11 resultados para National Network of Integrated Care

em Universidad Politécnica de Madrid


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This paper presents the knowledge model of a distributed decision support system, that has been designed for the management of a national network in Ukraine. It shows how advanced Artificial Intelligence techniques (multiagent systems and knowledge modelling) have been applied to solve this real-world decision support problem: on the one hand its distributed nature, implied by different loci of decision-making at the network nodes, suggested to apply a multiagent solution; on the other, due to the complexity of problem-solving for local network administration, it was useful to apply knowledge modelling techniques, in order to structure the different knowledge types and reasoning processes involved. The paper sets out from a description of our particular management problem. Subsequently, our agent model is described, pointing out the local problem-solving and coordination knowledge models. Finally, the dynamics of the approach is illustrated by an example.

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As a thermal separation method, distillation is one of the most important technologies in the chemical industry. Given its importance, it is no surprise that increasing efforts have been made in reducing its energy inefficiencies. A great deal of research is focused in the design and optimization of the Divided-Wall Column. Its applications are still reduced due to distrust of its controllability. Previous references studied the decentralized control of DWC but still few papers deal about Model Predictive Control. In this work we present a decentralized control of both a DWC column along with its equivalent MPC schema.

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This paper analyzes the correlation between the fluctuations of the electrical power generated by the ensemble of 70 DC/AC inverters from a 45.6 MW PV plant. The use of real electrical power time series from a large collection of photovoltaic inverters of a same plant is an impor- tant contribution in the context of models built upon simplified assumptions to overcome the absence of such data. This data set is divided into three different fluctuation categories with a clustering proce- dure which performs correctly with the clearness index and the wavelet variances. Afterwards, the time dependent correlation between the electrical power time series of the inverters is esti- mated with the wavelet transform. The wavelet correlation depends on the distance between the inverters, the wavelet time scales and the daily fluctuation level. Correlation values for time scales below one minute are low without dependence on the daily fluctuation level. For time scales above 20 minutes, positive high correlation values are obtained, and the decay rate with the distance depends on the daily fluctuation level. At intermediate time scales the correlation depends strongly on the daily fluctuation level. The proposed methods have been implemented using free software. Source code is available as supplementary material.

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Este proyecto colabora con la plataforma Integrated Language Learning Lab (ILLLab) aportando una serie de ejercicios de gramática inglesa para una nueva sección de la web basada íntegramente en la especialidad de Sistemas Electrónicos. Complementariamente se adentra en una nueva oportunidad basada en dispositivos móviles inteligentes creando una aplicación para el repaso de los conceptos estudiados en la titulación de Ingeniería Técnica de Telecomunicación en lengua inglesa.

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INFOBIOMED is an European Network of Excellence (NoE) funded by the Information Society Directorate-General of the European Commission (EC). A consortium of European organizations from ten different countries is involved within the network. Four pilots, all related to linking clinical and genomic information, are being carried out. From an informatics perspective, various challenges, related to data integration and mining, are included.

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One of the main outputs of the project is a collaborative platform which integrates a myriad of research and learning resources. This article presents the first prototype of this platform: the AFRICA BUILD Portal (ABP 1.0). The ABP is a Web 2.0 platform which facilitates the access, in a collaborative manner, to these resources. Through a usable web interface, the ABP has been designed to avoid, as much as possible, the connectivity problems of African institutions. In this paper, we suggest that the access to complex systems does not imply slow response rates, and that their development model guides the project to a natural technological transfer, adaptation and user acceptance. Finally, this platform aims to motivate research attitudes during the learning process and stimulate user?s collaborations.

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A methodology is described for understanding the interaction of karstic aquifers with allogenic rivers, where little information is available. This methodology includes conventional hydrogen- ology methods tracer tests and measurements of flow into, out of and circulating within the karstic system. The method is designed to un- derstand the hydrogeological behaviour of a river in sufficient detail, given a short study pe- riod. The methodology is applied to a karstic system in Spain, obtaining useful, quantitative results for a hydrological year, such as an esti- mate of the water balance, differentiation be- tween autogenic and allogenic natural recharge, relationship and connection between the river and the aquifer, and measurements of infiltration capacity in watercourses under different hydro- logical situations. The paper deals with a useful example that could be applied to other rivers and aquifers where few data are available. It can be applied to aquifers under a natural regime and Mediterranean climate.

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In collaboration with Antón García Abril.

