Procedure for the identification of population characteristics for targeting intervention services on the basis of outcome-goal priorities: Case management services for the chronic mentally ill

Although the processes involved in rational patient targeting may be obvious for certain services, for others, both the appropriate sub-populations to receive services and the procedures to be used for their identification may be unclear. This project was designed to address several research questions which arise in the attempt to deliver appropriate services to specific populations. The related difficulties are particularly evident for those interventions about which findings regarding effectiveness are conflicting. When an intervention clearly is not beneficial (or is dangerous) to a large, diverse population, consensus regarding withholding the intervention from dissemination can easily be reached. When findings are ambiguous, however, conclusions may be impossible.^ When characteristics of patients likely to benefit from an intervention are not obvious, and when the intervention is not significantly invasive or dangerous, the strategy proposed herein may be used to identify specific characteristics of sub-populations which may benefit from the intervention. The identification of these populations may be used both in further informing decisions regarding distribution of the intervention and for purposes of planning implementation of the intervention by identifying specific target populations for service delivery.^ This project explores a method for identifying such sub-populations through the use of related datasets generated from clinical trials conducted to test the effectiveness of an intervention. The method is specified in detail and tested using the example intervention of case management for outpatient treatment of populations with chronic mental illness. These analyses were applied in order to identify any characteristics which distinguish specific sub-populations who are more likely to benefit from case management service, despite conflicting findings regarding its effectiveness for the aggregate population, as reported in the body of related research. However, in addition to a limited set of characteristics associated with benefit, the findings generated, a larger set of characteristics of patients likely to experience greater improvement without intervention. ^

Sharing Human-Generated Observations by Integrating HMI and the Semantic Sensor Web

Current “Internet of Things” concepts point to a future where connected objects gather meaningful information about their environment and share it with other objects and people. In particular, objects embedding Human Machine Interaction (HMI), such as mobile devices and, increasingly, connected vehicles, home appliances, urban interactive infrastructures, etc., may not only be conceived as sources of sensor information, but, through interaction with their users, they can also produce highly valuable context-aware human-generated observations. We believe that the great promise offered by combining and sharing all of the different sources of information available can be realized through the integration of HMI and Semantic Sensor Web technologies. This paper presents a technological framework that harmonizes two of the most influential HMI and Sensor Web initiatives: the W3C’s Multimodal Architecture and Interfaces (MMI) and the Open Geospatial Consortium (OGC) Sensor Web Enablement (SWE) with its semantic extension, respectively. Although the proposed framework is general enough to be applied in a variety of connected objects integrating HMI, a particular development is presented for a connected car scenario where drivers’ observations about the traffic or their environment are shared across the Semantic Sensor Web. For implementation and evaluation purposes an on-board OSGi (Open Services Gateway Initiative) architecture was built, integrating several available HMI, Sensor Web and Semantic Web technologies. A technical performance test and a conceptual validation of the scenario with potential users are reported, with results suggesting the approach is sound

Network convergence and QoS for future multimedia services in the VISION project

The emerging use of real-time 3D-based multimedia applications imposes strict quality of service (QoS) requirements on both access and core networks. These requirements and their impact to provide end-to-end 3D videoconferencing services have been studied within the Spanish-funded VISION project, where different scenarios were implemented showing an agile stereoscopic video call that might be offered to the general public in the near future. In view of the requirements, we designed an integrated access and core converged network architecture which provides the requested QoS to end-to-end IP sessions. Novel functional blocks are proposed to control core optical networks, the functionality of the standard ones is redefined, and the signaling improved to better meet the requirements of future multimedia services. An experimental test-bed to assess the feasibility of the solution was also deployed. In such test-bed, set-up and release of end-to-end sessions meeting specific QoS requirements are shown and the impact of QoS degradation in terms of the user perceived quality degradation is quantified. In addition, scalability results show that the proposed signaling architecture is able to cope with large number of requests introducing almost negligible delay.

