Integration of heterogeneous data sources and automated reasoning in healthcare and domotic IoT systems

In recent years, IoT technology has radically transformed many crucial industrial and service sectors such as healthcare. The multi-facets heterogeneity of the devices and the collected information provides important opportunities to develop innovative systems and services. However, the ubiquitous presence of data silos and the poor semantic interoperability in the IoT landscape constitute a significant obstacle in the pursuit of this goal. Moreover, achieving actionable knowledge from the collected data requires IoT information sources to be analysed using appropriate artificial intelligence techniques such as automated reasoning. In this thesis work, Semantic Web technologies have been investigated as an approach to address both the data integration and reasoning aspect in modern IoT systems. In particular, the contributions presented in this thesis are the following: (1) the IoT Fitness Ontology, an OWL ontology that has been developed in order to overcome the issue of data silos and enable semantic interoperability in the IoT fitness domain; (2) a Linked Open Data web portal for collecting and sharing IoT health datasets with the research community; (3) a novel methodology for embedding knowledge in rule-defined IoT smart home scenarios; and (4) a knowledge-based IoT home automation system that supports a seamless integration of heterogeneous devices and data sources.

Internet of healthcare (law): privacy and data protection aspects in an internet of everything

The purpose of this research study is to discuss privacy and data protection-related regulatory and compliance challenges posed by digital transformation in healthcare in the wake of the COVID-19 pandemic. The public health crisis accelerated the development of patient-centred remote/hybrid healthcare delivery models that make increased use of telehealth services and related digital solutions. The large-scale uptake of IoT-enabled medical devices and wellness applications, and the offering of healthcare services via healthcare platforms (online doctor marketplaces) have catalysed these developments. However, the use of new enabling technologies (IoT, AI) and the platformisation of healthcare pose complex challenges to the protection of patient’s privacy and personal data. This happens at a time when the EU is drawing up a new regulatory landscape for the use of data and digital technologies. Against this background, the study presents an interdisciplinary (normative and technology-oriented) critical assessment on how the new regulatory framework may affect privacy and data protection requirements regarding the deployment and use of Internet of Health Things (hardware) devices and interconnected software (AI systems). The study also assesses key privacy and data protection challenges that affect healthcare platforms (online doctor marketplaces) in their offering of video API-enabled teleconsultation services and their (anticipated) integration into the European Health Data Space. The overall conclusion of the study is that regulatory deficiencies may create integrity risks for the protection of privacy and personal data in telehealth due to uncertainties about the proper interplay, legal effects and effectiveness of (existing and proposed) EU legislation. The proliferation of normative measures may increase compliance costs, hinder innovation and ultimately, deprive European patients from state-of-the-art digital health technologies, which is paradoxically, the opposite of what the EU plans to achieve.

Capitale sociale e sistema del valore: Il caso del pesce azzurro in Puglia

The aim of my project is to find operational strategies for increasing the commercial exploitation of fish in Apulia region and to acquire a thorough knowledge of several important aspects of this system order to propose concrete, suitable and appropriate development tools. The plan is to analyze the impact that the socio-economic context has on blue fish systems of fishing and marketing in the various maritime regions. The sector of fishery is typified by a settled downward trend due to both communitarian policies driving towards a reduction of the fishery effort and to reduction of fishing resources. In the same time in Italy a increasing of costs (expecially fuel) and a reduction of market prices, because of the increasing of imports, are observed. Although a big part of Italian fishing fleet is to be referred to Apulia region, this dynamics are worsen, here, also because of market inefficiency and lack of integration and cooperation among fishermen. In this first part of my work I have investigated two areas that are relevant for regional fishery. On a first step I have evaluated fish amount for each kind of dealer working in each one of the two areas than, according to Porter's value chain analysis theory. Than i have applied the approach of value system to evaluate the value chains of the firm's supplier, the firm of fishery itself, and the firms distribution channels. Distribution of value has been resulted different but very unfavorable to fisherman in both investigated areas. The second step of my study has been the evaluation of the social capital value in both areas, defining the networks of fishery consistence and number of their mutual relationship. Results lay stress on a relation to an higher social capital value and a distribution of value system more profitable for fishermen.