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There is a need for in-situ soil moisture conservation in arid and semi-arid regions due to insufficient rainfall for agriculture. For this purpose, a combination implement [integrated reservoir tillage system (RT)] comprised of a single-row chisel plow, single-row spike tooth harrow, modified seeder, and spiked roller was developed and compared to the popular tillage practices, viz., minimum tillage (MT) and conventional tillage (CT) in an arid Mediterranean environment in Egypt. The different tillage practices were conducted at tillage depths of 15, 20, and 25 cm and forward speeds of 0.69, 1, 1.25, and 1.53 m s-1. Some soil physical properties, runoff, soil loss, water harvesting efficiency and yield of wheat were evaluated. The different tillage practices caused significant differences in soil physical properties as the RT increased soil infiltration, producing a rate of 48% and 65% higher than that obtained in MT and CT, respectively. The lowest values of runoff and soil loss were recorded under RT as 4.91 mm and 0.65 t ha-1, whereas the highest values were recorded under CT as 11.36 mm and 1.66 t ha-1, respectively. In conclusion, the RT enhanced the infiltration rate, increased water harvesting efficiency, reduced runoff and achieved the highest yield of wheat. The best tillage operating parameters appeared to be at a tillage depth of 20 cm and speed between 1.00 and 1.25 m s-1.

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The Institute of Tropical Medicine in Antwerp hereby presents the results of two pilot distance learning training programmes, developed under the umbrella of the AFRICA BUILD project (FP7). The two courses focused on evidence-based medicine (EBM): with the aim of enhancing research and education, via novel approaches and to identify research needs emanating from the field. These pilot experiences, which were run both in English-speaking (Ghana), and French-speaking (Mali and Cameroon) partner institutions, produced targeted courses for the strengthening of research methodology and policy. The courses and related study materials are in the public domain and available through the AFRICA BUILD Portal (http://www.africabuild.eu/taxonomy/term/37); the training modules were delivered live via Dudal webcasts. This paper assesses the success and difficulties of transferring EBM skills with these two specific training programmes, offered through three different approaches: fully online facultative courses, fully online tutor supported courses or through a blended approach with both online and face-to-face sessions. Key factors affecting the selection of participants, the accessibility of the courses, how the learning resources are offered, and how interactive online communities are formed, are evaluated and discussed.

