User benefit assessment by a dynamic LUTI model for Madrid

Assessing users’ benefit in a transport policy implementation has been studied by many researchers using theoretical or empirical measures. However, few of them measure users’ benefit in a different way from the consumer surplus. Therefore, this paper aims to assess a new measure of user benefits by weighting consumer surplus in order to include equity assessment for different transport policies simulated in a dynamic middle-term LUTI model adapted to the case study of Madrid. Three different transport policies, including road pricing, parking charge and public transport improvement have been simulated through the Metropolitan Activity Relocation Simulator, MARS, the LUTI calibrated model for Madrid). A social welfare function (WF) is defined using a cost benefit analysis function that includes mainly costs and benefits of users and operators of the transport system. Particularly, the part of welfare function concerning the users, (i.e. consumer surplus), is modified by a compensating weight (CW) which represents the inverse of household income level. Based on the modified social welfare function, the effects on the measure of users benefits are estimated and compared with the old WF ́s results as well. The result of the analysis shows that road pricing leads a negative effect on the users benefits specially on the low income users. Actually, the road pricing and parking charge implementation results like a regressive policy especially at long term. Public transport improvement scenario brings more positive effects on low income user benefits. The integrated (road pricing and increasing public services) policy scenario is the one which receive the most user benefits. The results of this research could be a key issue to understanding the relationship between transport systems policies and user benefits distribution in a metropolitan context.

Modeling impact assessment of transport policies through a multiregional input-output integrated approach

El objetivo de esta investigación es desarrollar una metodología para estimar los potenciales impactos económicos y de transporte generados por la aplicación de políticas en el sector transporte. Los departamentos de transporte y otras instituciones gubernamentales relacionadas se encuentran interesadas en estos análisis debido a que son presentados comúnmente de forma errónea por la insuficiencia de datos o por la falta de metodologías adecuadas. La presente investigación tiene por objeto llenar este vacío haciendo un análisis exhaustivo de las técnicas disponibles que coincidan con ese propósito. Se ha realizado un análisis que ha identificado las diferencias cuando son aplicados para la valoración de los beneficios para el usuario o para otros efectos como aspectos sociales. Como resultado de ello, esta investigación ofrece un enfoque integrado que incluye un modelo Input-Output de múltiples regiones basado en la utilidad aleatoria (RUBMRIO), y un modelo de red de transporte por carretera. Este modelo permite la reproducción con mayor detalle y realismo del transporte de mercancías que por medio de su estructura sectorial identifica los vínculos de las compras y ventas inter-industriales dentro de un país utilizando los servicios del transporte de mercancías. Por esta razón, el modelo integrado es aplicable a diversas políticas de transporte. En efecto, el enfoque se ha aplicado para estudiar los efectos macroeconómicos regionales de la implementación de dos políticas diferentes en el sistema de transporte de mercancías de España, tales como la tarificación basada en la distancia recorrida por vehículo-kilómetro (€/km) aplicada a los vehículos del transporte de mercancías, y para la introducción de vehículos más largos y pesados de mercancías en la red de carreteras de España. El enfoque metodológico se ha evaluado caso por caso teniendo en cuenta una selección de la red de carreteras que unen las capitales de las regiones españolas. También se ha tenido en cuenta una dimensión económica a través de una tabla Input-Output de múltiples regiones (MRIO) y la base de datos de conteo de tráfico existente para realizar la validación del modelo. El enfoque integrado reproduce las condiciones de comercio observadas entre las regiones usando el sistema de transporte de mercancías por carretera, y que permite por comparación con los escenarios de políticas, determinar las contribuciones a los cambios distributivos y generativos. Así pues, el análisis estima los impactos económicos en cualquier región considerando los cambios en el Producto Interno Bruto (PIB) y el empleo. El enfoque identifica los cambios en el sistema de transporte a través de todos los caminos de la red de transporte a través de las medidas de efectividad (MOEs). Los resultados presentados en esta investigación proporcionan evidencia sustancial de que en la evaluación de las políticas de transporte, es necesario establecer un vínculo entre la estructura económica de las regiones y de los servicios de transporte. Los análisis muestran que para la mayoría de las regiones del país, los cambios son evidentes para el PIB y el empleo, ya que el comercio se fomenta o se inhibe. El enfoque muestra cómo el tráfico se desvía en ambas políticas, y también determina detalles de las emisiones de contaminantes en los dos escenarios. Además, las políticas de fijación de precios o de regulación de los sistemas de transporte de mercancías por carretera dirigidas a los productores y consumidores en las regiones promoverán transformaciones regionales afectando todo el país, y esto conduce a conclusiones diferentes. Así mismo, este enfoque integrado podría ser útil para evaluar otras políticas y otros países en todo el mundo. The purpose of this research is to develop a methodological approach aimed at assessing the potential economic and transportation impacts of transport policies. Transportation departments and other related government parties are interested in such analysis because it is commonly misrepresented for the insufficiency of data and suitable methodologies available. This research is directed at filling this gap by making a comprehensive analysis of the available techniques that match with that purpose. The differences when they are applied for the valuation of user benefits or for other impacts as social matters have been identified. As a result, this research presents an integrated approach which includes both a random utility-based multiregional Input-Output model (RUBMRIO), and a road transport network model. This model accounts for freight transport with more detail and realism because its commodity-based structure traces the linkages of inter-industry purchases and sales that use freight services within a given country. For this reason, the integrated model is applicable to various transport policies. In fact, the approach is applied to study the regional macroeconomic effects of implementing two different policies in the freight transport system of Spain, such as a distance-based charge in vehicle-kilometer (€/km) for Heavy Goods Vehicles (HGVs), and the introduction of Longer and Heavier Vehicles (LHVs) in the road network of Spain. The methodological approach has been evaluated on a case by case basis considering a selected road network of highways linking the capitals of the Spanish regions. It has also considered an economic dimension through a Multiregional Input Output Table (MRIO) and the existing traffic count database used in the model validation. The integrated approach replicates observed conditions of trade among regions using road freight transport systems that determine contributions to distributional and generative changes by comparison with policy scenarios. Therefore, the model estimates economic impacts in any given area by considering changes in Gross Domestic Product (GDP), employment (jobs), and in the transportation system across all paths of the transport network considering Measures of effectiveness (MOEs). The results presented in this research provide substantive evidence that in the assessment of transport policies it is necessary to establish a link between the economic structure of regions and the transportation services. The analysis shows that for most regions in the country, GDP and employment changes are noticeable when trade is encouraged or discouraged. This approach shows how traffic is diverted in both policies, and also provides details of the pollutant emissions in both scenarios. Furthermore, policies, such as pricing or regulation of road freight transportation systems, directed to producers and consumers in regions will promote different regional transformations across the country, and this lead to different conclusions. In addition, this integrated approach could be useful to assess other policies and countries worldwide.