Estimation of Perceived Quality in Convergent Services

Triple-Play (3P) and Quadruple-Play (4P) services are being widely offered by telecommunication services providers. Such services must be able to offer equal or higher quality levels than those obtained with traditional systems, especially for the most demanding services such as broadcast IPTV. This paper presents a matrix-based model, defined in terms of service components, user perceptions, agent capabilities, performance indicators and evaluation functions, which allows to estimate the overall quality of a set of convergent services, as perceived by the users, from a set of performance and/or Quality of Service (QoS) parameters of the convergent IP transport network

End-User Development Success Factors and their Application to Composite Web Development Environments

The Future Internet is expected to be composed of a mesh of interoperable Web services accessed from all over the Web. This approach has not yet caught on since global user-service interaction is still an open issue. Successful composite applications rely on heavyweight service orchestration technologies that raise the bar far above end-user skills. The weakness lies in the abstraction of the underlying service front-end architecture rather than the infrastructure technologies themselves. In our opinion, the best approach is to offer end-to-end composition from user interface to service invocation, as well as an understandable abstraction of both building blocks and a visual composition technique. In this paper we formalize our vision with regard to the next-generation front-end Web technology that will enable integrated access to services, contents and things in the Future Internet. We present a novel reference architecture designed to empower non-technical end users to create and share their own self-service composite applications. A tool implementing this architecture has been developed as part of the European FP7 FAST Project and EzWeb Project, allowing us to validate the rationale behind our approach.

Contribution to multiuser videoconferencing systems based on cloud computing

Multi-user videoconferencing systems offer communication between more than two users, who are able to interact through their webcams, microphones and other components. The use of these systems has been increased recently due to, on the one hand, improvements in Internet access, networks of companies, universities and houses, whose available bandwidth has been increased whilst the delay in sending and receiving packets has decreased. On the other hand, the advent of Rich Internet Applications (RIA) means that a large part of web application logic and control has started to be implemented on the web browsers. This has allowed developers to create web applications with a level of complexity comparable to traditional desktop applications, running on top of the Operating Systems. More recently the use of Cloud Computing systems has improved application scalability and involves a reduction in the price of backend systems. This offers the possibility of implementing web services on the Internet with no need to spend a lot of money when deploying infrastructures and resources, both hardware and software. Nevertheless there are not many initiatives that aim to implement videoconferencing systems taking advantage of Cloud systems. This dissertation proposes a set of techniques, interfaces and algorithms for the implementation of videoconferencing systems in public and private Cloud Computing infrastructures. The mechanisms proposed here are based on the implementation of a basic videoconferencing system that runs on the web browser without any previous installation requirements. To this end, the development of this thesis starts from a RIA application with current technologies that allow users to access their webcams and microphones from the browser, and to send captured data through their Internet connections. Furthermore interfaces have been implemented to allow end users to participate in videoconferencing rooms that are managed in different Cloud provider servers. To do so this dissertation starts from the results obtained from the previous techniques and backend resources were implemented in the Cloud. A traditional videoconferencing service which was implemented in the department was modified to meet typical Cloud Computing infrastructure requirements. This allowed us to validate whether Cloud Computing public infrastructures are suitable for the traffic generated by this kind of system. This analysis focused on the network level and processing capacity and stability of the Cloud Computing systems. In order to improve this validation several other general considerations were taken in order to cover more cases, such as multimedia data processing in the Cloud, as research activity has increased in this area in recent years. The last stage of this dissertation is the design of a new methodology to implement these kinds of applications in hybrid clouds reducing the cost of videoconferencing systems. Finally, this dissertation opens up a discussion about the conclusions obtained throughout this study, resulting in useful information from the different stages of the implementation of videoconferencing systems in Cloud Computing systems. RESUMEN Los sistemas de videoconferencia multiusuario permiten la comunicación entre más de dos usuarios que pueden interactuar a través de cámaras de video, micrófonos y otros elementos. En los últimos años el uso de estos sistemas se ha visto incrementado gracias, por un lado, a la mejora de las redes de acceso en las conexiones a Internet en empresas, universidades y viviendas, que han visto un aumento del ancho de banda disponible en dichas conexiones y una disminución en el retardo experimentado por los datos enviados y recibidos. Por otro lado también ayudó la aparación de las Aplicaciones Ricas de Internet (RIA) con las que gran parte de la lógica y del control de las aplicaciones web comenzó a ejecutarse en los mismos navegadores. Esto permitió a los desarrolladores la creación de aplicaciones web cuya complejidad podía compararse con la de las tradicionales aplicaciones de escritorio, ejecutadas directamente por los sistemas operativos. Más recientemente el uso de sistemas de Cloud Computing ha mejorado la escalabilidad y el abaratamiento de los costes para sistemas de backend, ofreciendo la posibilidad de implementar servicios Web en Internet sin la necesidad de grandes desembolsos iniciales en las áreas de infraestructuras y recursos tanto hardware como software. Sin embargo no existen aún muchas iniciativas con el objetivo de realizar sistemas de videoconferencia que aprovechen las ventajas del Cloud. Esta tesis doctoral propone un conjunto de técnicas, interfaces y algoritmos para la implentación de sistemas de videoconferencia en infraestructuras tanto públicas como privadas de Cloud Computing. Las técnicas propuestas en la tesis se basan en la realización de un servicio básico de videoconferencia que se ejecuta directamente en el navegador sin la necesidad de instalar ningún tipo de aplicación de escritorio. Para ello el desarrollo de esta tesis parte de una aplicación RIA con tecnologías que hoy en día permiten acceder a la cámara y al micrófono directamente desde el navegador, y enviar los datos que capturan a través de la conexión de Internet. Además se han implementado interfaces que permiten a usuarios finales la participación en salas de videoconferencia que se ejecutan en servidores de proveedores de Cloud. Para ello se partió de los resultados obtenidos en las técnicas anteriores de ejecución de aplicaciones en el navegador y se implementaron los recursos de backend en la nube. Además se modificó un servicio ya existente implementado en el departamento para adaptarlo a los requisitos típicos de las infraestructuras de Cloud Computing. Alcanzado este punto se procedió a analizar si las infraestructuras propias de los proveedores públicos de Cloud Computing podrían soportar el tráfico generado por los sistemas que se habían adaptado. Este análisis se centró tanto a nivel de red como a nivel de capacidad de procesamiento y estabilidad de los sistemas. Para los pasos de análisis y validación de los sistemas Cloud se tomaron consideraciones más generales para abarcar casos como el procesamiento de datos multimedia en la nube, campo en el que comienza a haber bastante investigación en los últimos años. Como último paso se ideó una metodología de implementación de este tipo de aplicaciones para que fuera posible abaratar los costes de los sistemas de videoconferencia haciendo uso de clouds híbridos. Finalmente en la tesis se abre una discusión sobre las conclusiones obtenidas a lo largo de este amplio estudio, obteniendo resultados útiles en las distintas etapas de implementación de los sistemas de videoconferencia en la nube.

