously on average (SD = 9). Overall, components were feasible (>80% attended) and acceptability was satisfactory. A total of 39% (26/66) who provided laboratory reports at follow-up evidenced viral suppression. Findings suggested no components were entirely unsuccessful. The lottery prize compared to fixed compensation was the most promising component level. In qualitative analyses, all components were seen as beneficial to individual wellbeing. The lottery prize appeared more interesting and engaging than fixed compensation. However, structural barriers including financial hardship interfered with abilities to reach viral suppression. The integrated analyses yielded areas of convergence and discrepancy and qualitative findings added depth and context to the quantitative results. Conclusions: The virtual and/or low-touch behavioral intervention components tested are acceptable and feasible and show enough potential to warrant refinement and testing in future research, particularly the lottery prize. Results must be interpreted in the context of the COVID-19 pandemic. Trial registration: NCT04518241 (https://clinicaltrials.gov/ct2/show/NCT04518241).

Using implementation science to support the adoption of routine HIV testing in a suburban emergency department

Background: Implementation science (IS) involves using techniques to promote implementation of evidence-based guidance to improve healthcare quality and outcomes. Sutton has an HIV prevalence rate of 2.5/1000 and a high late diagnosis rate. Testing in emergency departments (ED) has been shown to be effective and has been adopted in many UK metropolitan centres. Routine testing in EDs of high prevalence areas is recommended by NICE. Method(s): Our project started in November 2019 and was designed to promote uptake of opt-out HIV testing into routine practice through education, training, and incentives. Strategies employed outlined in table 1. We assessed acceptability and adoption of the guidance. Result(s): HIV testing increased from average 7.5 tests/ month to 592 tests/month (17,165 tests in 28 months). Three previously undiagnosed people and 1 individual with a known diagnosis who had disengaged were identified. Testing numbers ranged from 191-1229/month. Numbers dropped during the following challenging periods: 1. Tendering of the sexual health service 2. IT and sample processing issues on implementation 3. Emergence of SARS CoV-2 4. Blood bottle shortage in 2021 Conclusion(s): This project demonstrated that while implementation of routine opt out HIV testing in ED is feasible and acceptable, it took a long time for the practice to be embedded and it was easily de-railed by external circumstances. Acknowledgements- This project was conducted with support from an Implementation Science grant by ViiV. (Table Presented).

Equitable Access

The COVID-19 epidemic has once again highlighted the challenges to achieve equitable access to critical antimicrobials and vaccines. The problem is particularly acute for antimicrobials. Despite recent investments improving the pipeline for new treatments, most new treatments are not available to populations most in need, especially in low- and middle-income countries. Once a drug is approved a range of factors may hinder access, from lack incentives to register and commercialize products due to unattractive market potential to unfunded national action plans that can help improve the uptake and appropriate use of new tools to combat antibiotic resistance. Previous studies have shown that the majority of the 18 new antibacterials approved and launched between 2010-2020 were accessible in only 3 out of 14 high-income countries (Sweden, UK, and US). In low- and middle-income countries, the problem is even worse, with only 10 of the 25 new antibiotics that entered the market between 1999 and 2014 registered in more than ten countries. While lack of equitable access to life-saving medicines, diagnostics, and vaccines is not a new problem for infectious diseases, emerging opportunities and innovative approaches can help improve access globally. This talk will review promising recent developments in governance and collaborations, policies, economic models and initiatives that may help correct deadly inequities. For example, the objectives of the Access to COVID-19 Tools Accelerator may serve as model that convenes diverse actors to mount a coordinated access response which may be applied to access to other antimicrobials and vaccines. In addition, novel licensing agreements for access and stewardship to cefiderocol, an antimicrobial that is on the WHO Essential Medicines List can help serve as a pathfinder to accelerate equitable access to novel antimicrobials. The talk will also surface critiques of ongoing initiatives and raise questions for further study and discussion.Copyright © 2023

The effectiveness of incentive spirometry exercise on pulmonary function in COVID-19 survivors: a randomized controlled trial study

Background: COVID-19 survivors often result in persistent symptoms, even months after being discharged, that lead to decreased lung function. Incentive spirometry is commonly used in pulmonary rehabilitation as it encourages the patient to take slow and deep inspiration through visual feedback. This study aimed to analyze the effects of incentive spirometry exercise on pulmonary function in COVID-19 survivors. Method: Twenty COVID-19 survivors aged 18-59 were enrolled in the study and divided randomly into two groups;ten survivors in the experimental group that received incentive spirometry exercise and ten survivors in the control group that received diaphragmatic breathing exercise. Both exercises were performed five times daily, with ten repetitions each for four weeks. Peak expiratory flow (PEF) was measured by a peak flow meter before and after the treatment in both groups. The data were analyzed statistically. Result: There was a significant increase in pulmonary function in the experimental group (p=0.001) and control group (p=0.001). However, the two groups had no significant difference in pulmonary function (p=0.198). The incentive spirometry exercise shows a more significant effect on pulmonary function rather than diaphragmatic breathing. Conclusion: Incentive spirometry exercise could be an alternative therapy to improve the pulmonary function of COVID-19 survivors. © 2023, Sanglah General Hospital. All rights reserved.