A model to develop a platform for personalised health applications

Antecedentes Europa vive una situación insostenible. Desde el 2008 se han reducido los recursos de los gobiernos a raíz de la crisis económica. El continente Europeo envejece con ritmo constante al punto que se prevé que en 2050 habrá sólo dos trabajadores por jubilado [54]. A esta situación se le añade el aumento de la incidencia de las enfermedades crónicas, relacionadas con el envejecimiento, cuyo coste puede alcanzar el 7% del PIB de un país [51]. Es necesario un cambio de paradigma. Una nueva manera de cuidar de la salud de las personas: sustentable, eficaz y preventiva más que curativa. Algunos estudios abogan por el cuidado personalizado de la salud (pHealth). En este modelo las prácticas médicas son adaptadas e individualizadas al paciente, desde la detección de los factores de riesgo hasta la personalización de los tratamientos basada en la respuesta del individuo [81]. El cuidado personalizado de la salud está asociado a menudo al uso de las tecnologías de la información y comunicación (TICs) que, con su desarrollo exponencial, ofrecen oportunidades interesantes para la mejora de la salud. El cambio de paradigma hacia el pHealth está lentamente ocurriendo, tanto en el ámbito de la investigación como en la industria, pero todavía no de manera significativa. Existen todavía muchas barreras relacionadas a la economía, a la política y la cultura. También existen barreras puramente tecnológicas, como la falta de sistemas de información interoperables [199]. A pesar de que los aspectos de interoperabilidad están evolucionando, todavía hace falta un diseño de referencia especialmente direccionado a la implementación y el despliegue en gran escala de sistemas basados en pHealth. La presente Tesis representa un intento de organizar la disciplina de la aplicación de las TICs al cuidado personalizado de la salud en un modelo de referencia, que permita la creación de plataformas de desarrollo de software para simplificar tareas comunes de desarrollo en este dominio. Preguntas de investigación RQ1 >Es posible definir un modelo, basado en técnicas de ingeniería del software, que represente el dominio del cuidado personalizado de la salud de una forma abstracta y representativa? RQ2 >Es posible construir una plataforma de desarrollo basada en este modelo? RQ3 >Esta plataforma ayuda a los desarrolladores a crear sistemas pHealth complejos e integrados? Métodos Para la descripción del modelo se adoptó el estándar ISO/IEC/IEEE 42010por ser lo suficientemente general y abstracto para el amplio enfoque de esta tesis [25]. El modelo está definido en varias partes: un modelo conceptual, expresado a través de mapas conceptuales que representan las partes interesadas (stakeholders), los artefactos y la información compartida; y escenarios y casos de uso para la descripción de sus funcionalidades. El modelo fue desarrollado de acuerdo a la información obtenida del análisis de la literatura, incluyendo 7 informes industriales y científicos, 9 estándares, 10 artículos en conferencias, 37 artículos en revistas, 25 páginas web y 5 libros. Basándose en el modelo se definieron los requisitos para la creación de la plataforma de desarrollo, enriquecidos por otros requisitos recolectados a través de una encuesta realizada a 11 ingenieros con experiencia en la rama. Para el desarrollo de la plataforma, se adoptó la metodología de integración continua [74] que permitió ejecutar tests automáticos en un servidor y también desplegar aplicaciones en una página web. En cuanto a la metodología utilizada para la validación se adoptó un marco para la formulación de teorías en la ingeniería del software [181]. Esto requiere el desarrollo de modelos y proposiciones que han de ser validados dentro de un ámbito de investigación definido, y que sirvan para guiar al investigador en la búsqueda de la evidencia necesaria para justificarla. La validación del modelo fue desarrollada mediante una encuesta online en tres rondas con un número creciente de invitados. El cuestionario fue enviado a 134 contactos y distribuido en algunos canales públicos como listas de correo y redes sociales. El objetivo era evaluar la legibilidad del modelo, su nivel de cobertura del dominio y su potencial utilidad en el diseño de sistemas derivados. El cuestionario incluía preguntas cuantitativas de tipo Likert y campos para recolección de comentarios. La plataforma de desarrollo fue validada en dos etapas. En la primera etapa se utilizó la plataforma en un experimento a pequeña escala, que consistió en una sesión de entrenamiento de 12 horas en la que 4 desarrolladores tuvieron que desarrollar algunos casos de uso y reunirse en un grupo focal para discutir su uso. La segunda etapa se realizó durante los tests de un proyecto en gran escala llamado HeartCycle [160]. En este proyecto un equipo de diseñadores y programadores desarrollaron tres aplicaciones en el campo de las enfermedades cardio-vasculares. Una de estas aplicaciones fue testeada en un ensayo clínico con pacientes reales. Al analizar el proyecto, el equipo de desarrollo se reunió en un grupo focal para identificar las ventajas y desventajas de la plataforma y su utilidad. Resultados Por lo que concierne el modelo que describe el dominio del pHealth, la parte conceptual incluye una descripción de los roles principales y las preocupaciones de los participantes, un modelo de los artefactos TIC que se usan comúnmente y un modelo para representar los datos típicos que son necesarios formalizar e intercambiar entre sistemas basados en pHealth. El modelo funcional incluye un conjunto de 18 escenarios, repartidos en: punto de vista de la persona asistida, punto de vista del cuidador, punto de vista del desarrollador, punto de vista de los proveedores de tecnologías y punto de vista de las autoridades; y un conjunto de 52 casos de uso repartidos en 6 categorías: actividades de la persona asistida, reacciones del sistema, actividades del cuidador, \engagement" del usuario, actividades del desarrollador y actividades de despliegue. Como resultado del cuestionario de validación del modelo, un total de 65 personas revisó el modelo proporcionando su nivel de acuerdo con las dimensiones evaluadas y un total de 248 comentarios sobre cómo mejorar el modelo. Los conocimientos de los participantes variaban desde la ingeniería del software (70%) hasta las especialidades médicas (15%), con declarado interés en eHealth (24%), mHealth (16%), Ambient Assisted Living (21%), medicina personalizada (5%), sistemas basados en pHealth (15%), informática médica (10%) e ingeniería biomédica (8%) con una media de 7.25_4.99 años de experiencia en estas áreas. Los resultados de la encuesta muestran que los expertos contactados consideran el modelo fácil de leer (media de 1.89_0.79 siendo 1 el valor más