Pilot study: Intranet communication among chronically ill hospitalized pediatric individuals

Hospitalization can be a very stressful experience, especially for children. With the use of technology, Intranet communication can be successful in obtaining interaction that these individuals lack to accomplish a positive adjustment to the hospital setting. The purpose of this exploratory, pilot project is to examine the use of networking chronically ill, hospitalized children with other hospitalized chronically ill children through Intranet communication.^ A target population of chronically ill hospitalized children, in at least Piaget's concrete operational stage, was asked to use the Intranet system to network with other chronically ill hospitalized children during their hospital stay, for one month or until discharge. The length of time of usage was recorded on a log sheet, and questionnaires were filled out at the end of the study.^ Statistical analysis was utilized to determine frequency of network usage, duration, demographics, and the impact on hospitalization. Results indicated that Intranet communication between chronically ill hospitalized children was utilized by the participants from 7-15 age groups; and had a positive impact on their hospitalization. ^

System design and resource management in the next-generation integrated WLAN and 3G cellular networks

Next-generation integrated wireless local area network (WLAN) and 3G cellular networks aim to take advantage of the roaming ability in a cellular network and the high data rate services of a WLAN. To ensure successful implementation of an integrated network, many issues must be carefully addressed, including network architecture design, resource management, quality-of-service (QoS), call admission control (CAC) and mobility management. ^ This dissertation focuses on QoS provisioning, CAC, and the network architecture design in the integration of WLANs and cellular networks. First, a new scheduling algorithm and a call admission control mechanism in IEEE 802.11 WLAN are presented to support multimedia services with QoS provisioning. The proposed scheduling algorithms make use of the idle system time to reduce the average packet loss of realtime (RT) services. The admission control mechanism provides long-term transmission quality for both RT and NRT services by ensuring the packet loss ratio for RT services and the throughput for non-real-time (NRT) services. ^ A joint CAC scheme is proposed to efficiently balance traffic load in the integrated environment. A channel searching and replacement algorithm (CSR) is developed to relieve traffic congestion in the cellular network by using idle channels in the WLAN. The CSR is optimized to minimize the system cost in terms of the blocking probability in the interworking environment. Specifically, it is proved that there exists an optimal admission probability for passive handoffs that minimizes the total system cost. Also, a method of searching the probability is designed based on linear-programming techniques. ^ Finally, a new integration architecture, Hybrid Coupling with Radio Access System (HCRAS), is proposed for lowering the average cost of intersystem communication (IC) and the vertical handoff latency. An analytical model is presented to evaluate the system performance of the HCRAS in terms of the intersystem communication cost function and the handoff cost function. Based on this model, an algorithm is designed to determine the optimal route for each intersystem communication. Additionally, a fast handoff algorithm is developed to reduce the vertical handoff latency.^

Traffic congestion control in communication networks

Next generation networks are characterized by ever increasing complexity, intelligence, heterogeneous technologies and increasing user expectations. Telecommunication networks in particular have become truly global, consisting of a variety of national and regional networks, both wired and wireless. Consequently, the management of telecommunication networks is becoming increasingly complex. In addition, network security and reliability requirements require additional overheads which increase the size of the data records. This in turn causes acute network traffic congestions. There is no single network management methodology to control the various requirements of today's networks, and provides a good level of Quality of Service (QoS), and network security. Therefore, an integrated approach is needed in which a combination of methodologies can provide solutions and answers to network events (which cause severe congestions and compromise the quality of service and security). The proposed solution focused on a systematic approach to design a network management system based upon the recent advances in the mobile agent technologies. This solution has provided a new traffic management system for telecommunication networks that is capable of (1) reducing the network traffic load (thus reducing traffic congestion), (2) overcoming existing network latency, (3) adapting dynamically to the traffic load of the system, (4) operating in heterogeneous environments with improved security, and (5) having robust and fault tolerance behavior. This solution has solved several key challenges in the development of network management for telecommunication networks using mobile agents. We have designed several types of agents, whose interactions will allow performing some complex management actions, and integrating them. Our solution is decentralized to eliminate excessive bandwidth usage and at the same time has extended the capabilities of the Simple Network Management Protocol (SNMP). Our solution is fully compatible with the existing standards.