L’«educativo» in sanità: reti di complessità e orizzonti di possibilità

La tesi analizza il dialogo tra due prospettive disciplinari: pedagogia e scienze mediche aprendo ad una serie di riflessioni operative e metodologiche per lo sviluppo della competenza educativa in sanità. Si tratta di un lavoro di ricerca pedagogica articolata in due parti:una teoretica e una empirica. La prima parte pone l’attenzione in modo particolare all’epistemologia della cura sanitaria nella prospettiva della complessità e agli elementi che definiscono la competenza educativa degli operatori. La seconda parte presenta i dati di una indagine esplorativa realizzata tramite focus group che ha coinvolto medici, infermieri, ostetriche e fisioterapisti della provincia di Bologna e medici, infermieri e fisioterapisti del Canton Ticino, Svizzera per far emergere le esperienze, i vissuti e le opinioni legate alle azioni educative sanitarie

Temporary teams learning and performance: the case of 3D printing technology in orthopaedic surgery

This dissertation contributes to the scholarly debate on temporary teams by exploring team interactions and boundaries.The fundamental challenge in temporary teams originates from temporary participation in the teams. First, as participants join the team for a short period of time, there is not enough time to build trust, share understanding, and have effective interactions. Consequently, team outputs and practices built on team interactions become vulnerable. Secondly, as team participants move on and off the teams, teams’ boundaries become blurred over time. It leads to uncertainty among team participants and leaders about who is/is not identified as a team member causing collective disagreement within the team. Focusing on the above mentioned challenges, we conducted this research in healthcare organisations since the use of temporary teams in healthcare and hospital setting is prevalent. In particular, we focused on orthopaedic teams that provide personalised treatments for patients using 3D printing technology. Qualitative and quantitative data were collected using interviews, observations, questionnaires and archival data at Rizzoli Orthopaedic Institute, Bologna, Italy. This study provides the following research outputs. The first is a conceptual study that explores temporary teams’ literature using bibliometric analysis and systematic literature review to highlight research gaps. The second paper qualitatively studies temporary relationships within the teams by collecting data using group interviews and observations. The results highlighted the role of short-term dyadic relationships as a ground to share and transfer knowledge at the team level. Moreover, hierarchical structure of the teams facilitates knowledge sharing by supporting dyadic relationships within and beyond the team meetings. The third paper investigates impact of blurred boundaries on temporary teams’ performance. Using quantitative data collected through questionnaires and archival data, we concluded that boundary blurring in terms of fluidity, overlap and dispersion differently impacts team performance at high and low levels of task complexity.

Multi-Principal Agency and the Compliance with Professional Guidelines in Health Systems: Economic and Regulatory Perspectives

Amid the trend of rising health expenditure in developed economies, changing the healthcare delivery models is an important point of action for service regulators to contain this trend. Such a change is mostly induced by either financial incentives or regulatory tools issued by the regulators and targeting service providers and patients. This creates a tripartite interaction between service regulators, professionals, and patients that manifests a multi-principal agent relationship, in which professionals are agents to two principals: regulators and patients. This thesis is concerned with such a multi-principal agent relationship in healthcare and attempts to investigate the determinants of the (non-)compliance to regulatory tools in light of this tripartite relationship. In addition, the thesis provides insights into the different institutional, economic, and regulatory settings, which govern the multi-principal agent relationship in healthcare in different countries. Furthermore, the thesis provides and empirically tests a conceptual framework of the possible determinants of (non-)compliance by physicians to regulatory tools issued by the regulator. The main findings of the thesis are first, in a multi-principal agent setting, the utilization of financial incentives to align the objectives of professionals and the regulator is important but not the only solution. This finding is based on the heterogeneity in the financial incentives provided to professionals in different health markets, which does not provide a one-size-fits-all model of financial incentives to influence clinical decisions. Second, soft law tools as clinical practice guidelines (CPGs) are important tools to mitigate the problems of the multi-principal agent setting in health markets as they reduce information asymmetries while preserving the autonomy of professionals. Third, CPGs are complex and heterogeneous and so are the determinants of (non-)compliance to them. Fourth, CPGs work but under conditions. Factors such as intra-professional competition between service providers or practitioners might lead to non-compliance to CPGs – if CPGs are likely to reduce the professional’s utility. Finally, different degrees of soft law mandate have different effects on providers’ compliance. Generally, the stronger the mandate, the stronger the compliance, however, even with a strong mandate, drivers such as intra-professional competition and co-management of patients by different professionals affected the (non-)compliance.