favorable y 5 el peor), suficientemente abstracto (1.99_0.88) y formal (2.13_0.77), con una cobertura suficiente del dominio (2.26_0.95), útil para describir el dominio (2.02_0.7) y para generar sistemas más específicos (2_0.75). Los expertos también reportan un interés parcial en utilizar el modelo en su trabajo (2.48_0.91). Gracias a sus comentarios, el modelo fue mejorado y enriquecido con conceptos que faltaban, aunque no se pudo demonstrar su mejora en las dimensiones evaluadas, dada la composición diferente de personas en las tres rondas de evaluación. Desde el modelo, se generó una plataforma de desarrollo llamada \pHealth Patient Platform (pHPP)". La plataforma desarrollada incluye librerías, herramientas de programación y desarrollo, un tutorial y una aplicación de ejemplo. Se definieron cuatro módulos principales de la arquitectura: el Data Collection Engine, que permite abstraer las fuentes de datos como sensores o servicios externos, mapeando los datos a bases de datos u ontologías, y permitiendo interacción basada en eventos; el GUI Engine, que abstrae la interfaz de usuario en un modelo de interacción basado en mensajes; y el Rule Engine, que proporciona a los desarrolladores un medio simple para programar la lógica de la aplicación en forma de reglas \if-then". Después de que la plataforma pHPP fue utilizada durante 5 años en el proyecto HeartCycle, 5 desarrolladores fueron reunidos en un grupo de discusión para analizar y evaluar la plataforma. De estas evaluaciones se concluye que la plataforma fue diseñada para encajar las necesidades de los ingenieros que trabajan en la rama, permitiendo la separación de problemas entre las distintas especialidades, y simplificando algunas tareas de desarrollo como el manejo de datos y la interacción asíncrona. A pesar de ello, se encontraron algunos defectos a causa de la inmadurez de algunas tecnologías empleadas, y la ausencia de algunas herramientas específicas para el dominio como el procesado de datos o algunos protocolos de comunicación relacionados con la salud. Dentro del proyecto HeartCycle la plataforma fue utilizada para el desarrollo de la aplicación \Guided Exercise", un sistema TIC para la rehabilitación de pacientes que han sufrido un infarto del miocardio. El sistema fue testeado en un ensayo clínico randomizado en el cual a 55 pacientes se les dio el sistema para su uso por 21 semanas. De los resultados técnicos del ensayo se puede concluir que, a pesar de algunos errores menores prontamente corregidos durante el estudio, la plataforma es estable y fiable. Conclusiones La investigación llevada a cabo en esta Tesis y los resultados obtenidos proporcionan las respuestas a las tres preguntas de investigación que motivaron este trabajo: RQ1 Se ha desarrollado un modelo para representar el dominio de los sistemas personalizados de salud. La evaluación hecha por los expertos de la rama concluye que el modelo representa el dominio con precisión y con un balance apropiado entre abstracción y detalle. RQ2 Se ha desarrollado, con éxito, una plataforma de desarrollo basada en el modelo. RQ3 Se ha demostrado que la plataforma es capaz de ayudar a los desarrolladores en la creación de software pHealth complejos. Las ventajas de la plataforma han sido demostradas en el ámbito de un proyecto de gran escala, aunque el enfoque genérico adoptado indica que la plataforma podría ofrecer beneficios también en otros contextos. Los resultados de estas evaluaciones ofrecen indicios de que, ambos, el modelo y la plataforma serán buenos candidatos para poderse convertir en una referencia para futuros desarrollos de sistemas pHealth. ABSTRACT Background Europe is living in an unsustainable situation. The economic crisis has been reducing governments' economic resources since 2008 and threatening social and health systems, while the proportion of older people in the European population continues to increase so that it is foreseen that in 2050 there will be only two workers per retiree [54]. To this situation it should be added the rise, strongly related to age, of chronic diseases the burden of which has been estimated to be up to the 7% of a country's gross domestic product [51]. There is a need for a paradigm shift, the need for a new way of caring for people's health, shifting the focus from curing conditions that have arisen to a sustainable and effective approach with the emphasis on prevention. Some advocate the adoption of personalised health care (pHealth), a model where medical practices are tailored to the patient's unique life, from the detection of risk factors to the customization of treatments based on each individual's response [81]. Personalised health is often associated to the use of Information and Communications Technology (ICT), that, with its exponential development, offers interesting opportunities for improving healthcare. The shift towards pHealth is slowly taking place, both in research and in industry, but the change is not significant yet. Many barriers still exist related to economy, politics and culture, while others are purely technological, like the lack of interoperable information systems [199]. Though interoperability aspects are evolving, there is still the need of a reference design, especially tackling implementation and large scale deployment of pHealth systems. This thesis contributes to organizing the subject of ICT systems for personalised health into a reference model that allows for the creation of software development platforms to ease common development issues in the domain. Research questions RQ1 Is it possible to define a model, based on software engineering techniques, for representing the personalised health domain in an abstract and representative way? RQ2 Is it possible to build a development platform based on this model? RQ3 Does the development platform help developers create complex integrated pHealth systems? Methods As method for describing the model, the ISO/IEC/IEEE 42010 framework [25] is adopted for its generality and high level of abstraction. The model is specified in different parts: a conceptual model, which makes use of concept maps, for representing stakeholders, artefacts and shared information, and in scenarios and use cases for the representation of the functionalities of pHealth systems. The model was derived from literature analysis, including 7 industrial and scientific reports, 9 electronic standards, 10 conference proceedings papers, 37 journal papers, 25 websites and 5 books. Based on the reference model, requirements were drawn for building the development platform enriched with a set of requirements gathered in a survey run among 11 experienced engineers. For developing the platform, the continuous integration methodology [74] was adopted which allowed to perform automatic tests on a server and also to deploy packaged