Location management and routing in urban vehicular ad hoc networks

In recent years, urban vehicular ad hoc networks (VANETs) are gaining importance for inter-vehicle communication, because they allow for the local communication between vehicles without any infrastructure, configuration effort, and without expensive cellular networks. But such architecture may increase the complexity of routing since there is no central control system in urban VANETs. Therefore, a challenging research task is to improve urban VANETs' routing efficiency. ^ Hence, in this dissertation we propose two location-based routing protocols and a location management protocol to facilitate location-based routing in urban VANETs. The Multi-hop Routing Protocol (MURU) is proposed to make use of predicted mobility and geometry map in urban VANETs to estimate a path's life time and set up robust end-to-end routing paths. The Light-weight Routing Protocol (LIRU) is proposed to take advantage of the node diversity under dynamic channel condition to exploit opportunistic forwarding to achieve efficient data delivery. A scalable location management protocol (MALM) is also proposed to support location-based routing protocols in urban VANETs. MALM uses high mobility in VANETs to help disseminate vehicles' historical location information, and a vehicle is able to implement Kalman-filter based predicted to predict another vehicle's current location based on its historical location information. ^

An approach for design and analysis of User-centric Communication Middleware

Today, the development of domain-specific communication applications is both time-consuming and error-prone because the low-level communication services provided by the existing systems and networks are primitive and often heterogeneous. Multimedia communication applications are typically built on top of low-level network abstractions such as TCP/UDP socket, SIP (Session Initiation Protocol) and RTP (Real-time Transport Protocol) APIs. The User-centric Communication Middleware (UCM) is proposed to encapsulate the networking complexity and heterogeneity of basic multimedia and multi-party communication for upper-layer communication applications. And UCM provides a unified user-centric communication service to diverse communication applications ranging from a simple phone call and video conferencing to specialized communication applications like disaster management and telemedicine. It makes it easier to the development of domain-specific communication applications. The UCM abstraction and API is proposed to achieve these goals. The dissertation also tries to integrate the formal method into UCM development process. The formal model is created for UCM using SAM methodology. Some design errors are found during model creation because the formal method forces to give the precise description of UCM. By using the SAM tool, formal UCM model is translated to Promela formula model. In the dissertation, some system properties are defined as temporal logic formulas. These temporal logic formulas are manually translated to promela formulas which are individually integrated with promela formula model of UCM and verified using SPIN tool. Formal analysis used here helps verify the system properties (for example multiparty multimedia protocol) and dig out the bugs of systems.

A domain specific modeling approach for coordinating user-centric communication services

Rapid advances in electronic communication devices and technologies have resulted in a shift in the way communication applications are being developed. These new development strategies provide abstract views of the underlying communication technologies and lead to the so-called user-centric communication applications. One user-centric communication (UCC) initiative is the Communication Virtual Machine (CVM) technology, which uses the Communication Modeling Language (CML) for modeling communication services and the CVM for realizing these services. In communication-intensive domains such as telemedicine and disaster management, there is an increasing need for user-centric communication applications that are domain-specific and that support the dynamic coordination of communication services commonly found in collaborative communication scenarios. However, UCC approaches like the CVM offer little support for the dynamic coordination of communication services resulting from inherent dependencies between individual steps of a collaboration task. Users either have to manually coordinate communication services, or reply on a process modeling technique to build customized solutions for services in a specific domain that are usually costly, rigidly defined and technology specific. ^ This dissertation proposes a domain-specific modeling approach to address this problem by extending the CVM technology with communication-specific abstractions of workflow concepts commonly found in business processes. The extension involves (1) the definition of the Workflow Communication Modeling Language (WF-CML), a superset of CML, and (2) the extension of the functionality of CVM to process communication-specific workflows. The definition of WF-CML includes the meta-model and the dynamic semantics for control constructs and concurrency. We also extended the CVM prototype to handle the modeling and realization of WF-CML models. A comparative study of the proposed approach with other workflow environments validates the claimed benefits of WF-CML and CVM.^