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Hoy en día, por primera vez en la historia, la mayor parte de la población podrá vivir hasta los sesenta años y más (United Nations, 2015). Sin embargo, todavía existe poca evidencia que demuestre que las personas mayores, estén viviendo con mejor salud que sus padres, a la misma edad, ya que la mayoría de los problemas de salud en edades avanzadas están asociados a las enfermedades crónicas (WHO, 2015). Los sistemas sanitarios de los países desarrollados funcionan adecuadamente cuando se trata del cuidado de enfermedades agudas, pero no son lo suficientemente eficaces en la gestión de las enfermedades crónicas. Durante la última década, se han realizado esfuerzos para mejorar esta gestión, por medio de la utilización de estrategias de prevención y de reenfoque de la provisión de los servicios de atención para la salud (Kane et al. 2005). Según una revisión sistemática de modelos de cuidado de salud, comisionada por el sistema nacional de salud Británico, pocos modelos han conceptualizado cuáles son los componentes que hay que utilizar para proporcionar un cuidado crónico efectivo, y estos componentes no han sido suficientemente estructurados y articulados. Por lo tanto, no hay suficiente evidencia sobre el impacto real de cualquier modelo existente en la actualidad (Ham, 2006). Las innovaciones podrían ayudar a conseguir mejores diagnósticos, tratamientos y gestión de pacientes crónicos, así como a dar soporte a los profesionales y a los pacientes en el cuidado. Sin embargo, la forma en las que estas innovaciones se proporcionan no es lo suficientemente eficiente, efectiva y amigable para el usuario. Para mejorar esto, hace falta crear equipos de trabajo y estrategias multidisciplinares. En conclusión, hacen falta actividades que permitan conseguir que las innovaciones sean utilizadas en los sistemas de salud que quieren mejorar la gestión del cuidado crónico, para que sea posible: 1) traducir la “atención sanitaria basada en la evidencia” en “conocimiento factible”; 2) hacer frente a la complejidad de la atención sanitaria a través de una investigación multidisciplinaria; 3) identificar una aproximación sistemática para que se establezcan intervenciones innovadoras en el cuidado de salud. El marco de referencia desarrollado en este trabajo de investigación es un intento de aportar estas mejoras. Las siguientes hipótesis han sido propuestas: Hipótesis 1: es posible definir un proceso de traducción que convierta un modelo de cuidado crónico en una descripción estructurada de objetivos, requisitos e indicadores clave de rendimiento. Hipótesis 2: el proceso de traducción, si se ejecuta a través de elementos basados en la evidencia, multidisciplinares y de orientación económica, puede convertir un modelo de cuidado crónico en un marco descriptivo, que define el ciclo de vida de soluciones innovadoras para el cuidado de enfermedades crónicas. Hipótesis 3: es posible definir un método para evaluar procesos, resultados y capacidad de desarrollar habilidades, y asistir equipos multidisciplinares en la creación de soluciones innovadoras para el cuidado crónico. Hipótesis 4: es posible dar soporte al desarrollo de soluciones innovadoras para el cuidado crónico a través de un marco de referencia y conseguir efectos positivos, medidos en indicadores clave de rendimiento. Para verificar las hipótesis, se ha definido una aproximación metodológica compuesta de cuatro Fases, cada una asociada a una hipótesis. Antes de esto, se ha llevado a cabo una “Fase 0”, donde se han analizado los antecedentes sobre el problema (i.e. adopción sistemática de la innovación en el cuidado crónico) desde una perspectiva multi-dominio y multi-disciplinar. Durante la fase 1, se ha desarrollado un Proceso de Traducción del Conocimiento, elaborado a partir del JBI Joanna Briggs Institute (JBI) model of evidence-based healthcare (Pearson, 2005), y sobre el cual se han definido cuatro Bloques de Innovación. Estos bloques consisten en una descripción de elementos innovadores, definidos en la fase 0, que han sido añadidos a los cuatros elementos que componen el modelo JBI. El trabajo llevado a cabo en esta fase ha servido también para definir los materiales que el proceso de traducción tiene que ejecutar. La traducción que se ha llevado a cabo en la fase 2, y que traduce la mejor evidencia disponible de cuidado crónico en acción: resultado de este proceso de traducción es la parte descriptiva del marco de referencia, que consiste en una descripción de un modelo de cuidado crónico (se ha elegido el Chronic Care Model, Wagner, 1996) en términos de objetivos, especificaciones e indicadores clave de rendimiento y organizada en tres ciclos de innovación (diseño, implementación y evaluación). Este resultado ha permitido verificar la segunda hipótesis. Durante la fase 3, para demostrar la tercera hipótesis, se ha desarrollado un método-mixto de evaluación de equipos multidisciplinares que trabajan en innovaciones para el cuidado crónico. Este método se ha creado a partir del método mixto usado para la evaluación de equipo multidisciplinares translacionales (Wooden, 2013). El método creado añade una dimensión procedural al marco. El resultado de esta fase consiste, por lo tanto, en una primera versión del marco de referencia, lista para ser experimentada. En la fase 4, se ha validado el marco a través de un caso de estudio multinivel y con técnicas de observación-participante como método de recolección de datos. Como caso de estudio se han elegido las actividades de investigación que el grupo de investigación LifeStech ha desarrollado desde el 2008 para mejorar la gestión de la diabetes, actividades realizadas en un contexto internacional. Los resultados demuestran que el marco ha permitido mejorar las actividades de trabajo en distintos niveles: 1) la calidad y cantidad de las publicaciones; 2) se han conseguido dos contratos de investigación sobre diabetes: el primero es un proyecto de investigación aplicada, el segundo es un proyecto financiado para acelerar las innovaciones en el mercado; 3) a través de los indicadores claves de rendimiento propuestos en el marco, una prueba de concepto de un prototipo desarrollado en un proyecto de investigación ha sido transformada en una evaluación temprana de una intervención eHealth para el manejo de la diabetes, que ha sido recientemente incluida en Repositorio de prácticas innovadoras del Partenariado de Innovación Europeo en Envejecimiento saludable y