releases on a web site. As a validation methodology, a theory building framework for SW engineering was adopted from [181]. The framework, chosen as a guide to find evidence for justifying the research questions, imposed the creation of theories based on models and propositions to be validated within a scope. The validation of the model was conducted as an on-line survey in three validation rounds, encompassing a growing number of participants. The survey was submitted to 134 experts of the field and on some public channels like relevant mailing lists and social networks. Its objective was to assess the model's readability, its level of coverage of the domain and its potential usefulness in the design of actual, derived systems. The questionnaires included quantitative Likert scale questions and free text inputs for comments. The development platform was validated in two scopes. As a small-scale experiment, the platform was used in a 12 hours training session where 4 developers had to perform an exercise consisting in developing a set of typical pHealth use cases At the end of the session, a focus group was held to identify benefits and drawbacks of the platform. The second validation was held as a test-case study in a large scale research project called HeartCycle the aim of which was to develop a closed-loop disease management system for heart failure and coronary heart disease patients [160]. During this project three applications were developed by a team of programmers and designers. One of these applications was tested in a clinical trial with actual patients. At the end of the project, the team was interviewed in a focus group to assess the role the platform had within the project. Results For what regards the model that describes the pHealth domain, its conceptual part includes a description of the main roles and concerns of pHealth stakeholders, a model of the ICT artefacts that are commonly adopted and a model representing the typical data that need to be formalized among pHealth systems. The functional model includes a set of 18 scenarios, divided into assisted person's view, caregiver's view, developer's view, technology and services providers' view and authority's view, and a set of 52 Use Cases grouped in 6 categories: assisted person's activities, system reactions, caregiver's activities, user engagement, developer's activities and deployer's activities. For what concerns the validation of the model, a total of 65 people participated in the online survey providing their level of agreement in all the assessed dimensions and a total of 248 comments on how to improve and complete the model. Participants' background spanned from engineering and software development (70%) to medical specialities (15%), with declared interest in the fields of eHealth (24%), mHealth (16%), Ambient Assisted Living (21%), Personalized Medicine (5%), Personal Health Systems (15%), Medical Informatics (10%) and Biomedical Engineering (8%) with an average of 7.25_4.99 years of experience in these fields. From the analysis of the answers it is possible to observe that the contacted experts considered the model easily readable (average of 1.89_0.79 being 1 the most favourable scoring and 5 the worst), sufficiently abstract (1.99_0.88) and formal (2.13_0.77) for its purpose, with a sufficient coverage of the domain (2.26_0.95), useful for describing the domain (2.02_0.7) and for generating more specific systems (2_0.75) and they reported a partial interest in using the model in their job (2.48_0.91). Thanks to their comments, the model was improved and enriched with concepts that were missing at the beginning, nonetheless it was not possible to prove an improvement among the iterations, due to the diversity of the participants in the three rounds. From the model, a development platform for the pHealth domain was generated called pHealth Patient Platform (pHPP). The platform includes a set of libraries, programming and deployment tools, a tutorial and a sample application. The main four modules of the architecture are: the Data Collection Engine, which allows abstracting sources of information like sensors or external services, mapping data to databases and ontologies, and allowing event-based interaction and filtering, the GUI Engine, which abstracts the user interface in a message-like interaction model, the Workow Engine, which allows programming the application's user interaction ows with graphical workows, and the Rule Engine, which gives developers a simple means for programming the application's logic in the form of \if-then" rules. After the 5 years experience of HeartCycle, partially programmed with pHPP, 5 developers were joined in a focus group to discuss the advantages and drawbacks of the platform. The view that emerged from the training course and the focus group was that the platform is well-suited to the needs of the engineers working in the field, it allowed the separation of concerns among the different specialities and it simplified some common development tasks like data management and asynchronous interaction. Nevertheless, some deficiencies were pointed out in terms of a lack of maturity of some technological choices, and for the absence of some domain-specific tools, e.g. for data processing or for health-related communication protocols. Within HeartCycle, the platform was used to develop part of the Guided Exercise system, a composition of ICT tools for the physical rehabilitation of patients who suffered from myocardial infarction. The system developed using the platform was tested in a randomized controlled clinical trial, in which 55 patients used the system for 21 weeks. The technical results of this trial showed that the system was stable and reliable. Some minor bugs were detected, but these were promptly corrected using the platform. This shows that the platform, as well as facilitating the development task, can be successfully used to produce reliable software. Conclusions The research work carried out in developing this thesis provides responses to the three three research questions that were the motivation for the work. RQ1 A model was developed representing the domain of personalised health systems, and the assessment of experts in the field was that it represents the domain accurately, with an appropriate balance between abstraction and detail. RQ2 A development platform based on the model was successfully developed. RQ3 The platform has been shown to assist developers create complex pHealth software. This was demonstrated within the scope of one large-scale project, but the generic approach adopted provides indications that it would offer benefits more widely. The results of these evaluations provide indications that both the model and the platform are good candidates for being a reference for future pHealth developments.