Medical advice, diabetes self-management, and health outcomes of a multi-ethnic population from the National Health and Nutrition Examination Survey 2007--2008

Diabetes self-management, an essential component of diabetes care, includes weight control practices and requires guidance from providers. Minorities are likely to have less access to quality health care than White non-Hispanics (WNH) (American College of Physicians-American Society of Internal Medicine, 2000). Medical advice received and understood may differ by race/ethnicity as a consequence of the patient-provider communication process; and, may affect diabetes self-management. ^ This study examined the relationships among participants’ report of: (1) medical advice given; (2) diabetes self-management, and; (3) health outcomes for Mexican-Americans (MA) and Black non-Hispanics (BNH) as compared to WNH (reference group) using data available through the National Health and Nutrition Examination Survey (NHANES) for the years 2007–2008. This study was a secondary, single point analysis. Approximately 30 datasets were merged; and, the quality and integrity was assured by analysis of frequency, range and quartiles. The subjects were extracted based on the following inclusion criteria: belonging to either the MA, BNH or WNH categories; 21 years or older; responded yes to being diagnosed with diabetes. A final sample size of 654 adults [MA (131); BNH (223); WNH (300)] was used for the analyses. The findings revealed significant statistical differences in medical advice reported given. BNH [OR = 1.83 (1.16, 2.88), p = 0.013] were more likely than WNH to report being told to reduce fat or calories. Similarly, BNH [OR = 2.84 (1.45, 5.59), p = 0.005] were more likely than WNH to report that they were told to increase their physical activity. Mexican-Americans were less likely to self-monitor their blood glucose than WNH [OR = 2.70 (1.66, 4.38), p<0.001]. There were differences among ethnicities for reporting receiving recent diabetes education. Black, non-Hispanics were twice as likely to report receiving diabetes education than WNH [OR = 2.29 (1.36, 3.85), p = 0.004]. Medical advice reported given and ethnicity/race, together, predicted several health outcomes. Having recent diabetes education increased the likelihood of performing several diabetes self-management behaviors, independent of race. ^ These findings indicate a need for patient-provider communication and care to be assessed for effectiveness and, the importance of ongoing diabetes education for persons with diabetes.^

Crisis Management in the Hospitality Industry

The authors identify several guidelines associated with effective crisis communication for the hospitality industry and explore the feasibility of these guidelines based upon the diverse resources available to hospitality organizations of all sizes

Differential Impacts of Information Technology Services in the Korean Hotel Industry: A Study of Management Perceptions

Successful introduction of information technology applications in various operations of hotel management is vital to most service firms. In recent decades, technologies of information, automation, and communication are increasingly recognized as essential components of a hotel company’s strategic plan. In this study, 62 super-deluxe hotels (5 star), deluxe hotels (4 star), and tourist hotels (3 star) in Korea are examined for differences in the impact of information technology services on guest’ satisfaction, guest convenience, and operational efficiency. The findings generally suggest that the impacts of information technology-enhanced services vary according to the category of hotels in Korea. The results of the study are expected to assist managers in the selections and implementation of information technology systems in their hotel.