The effect of exercise using incentive spirometry on heart rate variability in patients after COVID-19 infection

Background: COVID-19 infection causes various sequelae and complications after recovery. Changes in heart rate variability (HRV) were found in patients with COVID-19 infection, suggesting a disturbance in the autonomic system. Breathing exercises with diaphragmatic breathing and incentive spirometry have been shown to increase HRV by increasing lung capacity, respiratory muscle strength, and pulmonary O2 pressure, which can affect baroreflex signals. Incentive spirometry is one of the easy-to-use, safe, inexpensive pulmonary rehabilitation exercises that can be done at home without supervision and are accompanied by a visual display as a guide to the patient. The purpose of the study was to determine the effect of giving breathing exercises using Incentive Spirometry for four weeks on Heart Rate Variability in patients post COVID-19 infection. Method: This research is an experimental study with a pre-post-test control group design. The treatment group was given breathing exercises using Incentive Spirometry, while the control group used diaphragmatic breathing five times a day, seven times per week, for four weeks in each group. HRV measurement was performed before and after four weeks of intervention, using the parameter Root Mean Square of Successive Differences between normal heartbeats (RMSSD), Standard Deviation of N-N intervals (SDNN), and LF/HF ratio of Heart Rate Variability (HRV). Result: There subject of this study was 20 post-COVID-19 patients divided into a treatment group (n=10) and a control group (n=10). There was no significant increase in RMSSD, SDNN, and LF/HF ratio pre and post-intervention in both groups, suggesting no significant increase in HRV. Conclusion: Exercise with Incentive Spirometry and Diaphragmatic Breathing for four weeks did not increase the Heart Rate Variability value in post-COVID-19 patients. © 2023, Sanglah General Hospital. All rights reserved.

Inverted South Trilogy: creation of theatrical texts based on perspectives of the south region of Rio Grande do Sul

This article discusses the starting point for the creation of the theatrical texts for the Inverted South Trilogy: southern Rio Grande do Sul, a Brazilian state. By observing the three plays and their respective genesis, it is possible to see how this region is used as the background of the works comprising the trilogy. The collection, written by Ingrid Duarte, Mario Celso, and Thalles Echeverry, professors graduated from the Universidade Federal de Pelotas, was launched during the COVID-19 pandemic with resources granted according to Federal Law n.degrees 14017 (Aldir Blanc Law). This trilogy highlights a change in perspective which goes beyond the capital of the state to address cities located outside the metropolitan areas, and demonstrates the importance of creating spaces for training and incentive to writing of plays, particularly to new authors.

The effectiveness of financial incentives for COVID-19 vaccination: A systematic review.

Financial incentives are a controversial strategy for increasing vaccination. In this systematic review, we evaluated: 1) the effects of incentives on COVID-19 vaccinations; 2) whether effects differed based on study outcome, study design, incentive type and timing, or sample sociodemographic characteristics; and 3) the cost of incentives per additional vaccine administered. We searched PubMed, EMBASE, Scopus, and Econlit up to March 2022 for terms related to COVID, vaccines, and financial incentives, and identified 38 peer-reviewed, quantitative studies. Independent raters extracted study data and evaluated study quality. Studies examined the impact of financial incentives on COVID-19 vaccine uptake (k = 18), related psychological outcomes (e.g., vaccine intentions, k = 19), or both types of outcomes. For studies of vaccine uptake, none found that financial incentives had a negative effect on uptake, and most rigorous studies found that incentives had a positive effect on uptake. By contrast, studies of vaccine intentions were inconclusive. While three studies concluded that incentives may negatively impact vaccine intentions for some individuals, they had methodological limitations. Study outcomes (uptake versus intentions) and study design (experimental versus observational frameworks) appeared to influence results more than incentive type or timing. Additionally, income and political affiliation may moderate responses to incentives. Most studies evaluating cost per additional vaccine administered found that they ranged from $49-75. Overall, fears about financial incentives decreasing COVID-19 vaccine uptake are not supported by the evidence. Financial incentives likely increase COVID-19 vaccine uptake. While these increases appear to be small, they may be meaningful across populations. Registration: PROSPERO, CRD42022316086 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022316086).