Enhancement of a body area network to support smart health monitoring at the digital home

The deployment of home-based smart health services requires effective and reliable systems for personal and environmental data management. ooperation between Home Area Networks (HAN) and Body Area Networks (BAN) can provide smart systems with ad hoc reasoning information to support health care. This paper details the implementation of an architecture that integrates BAN, HAN and intelligent agents to manage physiological and environmental data to proactively detect risk situations at the digital home. The system monitors dynamic situations and timely adjusts its behavior to detect user risks concerning to health. Thus, this work provides a reasoning framework to infer appropriate solutions in cases of health risk episodes. Proposed smart health monitoring approach integrates complex reasoning according to home environment, user profile and physiological parameters defined by a scalable ontology. As a result, health care demands can be detected to activate adequate internal mechanisms and report public health services for requested actions.

AFRICA BUILD Portal: developing a social network of African health researchers and educators

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.

Integration of wearable devices in a wireless sensor network for an e-health application

Applications based on Wireless Sensor Networks for Internet of Things scenarios are on the rise. The multiple possibilities they offer have spread towards previously hard to imagine fields, like e-health or human physiological monitoring. An application has been developed for its usage in scenarios where data collection is applied to smart spaces, aiming at its usage in fire fighting and sports. This application has been tested in a gymnasium with real, non-simulated nodes and devices. A Graphic User Interface has been implemented to suggest a series of exercises to improve a sportsman/woman s condition, depending on the context and their profile. This system can be adapted to a wide variety of e-health applications with minimum changes, and the user will interact using different devices, like smart phones, smart watches and/or tablets.

Feasibility of a wireless health monitoring system for prevention and health assessment of elderly people

The work presented in this paper comprises the methodology and results of a pilot study on the feasibility of a wireless health monitoring system designed under main EU challenges for the promotion of healthy and active ageing. The system is focused on health assessment, prevention and lifestyle promotion of elderly people. Over a hundred participants including elderly users and caregivers tested the system in four pilot sites across Europe. Tests covered several scenarios in senior centers and real home environments, including performance and usability assessment. Results indicated strong satisfactoriness on usability, usefulness and user friendliness, and the acceptable level of reliability obtained supports future investigation on the same direction for further improvement and transfer of conclusions to the real world in the healthcare delivery.

HeartCycle: User interaction and patient education

Cardiovascular Diseases are the most prevalent and serious chronic conditions existing nowadays. They are the primary cause of death in the world and generate enormous expenditures to the health systems. Tele-monitoring and personal health systems have proven to be good options for tackling this situation; however they are still lacking many functionalities. It is necessary to find solutions that allow health professionals to follow up patients more closely and efficiently, while reducing the non-adherence of patients to the treatment regime. HeartCycle research project (partially funded by the European Commission) has developed a personal health system for cardiovascular diseases management with the aim to address this problem. This paper describes the Patient Loop of this solution, including the different components, the adopted user interaction, and the implemented patients education and coaching strategy.

Air quality modeling and mortality impact of fine particles reduction policies in Spain

Background: In recent years, Spain has implemented a number of air quality control measures that are expected to lead to a future reduction in fine particle concentrations and an ensuing positive impact on public health. Objectives: We aimed to assess the impact on mortality attributable to a reduction in fine particle levels in Spain in 2014 in relation to the estimated level for 2007. Methods: To estimate exposure, we constructed fine particle distribution models for Spain for 2007 (reference scenario) and 2014 (projected scenario) with a spatial resolution of 16x16 km2. In a second step, we used the concentration-response functions proposed by cohort studies carried out in Europe (European Study of Cohorts for Air Pollution Effects and Rome longitudinal cohort) and North America (American Cancer Society cohort, Harvard Six Cities study and Canadian national cohort) to calculate the number of attributable annual deaths corresponding to all causes, all non-accidental causes, ischemic heart disease and lung cancer among persons aged over 25 years (2005-2007 mortality rate data). We examined the effect of the Spanish demographic shift in our analysis using 2007 and 2012 population figures. Results: Our model suggested that there would be a mean overall reduction in fine particle levels of 1mg/m3 by 2014. Taking into account 2007 population data, between 8 and 15 all-cause deaths per 100,000 population could be postponed annually by the expected reduction in fine particle levels. For specific subgroups, estimates varied from 10 to 30 deaths for all non-accidental causes, from 1 to 5 for lung cancer, and from 2 to 6 for ischemic heart disease. The expected burden of preventable mortality would be even higher in the future due to the Spanish population growth. Taking into account the population older than 30 years in 2012, the absolute mortality impact estimate would increase approximately by 18%. Conclusions: Effective implementation of air quality measures in Spain, in a scenario with a short-term projection, would amount to an appreciable decline infine particle concentrations, and this, in turn, would lead to notable health-related benefits. Recent European cohort studies strengthen the evidence of an association between long-term exposure to fine particles and health effects, and could enhance the health impact quantification in Europe. Air quality models can contribute to improved assessment of air pollution health impact estimates, particularly in study areas without air pollution monitoring data.

Managing daily surgery schedules in a teaching hospital: a mixed-integer optimization approach

Background: This study examined the daily surgical scheduling problem in a teaching hospital. This problem relates to the use of multiple operating rooms and different types of surgeons in a typical surgical day with deterministic operation durations (preincision, incision, and postincision times). Teaching hospitals play a key role in the health-care system; however, existing models assume that the duration of surgery is independent of the surgeon's skills. This problem has not been properly addressed in other studies. We analyze the case of a Spanish public hospital, in which continuous pressures and budgeting reductions entail the more efficient use of resources. Methods: To obtain an optimal solution for this problem, we developed a mixed-integer programming model and user-friendly interface that facilitate the scheduling of planned operations for the following surgical day. We also implemented a simulation model to assist the evaluation of different dispatching policies for surgeries and surgeons. The typical aspects we took into account were the type of surgeon, potential overtime, idling time of surgeons, and the use of operating rooms. Results: It is necessary to consider the expertise of a given surgeon when formulating a schedule: such skill can decrease the probability of delays that could affect subsequent surgeries or cause cancellation of the final surgery. We obtained optimal solutions for a set of given instances, which we obtained through surgical information related to acceptable times collected from a Spanish public hospital. Conclusions: We developed a computer-aided framework with a user-friendly interface for use by a surgical manager that presents a 3-D simulation of the problem. Additionally, we obtained an efficient formulation for this complex problem. However, the spread of this kind of operation research in Spanish public health hospitals will take a long time since there is a lack of knowledge of the beneficial techniques and possibilities that operational research can offer for the health-care system.