activo. La verificación de las 4 hipótesis ha permitido demonstrar la hipótesis principal de este trabajo de investigación: es posible contribuir a crear un puente entre la atención sanitaria y la innovación y, por lo tanto, mejorar la manera en que el cuidado crónico sea procurado en los sistemas sanitarios. ABSTRACT Nowadays, for the first time in history, most people can expect to live into their sixties and beyond (United Nations, 2015). However, little evidence suggests that older people are experiencing better health than their parents, and most of the health problems of older age are linked to Chronic Diseases (WHO, 2015). The established health care systems in developed countries are well suited to the treatment of acute diseases but are mostly inadequate for dealing with CDs. Healthcare systems are challenging the burden of chronic diseases by putting more emphasis on the prevention of disease and by looking for new ways to reorient the provision of care (Kane et al., 2005). According to an evidence-based review commissioned by the British NHS Institute, few models have conceptualized effective components of care for CDs and these components have been not structured and articulated. “Consequently, there is limited evidence about the real impact of any of the existing models” (Ham, 2006). Innovations could support to achieve better diagnosis, treatment and management for patients across the continuum of care, by supporting health professionals and empowering patients to take responsibility. However, the way they are delivered is not sufficiently efficient, effective and consumer friendly. The improvement of innovation delivery, involves the creation of multidisciplinary research teams and taskforces, rather than just working teams. There are several actions to improve the adoption of innovations from healthcare systems that are tackling the epidemics of CDs: 1) Translate Evidence-Based Healthcare (EBH) into actionable knowledge; 2) Face the complexity of healthcare through multidisciplinary research; 3) Identify a systematic approach to support effective implementation of healthcare interventions through innovation. The framework proposed in this research work is an attempt to provide these improvements. The following hypotheses have been drafted: Hypothesis 1: it is possible to define a translation process to convert a model of chronic care into a structured description of goals, requirements and key performance indicators. Hypothesis 2: a translation process, if executed through evidence-based, multidisciplinary, holistic and business-oriented elements, can convert a model of chronic care in a descriptive framework, which defines the whole development cycle of innovative solutions for chronic disease management. Hypothesis 3: it is possible to design a method to evaluate processes, outcomes and skill acquisition capacities, and assist multidisciplinary research teams in the creation of innovative solutions for chronic disease management. Hypothesis 4: it is possible to assist the development of innovative solutions for chronic disease management through a reference framework and produce positive effects, measured through key performance indicators. In order to verify the hypotheses, a methodological approach, composed of four Phases that correspond to each one of the stated hypothesis, was defined. Prior to this, a “Phase 0”, consisting in a multi-domain and multi-disciplinary background analysis of the problem (i.e.: systematic adoption of innovation to chronic care), was carried out. During phase 1, in order to verify the first hypothesis, a Knowledge Translation Process (KTP) was developed, starting from the JBI Joanna Briggs Institute (JBI) model of evidence-based healthcare was used (Pearson, 2005) and adding Four Innovation Blocks. These blocks represent an enriched description, added to the JBI model, to accelerate the transformation of evidence-healthcare through innovation; the innovation blocks are built on top of the conclusions drawn after Phase 0. The background analysis gave also indication on the materials and methods to be used for the execution of the KTP, carried out during phase 2, that translates the actual best available evidence for chronic care into action: this resulted in a descriptive Framework, which is a description of a model of chronic care (the Chronic Care Model was chosen, Wagner, 1996) in terms of goals, specified requirements and Key Performance Indicators, and articulated in the three development cycles of innovation (i.e. design, implementation and evaluation). Thanks to this result the second hypothesis was verified. During phase 3, in order to verify the third hypothesis, a mixed-method to evaluate multidisciplinary teams working on innovations for chronic care, was created, based on a mixed-method used for the evaluation of Multidisciplinary Translational Teams (Wooden, 2013). This method adds a procedural dimension to the descriptive component of the Framework, The result of this phase consisted in a draft version of the framework, ready to be tested in a real scenario. During phase 4, a single and multilevel case study, with participant-observation data collection, was carried out, in order to have a complete but at the same time multi-sectorial evaluation of the framework. The activities that the LifeStech research group carried out since 2008 to improve the management of diabetes have been selected as case study. The results achieved showed that the framework allowed to improve the research activities in different directions: the quality and quantity of the research publications that LifeStech has issued, have increased substantially; 2 project grants to improve the management of diabetes, have been assigned: the first is a grant funding applied research while the second is about accelerating innovations into the market; by using the assessment KPIs of the framework, the proof of concept validation of a prototype developed in a research project was transformed into an early stage assessment of innovative eHealth intervention for Diabetes Management, which has been recently included in the repository of innovative practice of the European Innovation Partnership on Active and Health Ageing initiative. The verification of the 4 hypotheses lead to verify the main hypothesis of this research work: it is possible to contribute to bridge the gap between healthcare and innovation and, in turn, improve the way chronic care is delivered by healthcare systems.