Preschool education optimization based on mobile edge computing under COVID‐19

The COVID‐19 pandemic has brought profound changes in people's live and work. It has also accelerated the development of education from traditional model to online model, which is particularly important in preschool education. Preschoolers communicate with teachers through online video, so how to provide high quality and low latency online teaching has become a new challenge. In cloud computing, users offload computing tasks to the cloud to meet the high computing demands of their devices, but cloud‐based solutions have led to huge bandwidth usage and unpredictable latency. In order to solve this problem, mobile edge computing (MEC) deploys the server at the edge of the network to provide the service with close range and low latency. In task scheduling, edge computing (EC) devices have rational thinking, and they are unwilling to collaborate with MEC server to perform tasks due to their selfishness. Therefore, it is necessary to design an effective incentive mechanism to encourage the collaboration of EC devices. Through analysis of MEC server and EC devices, we propose a distributed task scheduling algorithm—Stackelberg game approach based on alternating direction method of multipliers, which selects the appropriate incentive mechanism to encourage the collaboration of EC devices. The experimental results demonstrate that the proposed approach can rapidly converge to a certain accuracy within 40 iterations, and in incentive mechanism comparison and quality of experience, the proposed approach also has a good performance in anti‐jitter and low latency. [ FROM AUTHOR] Copyright of Expert Systems is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Crowdsourced product returns in C2B e-commerce: a post-pandemic no-contact consumer incentive-based model

PurposeThis study aims to investigate the conditions for the financial feasibility of an incentive-based model for self-drop or crowdsourced drop of the product to be returned at designated drop boxes (thereby ensuring a contactless process).Design/methodology/approachConstraint-based non-linear mathematical modeling was done for cost differential with and without crowdsourcing. This was analyzed against returns on investment for the installed infrastructure. Scenarios were looked into from the linear, iso-elastic and logarithmic demand functions to identify the optimal incentive policy. The results were further evaluated using "willingness to return” for customer willingness for product returns via drop boxes.FindingsCrowdsourcing is viable when product returns are no more than 15%–20% of the overall products, with a logistics cost differential of 15%–25%. These were only viable when the product return incentive was within the range of 15%–20% of the product cost, as well as the penalty was in the range of 25 to 40% for wrong returns.Research limitations/implicationsThe findings are expected to aid the organizations in successfully designing product return policies while adhering to the post-COVID-19 norms, including contactless transactions and social distancing.Originality/valueThe study provides a look into the viability sensitivity of effective gains/profitability against the required level of service for returns, wrong returns, penalties and incentives for crowdsourcing in a developing country like India.

Optimal design for redistributions among endogenous buyers and sellers

Given a large market of individuals entitled to equal shares of a limited resource, each allowed to buy or sell the shares, we characterize the interim incentive-constrained Pareto frontier subject to market clearance and budget balance. At most two prices—partitioning the type space into at most three tiers and using rations only on the middle tier—are needed to attain any interim Pareto optimum. When the virtual surplus function satisfies a single crossing condition without having to be monotone, the optimal mechanism reduces to a single, posted price and requires neither rationing nor lump sum transfers. We find which types gain, and which types lose, when the social planner chooses a rationing mechanism over the single-price solution, as well as the welfare weight of which type is crucial to the choice. The finding suggests a market-like mechanism to distribute Covid vaccines optimally within the same priority group.

Community Mobilization and Community Incentivization (CoMIC) Strategy for Child Health in a Rural Setting of Pakistan: Study Protocol for a Randomized Controlled Trial.

Despite the decline in under-five mortality by over 60% in the last three decades, majority of child mortality is still attributable to communicable and infectious diseases that are not only preventable, but they are also treatable. We evaluated the potential impact of a participatory community engagement and innovative community incentivization (C3I) strategy for improving the coverage of child health interventions in a rural setting in Pakistan. We first undertook formative research to assess community knowledge and the likelihood of collective community strategy and conditional incentives for improving existing preventive and care-seeking practices for childhood diarrhea and pneumonia. We developed options for community incentivization and improving group practices, taking local norms and customs into account in the design of the community mobilization strategies and messages. These interventions were then formally evaluated prospectively in a three-arm cluster randomized controlled trial. Clusters were randomly assigned by a computer algorithm using restricted randomization by an external statistician (1:1:1) into three groups: community mobilization and incentivization (CMI); community mobilization only using an enhanced communication package (CM); and control group. The C3I was an innovative strategy as it involved serial incremental targets of collective improvement in community behavior related to improvement in the coverage of a composite indicator of fully immunized children (FIC), oral rehydration salt (ORS), and the sanitation index (SI). The evaluation was done by an independent data collection and analysis team at baseline and end line (after 24 months).

A data sharing method for remote medical system based on federated distillation learning and consortium blockchain

With the development of Medical Internet of Things (MIoT) technology and the global COVID-19 pandemic, hospitals gain access to patients' health data from remote wearable medical equipment. Federated learning (FL) addresses the difficulty of sharing data in remote medical systems. However, some key issues and challenges persist, such as heterogeneous health data stored in hospitals, which leads to high communication cost and low model accuracy. There are many approaches of federated distillation (FD) methods used to solve these problems, but FD is very vulnerable to poisoning attacks and requires a centralised server for aggregation, which is prone to single-node failure. To tackle this issue, we combine FD and blockchain to solve data sharing in remote medical system called FedRMD. FedRMD use reputation incentive to defend against poisoning attacks and store reputation values and soft labels of FD in Hyperledger Fabric. Experimenting on COVID-19 radiography and COVID-Chestxray datasets shows our method can reduce communication cost, and the performance is higher than FedAvg, FedDF, and FedGen. In addition, the reputation incentive can reduce the impact of poisoning attacks. © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.