Application of PZT and FBG impedance sensors for structural health monitoring of reinforced concrete beams strengthened with FRP composite materials

Esta Tesis tiene como objetivo principal el desarrollo de métodos de identificación del daño que sean robustos y fiables, enfocados a sistemas estructurales experimentales, fundamentalmente a las estructuras de hormigón armado reforzadas externamente con bandas fibras de polímeros reforzados (FRP). El modo de fallo de este tipo de sistema estructural es crítico, pues generalmente es debido a un despegue repentino y frágil de la banda del refuerzo FRP originado en grietas intermedias causadas por la flexión. La detección de este despegue en su fase inicial es fundamental para prevenir fallos futuros, que pueden ser catastróficos. Inicialmente, se lleva a cabo una revisión del método de la Impedancia Electro-Mecánica (EMI), de cara a exponer sus capacidades para la detección de daño. Una vez la tecnología apropiada es seleccionada, lo que incluye un analizador de impedancias así como novedosos sensores PZT para monitorización inteligente, se ha diseñado un procedimiento automático basado en los registros de impedancias de distintas estructuras de laboratorio. Basándonos en el hecho de que las mediciones de impedancias son posibles gracias a una colocación adecuada de una red de sensores PZT, la estimación de la presencia de daño se realiza analizando los resultados de distintos indicadores de daño obtenidos de la literatura. Para que este proceso sea automático y que no sean necesarios conocimientos previos sobre el método EMI para realizar un experimento, se ha diseñado e implementado un Interfaz Gráfico de Usuario, transformando la medición de impedancias en un proceso fácil e intuitivo. Se evalúa entonces el daño a través de los correspondientes índices de daño, intentando estimar no sólo su severidad, sino también su localización aproximada. El desarrollo de estos experimentos en cualquier estructura genera grandes cantidades de datos que han de ser procesados, y algunas veces los índices de daño no son suficientes para una evaluación completa de la integridad de una estructura. En la mayoría de los casos se pueden encontrar patrones de daño en los datos, pero no se tiene información a priori del estado de la estructura. En este punto, se ha hecho una importante investigación en técnicas de reconocimiento de patrones particularmente en aprendizaje no supervisado, encontrando aplicaciones interesantes en el campo de la medicina. De ahí surge una idea creativa e innovadora: detectar y seguir la evolución del daño en distintas estructuras como si se tratase de un cáncer propagándose por el cuerpo humano. En ese sentido, las lecturas de impedancias se emplean como información intrínseca de la salud de la propia estructura, de forma que se pueden aplicar las mismas técnicas que las empleadas en la investigación del cáncer. En este caso, se ha aplicado un algoritmo de clasificación jerárquica dado que ilustra además la clasificación de los datos de forma gráfica, incluyendo información cualitativa y cuantitativa sobre el daño. Se ha investigado la efectividad de este procedimiento a través de tres estructuras de laboratorio, como son una viga de aluminio, una unión atornillada de aluminio y un bloque de hormigón reforzado con FRP. La primera ayuda a mostrar la efectividad del método en sencillos escenarios de daño simple y múltiple, de forma que las conclusiones extraídas se aplican sobre los otros dos, diseñados para simular condiciones de despegue en distintas estructuras. Demostrada la efectividad del método de clasificación jerárquica de lecturas de impedancias, se aplica el procedimiento sobre las estructuras de hormigón armado reforzadas con bandas de FRP objeto de esta tesis, detectando y clasificando cada estado de daño. Finalmente, y como alternativa al anterior procedimiento, se propone un método para la monitorización continua de la interfase FRP-Hormigón, a través de una red de sensores FBG permanentemente instalados en dicha interfase. De esta forma, se obtienen medidas de deformación de la interfase en condiciones de carga continua, para ser implementadas en un modelo de optimización multiobjetivo, cuya solución se haya por medio de una expansión multiobjetivo del método Particle Swarm Optimization (PSO). La fiabilidad de este último método de detección se investiga a través de sendos ejemplos tanto numéricos como experimentales. ABSTRACT This thesis aims to develop robust and reliable damage identification methods focused on experimental structural systems, in particular Reinforced Concrete (RC) structures externally strengthened with Fiber Reinforced Polymers (FRP) strips. The failure mode of this type of structural system is critical, since it is usually due to sudden and brittle debonding of the FRP reinforcement originating from intermediate flexural cracks. Detection of the debonding in its initial stage is essential thus to prevent future failure, which might be catastrophic. Initially, a revision of the Electro-Mechanical Impedance (EMI) method is carried out, in order to expose its capabilities for local damage detection. Once the appropriate technology is selected, which includes impedance analyzer as well as novel PZT sensors for smart monitoring, an automated procedure has been design based on the impedance signatures of several lab-scale structures. On the basis that capturing impedance measurements is possible thanks to an adequately deployed PZT sensor network, the estimation of damage presence is done by analyzing the results of different damage indices obtained from the literature. In order to make this process automatic so that it is not necessary a priori knowledge of the EMI method to carry out an experimental test, a Graphical User Interface has been designed, turning the impedance measurements into an easy and intuitive procedure. Damage is then assessed through the analysis of the corresponding damage indices, trying to estimate not only the damage severity, but also its approximate location. The development of these tests on any kind of structure generates large amounts of data to be processed, and sometimes the information provided by damage indices is not enough to achieve a complete analysis of the structural health condition. In most of the cases, some damage patterns can be found in the data, but none a priori knowledge of the health condition is given for any structure. At this point, an important research on pattern recognition techniques has been carried out, particularly on unsupervised learning techniques, finding interesting applications in the medicine field. From this investigation, a creative and innovative idea arose: to detect and track the evolution of damage in different structures, as if it were a cancer propagating through a human body. In that sense, the impedance signatures are used to give intrinsic information of the health condition of the structure, so that the same clustering algorithms applied in the cancer research can be applied to the problem addressed in this dissertation. Hierarchical clustering is then applied since it also provides a graphical display of the clustered data, including quantitative and qualitative information about damage. The performance of this approach is firstly investigated using three lab-scale structures, such as a simple aluminium beam, a bolt-jointed aluminium beam and an FRP-strengthened concrete specimen. The first one shows the performance of the method on simple single and multiple damage scenarios, so that the first conclusions can be extracted and applied to the other two experimental tests, which are designed to simulate a debonding condition on different structures. Once the performance of the impedance-based hierarchical clustering method is proven to be successful, it is then applied to the structural system studied in this dissertation, the RC structures externally strengthened with FRP strips, where the debonding failure in the interface between the FRP and the concrete is successfully detected and classified, proving thus the feasibility of this method. Finally, as an alternative to the previous approach, a continuous monitoring procedure of the FRP-Concrete interface is proposed, based on an FBGsensors Network permanently deployed within that interface. In this way, strain measurements can be obtained under controlled loading conditions, and then they are used in order to implement a multi-objective model updating method solved by a multi-objective expansion of the Particle Swarm Optimization (PSO) method. The feasibility of this last proposal is investigated and successfully proven on both numerical and experimental RC beams strengthened with FRP.