Medical advice and diabetes self-management reported by Mexican-American, Black- and White-non-Hispanic adults across the United States

Background Diabetes has reached epidemic proportions in the United States, particularly among minorities, and if improperly managed can lead to medical complications and death. Healthcare providers play vital roles in communicating standards of care, which include guidance on diabetes self-management. The background of the client may play a role in the patient-provider communication process. The aim of this study was to determine the association between medical advice and diabetes self care management behaviors for a nationally representative sample of adults with diabetes. Moreover, we sought to establish whether or not race/ethnicity was a modifier for reported medical advice received and diabetes self-management behaviors. Methods We analyzed data from 654 adults aged 21 years and over with diagnosed diabetes [130 Mexican-Americans; 224 Black non-Hispanics; and, 300 White non-Hispanics] and an additional 161 with 'undiagnosed diabetes' [N = 815(171 MA, 281 BNH and 364 WNH)] who participated in the National Health and Nutrition Examination Survey (NHANES) 2007-2008. Logistic regression models were used to evaluate whether medical advice to engage in particular self-management behaviors (reduce fat or calories, increase physical activity or exercise, and control or lose weight) predicted actually engaging in the particular behavior and whether the impact of medical advice on engaging in the behavior differed by race/ethnicity. Additional analyses examined whether these relationships were maintained when other factors potentially related to engaging in diabetes self management such as participants' diabetes education, sociodemographics and physical characteristics were controlled. Sample weights were used to account for the complex sample design. Results Although medical advice to the patient is considered a standard of care for diabetes, approximately one-third of the sample reported not receiving dietary, weight management, or physical activity self-management advice. Participants who reported being given medical advice for each specific diabetes self-management behaviors were 4-8 times more likely to report performing the corresponding behaviors, independent of race. These results supported the ecological model with certain caveats. Conclusions Providing standard medical advice appears to lead to diabetes self-management behaviors as reported by adults across the United States. Moreover, it does not appear that race/ethnicity influenced reporting performance of the standard diabetes self-management behavior. Longitudinal studies evaluating patient-provider communication, medical advice and diabetes self-management behaviors are needed to clarify our findings.

Medical Advice and Diabetes Self-Management Reported by Mexican-American, Black- and White-Non-Hispanic Adults Across the United States

Background: Diabetes has reached epidemic proportions in the United States, particularly among minorities, and if improperly managed can lead to medical complications and death. Healthcare providers play vital roles in communicating standards of care, which include guidance on diabetes self-management. The background of the client may play a role in the patient-provider communication process. The aim of this study was to determine the association between medical advice and diabetes self care management behaviors for a nationally representative sample of adults with diabetes. Moreover, we sought to establish whether or not race/ethnicity was a modifier for reported medical advice received and diabetes self-management behaviors. Methods: We analyzed data from 654 adults aged 21 years and over with diagnosed diabetes [130 MexicanAmericans; 224 Black non-Hispanics; and, 300 White non-Hispanics] and an additional 161 with ‘undiagnosed diabetes’ [N = 815(171 MA, 281 BNH and 364 WNH)] who participated in the National Health and Nutrition Examination Survey (NHANES) 2007-2008. Logistic regression models were used to evaluate whether medical advice to engage in particular self-management behaviors (reduce fat or calories, increase physical activity or exercise, and control or lose weight) predicted actually engaging in the particular behavior and whether the impact of medical advice on engaging in the behavior differed by race/ethnicity. Additional analyses examined whether these relationships were maintained when other factors potentially related to engaging in diabetes self management such as participants’ diabetes education, sociodemographics and physical characteristics were controlled. Sample weights were used to account for the complex sample design. Results: Although medical advice to the patient is considered a standard of care for diabetes, approximately onethird of the sample reported not receiving dietary, weight management, or physical activity self-management advice. Participants who reported being given medical advice for each specific diabetes self-management behaviors were 4-8 times more likely to report performing the corresponding behaviors, independent of race. These results supported the ecological model with certain caveats. Conclusions: Providing standard medical advice appears to lead to diabetes self-management behaviors as reported by adults across the United States. Moreover, it does not appear that race/ethnicity influenced reporting performance of the standard diabetes self-management behavior. Longitudinal studies evaluating patient-provider communication, medical advice and diabetes self-management behaviors are needed to clarify our findings.