Il corpo e l'individuo tra proprietà ed autodeterminazione. Con particolare riferimento al fenomeno delle biobanche

La bioetica è il luogo ideale per cercare risposte ai grandi interrogativi concernenti la vita, la morte e la cura dell'essere umano. I recenti dibattiti sull'uso, ed il temuto abuso, del corpo umano in medicina hanno messo in evidenza la necessità di una discussione approfondita sul potere di scelta che l'individuo può esercitare sulla propria mente e sul proprio corpo. Spinta dal desidero di indagare l'estensione di tale potere di scelta ho voluto analizzare le tematiche riguardanti “il corpo”, “l'individuo”, “la proprietà” e “l'autodeterminazione”. L'analisi è stata condotta individuando alcuni dei differenti significati che questi termini assumono nei diversi ambiti che la bioetica lambisce e mostrando, in particolare, la visione di tale realtà attraverso le lenti del giurista. A chi appartiene il corpo? Chi ha il potere di decidere su di esso? Il potere di scelta valica gli antichi i confini legati al corpo del paziente e coinvolge tessuti, organi e cellule staccati dal corpo umano, parti che un tempo erano considerati scarti operatori sono oggi divenuti tesori inestimabili per la ricerca. L'importanza assunta dai campioni biologici ha portato alla creazione di biobanche nelle quali sono raccolti, catalogati e il DNA studiato in campioni biologici Le biobanche riflettono le tensioni della bioetica e del biodititto. Lo studio delle biobanche riguarda, tra l'altro, la riceca dell'equilibrio tra le diverse esigenze meritevoli di tutela: in primo luogo il diritto alla privacy, diritto a che le “proprie informazioni” non vengano divulgate ed il diritto a non essere discriminato ed in secondo luogo le necessità dettate dalla ricerca e dalla scienza medica. Nel 2009 la rivista Times messo biobanche tra le 10 idee in grado di cambiare il mondo anche in considarazione della medicina personalizzata e del fatto che costituiscono una la speranza per la ricerca contro le malattie attuali e future.

Nanotechnology control of self organized biomolecules and biomaterials for medical research

Nanotechnology entails the manufacturing and manipulation of matter at length scales ranging from single atoms to micron-sized objects. The ability to address properties on the biologically-relevant nanometer scale has made nanotechnology attractive for Nanomedicine. This is perceived as a great opportunity in healthcare especially in diagnostics, therapeutics and more in general to develop personalized medicine. Nanomedicine has the potential to enable early detection and prevention, and to improve diagnosis, mass screening, treatment and follow-up of many diseases. From the biological standpoint, nanomaterials match the typical size of naturally occurring functional units or components of living organisms and, for this reason, enable more effective interaction with biological systems. Nanomaterials have the potential to influence the functionality and cell fate in the regeneration of organs and tissues. To this aim, nanotechnology provides an arsenal of techniques for intervening, fabricate, and modulate the environment where cells live and function. Unconventional micro- and nano-fabrication techniques allow patterning biomolecules and biocompatible materials down to the level of a few nanometer feature size. Patterning is not simply a deterministic placement of a material; in a more extended acception it allows a controlled fabrication of structures and gradients of different nature. Gradients are emerging as one of the key factors guiding cell adhesion, proliferation, migration and even differentiation in the case of stem cells. The main goal of this thesis has been to devise a nanotechnology-based strategy and tools to spatially and temporally control biologically-relevant phenomena in-vitro which are important in some fields of medical research.

Identity Changes and Consumer Behavior. How Becoming Parents Changes Our Consumption Choices

This research aims at investigating the impact of the identity change on consumption. An identity change is defined as the acquisition of a new identity after a life change event. For instance after the birth of the first child the new identity as parent is acquired and a woman can define herself as a mother. Despite marketing research recognizes that individuals’ identity is unstable and susceptible to change, the investigation of the identity change is still in its infancy. Furthermore, marketing research did not investigate the contextual effect of the new as well as the old identity on individuals’ reaction toward identity-marketing. In order words, whether people show a more favorable reaction toward product related to their new or their old identities after an identity change is still unclear. In order to answer this question, five studies are conducted. Results show that when the new identity substitutes the old one, people show a more positive reaction toward new-identity related products, while when the new identity is added to the old ones, people show a more positive reaction toward old-identity related products. This is the case also when the new identity accounts for high levels of identification (study three) and when the old identity is squeezed by the new one (studies four and five). A new concept, the identity strain, is then introduced and discussed.

Challenges and Opportunities of Machine Learning for Clinical and Omics Data

Clinical and omics data are a promising field of application for machine learning techniques even though these methods are not yet systematically adopted in healthcare institutions. Despite artificial intelligence has proved successful in terms of prediction of pathologies or identification of their causes, the systematic adoption of these techniques still presents challenging issues due to the peculiarities of the analysed data. The aim of this thesis is to apply machine learning algorithms to both clinical and omics data sets in order to predict a patient's state of health and get better insights on the possible causes of the analysed diseases. In doing so, many of the arising issues when working with medical data will be discussed while possible solutions will be proposed to make machine learning provide feasible results and possibly become an effective and reliable support tool for healthcare systems.