Context modelling for natural Human Computer Interaction applications in e-health

The conception of IoT (Internet of Things) is accepted as the future tendency of Internet among academia and industry. It will enable people and things to be connected at anytime and anyplace, with anything and anyone. IoT has been proposed to be applied into many areas such as Healthcare, Transportation，Logistics, and Smart environment etc. However, this thesis emphasizes on the home healthcare area as it is the potential healthcare model to solve many problems such as the limited medical resources, the increasing demands for healthcare from elderly and chronic patients which the traditional model is not capable of. A remarkable change in IoT in semantic oriented vision is that vast sensors or devices are involved which could generate enormous data. Methods to manage the data including acquiring, interpreting, processing and storing data need to be implemented. Apart from this, other abilities that IoT is not capable of are concluded, namely, interoperation, context awareness and security & privacy. Context awareness is an emerging technology to manage and take advantage of context to enable any type of system to provide personalized services. The aim of this thesis is to explore ways to facilitate context awareness in IoT. In order to realize this objective, a preliminary research is carried out in this thesis. The most basic premise to realize context awareness is to collect, model, understand, reason and make use of context. A complete literature review for the existing context modelling and context reasoning techniques is conducted. The conclusion is that the ontology-based context modelling and ontology-based context reasoning are the most promising and efficient techniques to manage context. In order to fuse ontology into IoT, a specific ontology-based context awareness framework is proposed for IoT applications. In general, the framework is composed of eight components which are hardware, UI (User Interface), Context modelling, Context fusion, Context reasoning, Context repository, Security unit and Context dissemination. Moreover, on the basis of TOVE (Toronto Virtual Enterprise), a formal ontology developing methodology is proposed and illustrated which consists of four stages: Specification & Conceptualization, Competency Formulation, Implementation and Validation & Documentation. In addition, a home healthcare scenario is elaborated by listing its well-defined functionalities. Aiming at representing this specific scenario, the proposed ontology developing methodology is applied and the ontology-based model is developed in a free and open-source ontology editor called Protégé. Finally, the accuracy and completeness of the proposed ontology are validated to show that this proposed ontology is able to accurately represent the scenario of interest.

El recorrido: evaluación de las cualidades sensoriales y formales del medio urbano como parte de los criterios de caminabilidad. La ciudad de Taipei como caso de estudio

La presente investigación aborda el análisis de las cualidades del entorno urbano que inciden en la experiencia perceptiva de su recorrido. Los intereses que la motivan tienen que ver con la recuperación de la ciudad para el viandante y se sitúa dentro de un marco de intereses más amplio como es el de la ciudad sostenible. En primer lugar, se contextualiza el tema de la experiencia del recorrido a través de disciplinas diferentes como son el cine, la literatura, la arquitectura, el urbanismo, la arquitectura del paisaje, la psicología y la estética ambiental. De este modo, se refuerza el argumento en torno al papel que desempeñan la forma y otros estímulos sensoriales en la experiencia del espacio, ya sea éste urbano, arquitectónico o natural. La experiencia que las personas viven al desplazarse por un entorno viene definida por infinitos factores que van desde la configuración física del entorno recorrido, hasta el aprendizaje cultural de la persona que camina; desde los estímulos sensoriales que se reciben, hasta las condiciones físicas que posibilitan la funcionalidad del recorrido; desde las sutilezas de índole secuencial que se desvelan a medida que avanzamos, hasta las condiciones higrotérmicas en el momento en que se lleva a cabo el desplazamiento. Sin embargo, factores como las motivaciones y atenciones personales del que anda, así como sus recuerdos de experiencias anteriores, deseos, imaginación y estado de ánimo, también definen nuestra experiencia al caminar que, indudablemente, se encuentra ligada a nuestra personalidad y, por lo tanto, no puede ser exacta a la de otra persona. Conscientes de que todos estos factores se funden en un fenómeno global, y que no se dan en la vida por separado, nos hemos esforzado por independizar las cualidades sensoriales y formales, únicamente a efectos de investigación. La importancia del tema a investigar reside en las conexiones que existen entre las cualidades del medio construido y la experiencia cotidiana de su recorrido, en la medida en que dicha vinculación establece relaciones con la calidad de vida, la salud de los ciudadanos y sus sentimientos de identidad. En este sentido, el problema clave encontrado es que si la definición de la experiencia del recorrido urbano es demasiado amplia, se vuelve nebulosa e inoperativa, pero si se precisa demasiado, se pueden excluir variables importantes. Hemos concentrado nuestros esfuerzos en buscar un medio que permita hacer operativo el estudio de aspectos que, por su propia naturaleza, son difíciles de controlar y aplicar en la práctica. En este sentido, el campo de estudio que aúna interés en el tema, producción científica y vocación práctica, es el de la caminabilidad de las ciudades. Por esta razón, hemos situado nuestro trabajo dentro del marco de criterios que este campo establece para valorar un entorno caminable. Sin embargo, hemos detectado que los trabajos sobre caminabilidad tienden a desarrollarse dentro de la disciplina del planeamiento de transporte y, con frecuencia, siguiendo las mismas pautas que la investigación sobre el transporte motorizado. Además, la tendencia a proporcionar datos numéricos producto de la medición controlada de variables, para respaldar iniciativas dentro de los ámbitos de toma de decisiones, lleva consigo un progresivo alejamiento de los aspectos más sutiles y próximos de la experiencia de las personas y la especificidad de los lugares. Por estas razones, hemos estimado necesario profundizar en la experiencia peatonal explorando otras líneas de trabajo como son la habitabilidad de las ciudades, políticas llevadas a cabo para mejorar la calidad del espacio público o las certificaciones de sostenibilidad en el ámbito del urbanismo. También se han estudiado las aproximaciones gráficas a la representación y simulación de recorridos urbanos por su importancia en la comunicación y promoción de caminar. Para detectar las problemáticas implicadas en la definición de una herramienta que permita valorar, de manera operativa, la calidad de la experiencia del recorrido urbano, la metodología de valoración propuesta se ha basado en la combinación de distintos métodos y en la conjugación de tres aproximaciones: valoración por parte del investigador en calidad de experto, valoración realizada por el investigador en el papel de usuario y valoración por el ciudadano. El desarrollo de esta investigación se ha visto condicionado por la intención de aplicar lo estudiado en un caso práctico. El marco de criterios que los trabajos sobre caminabilidad de las ciudades establecen para que se dé un entorno caminable, se puede resumir en que concurran los siguientes factores: mezcla de usos, densidad de población y edificación relativamente altas, destinos públicos accesibles a pie, un alto grado de seguridad con respecto al tráfico y actos delictivos, alta funcionalidad (dimensiones, pendientes, etc.) y atractivo. Una vez definido el modelo de ciudad en que es pertinente realizar una investigación sobre las cualidades del entorno urbano responsables de que éste se perciba como atractivo, se escogió la ciudad de Taipei, entre otras razones, por cumplir con los requisitos restantes. Con respecto al caso práctico, el objetivo es detectar fortalezas y debilidades del área central de la ciudad de Taipei en cuanto a la experiencia perceptiva que proporciona a los viandantes. ABSTRACT This research addresses the analysis of the qualities of the urban environment that affect the perceptual experience of walking. The interests lying behind it are related to the recovery of the city for pedestrians, and is framed within the sustainable city framework of interests. Firstly, the issue of the experience of walking is contextualized through different disciplines such as film, literature, architecture, urban planning, landscape architecture, environmental psychology and aesthetics. This way, the argument about the role that form and other sensory stimuli play in the experience of space, whether it is urban, architectural or natural, is strengthened. The walking experience of people is defined by factors ranging from the physical configuration of the environment to the cultural background of the person who walks, from the sensory stimuli that are perceived to the physical conditions that enable the functionality of the walk, from the subtleties of sequential nature that are revealed as we move around to hygrothermal conditions at the specific time of walking. Nevertheless, factors such as personal motivations and attentions of the walker, as well as memories of past experiences, desires, imagination and mood, also define our walking experience that is undoubtedly linked to our personality and, therefore, it cannot be exactly the same as other people's experience. Being aware that all these factors come together in a total phenomenon and that, in real life, they do not exist separately, we focused on separating sensory and formal qualities only for research purposes. The importance of the research topic lies in the connections between the qualities of the built environment and the quotidian experience of walking through it, to the extent that such link establishes relationships with the quality of life, health and feelings of identity of citizens. In this sense, the key problem encountered is that, if the definition of urban walking experience is too broad, it becomes nebulous and non‐operational, but if it is too precise, important variables can be excluded. We concentrated our efforts on finding a way to operationalize the study of questions that, by their very nature, are difficult to control and apply in practice. In this regard, the field of study that combines interest in the topic, scientific production and practical purpose, is the walkability of cities. For this reason, we placed our work within the framework of the set of criteria that this field establishes for assessing an environment as walkable. However, we found that works on walkability tend to be developed within the discipline of transportation planning and often following the same guidelines that research on motorized transport. Furthermore, the tendency to provide numerical data as a result of the controlled measurement of variables in order to support initiatives in decision making areas, involves a progressive distancing from the proximity and the most subtle aspects of the experience of people, and from the specificity of places. For these reasons, we considered it was necessary to deepen into the study of pedestrians experience, by exploring other lines of work such as the livability of cities, implemented policies to improve the quality of the public space or sustainability certifications in urbanism. Graphic representation and simulation of urban walks are also studied due to their important role in communication and promotion of walking. In order to find the issues involved in defining a tool to assess, in an operational way, the quality of urban walking experience, the proposed assessment methodology is based on the combination of different methods and the synthesis of three approaches: assessment by the researcher as expert, assessment by the researcher playing the role of user and assessment by the citizens. The development of this research has been conditioned by our intention of applying it in a case study. The framework of criteria that works on walkability of cities set to define a walkable environment, can be summarized in the following factors: mix of uses, population and building density rather high, public destinations accessible on foot, high levels of safety in terms of traffic and crime, high functionality (dimensions, slopes, etc.) and attractiveness. After defining the model of city in which it is relevant to conduct an investigation on the qualities that are responsible of the attractiveness of the environment; Taipei City was selected because it meets the remaining requirements, among other reasons. Regarding the case study, the goal is to identify strengths and weaknesses in the central area of Taipei City in terms of the perceptual experience of pedestrians.