Developing front-end Web 2.0 technologies to access services, content and things in the future Internet

The future Internet is expected to be composed of a mesh of interoperable web services accessible from all over the web. This approach has not yet caught on since global user?service interaction is still an open issue. This paper states one vision with regard to next-generation front-end Web 2.0 technology that will enable integrated access to services, contents and things in the future Internet. In this paper, we illustrate how front-ends that wrap traditional services and resources can be tailored to the needs of end users, converting end users into prosumers (creators and consumers of service-based applications). To do this, we propose an architecture that end users without programming skills can use to create front-ends, consult catalogues of resources tailored to their needs, easily integrate and coordinate front-ends and create composite applications to orchestrate services in their back-end. The paper includes a case study illustrating that current user-centred web development tools are at a very early stage of evolution. We provide statistical data on how the proposed architecture improves these tools. This paper is based on research conducted by the Service Front End (SFE) Open Alliance initiative.

Application of backend database contents and structure to the design of spoken dialog services

Current development platforms for designing spoken dialog services feature different kinds of strategies to help designers build, test, and deploy their applications. In general, these platforms are made up of several assistants that handle the different design stages (e.g. definition of the dialog flow, prompt and grammar definition, database connection, or to debug and test the running of the application). In spite of all the advances in this area, in general the process of designing spoken-based dialog services is a time consuming task that needs to be accelerated. In this paper we describe a complete development platform that reduces the design time by using different types of acceleration strategies based on using information from the data model structure and database contents, as well as cumulative information obtained throughout the successive steps in the design. Thanks to these accelerations, the interaction with the platform is simplified and the design is reduced, in most cases, to simple confirmations to the “proposals” that the platform automatically provides at each stage. Different kinds of proposals are available to complete the application flow such as the possibility of selecting which information slots should be requested to the user together, predefined templates for common dialogs, the most probable actions that make up each state defined in the flow, different solutions to solve specific speech-modality problems such as the presentation of the lists of retrieved results after querying the backend database. The platform also includes accelerations for creating speech grammars and prompts, and the SQL queries for accessing the database at runtime. Finally, we will describe the setup and results obtained in a simultaneous summative, subjective and objective evaluations with different designers used to test the usability of the proposed accelerations as well as their contribution to reducing the design time and interaction.

End-User-Oriented Telco Mashups: The OMELETTE Approach

With the success of Web 2.0 we are witnessing a growing number of services and APIs exposed by Telecom, IT and content providers. Targeting the Web community and, in particular, Web application developers, service providers expose capabilities of their infrastructures and applications in order to open new markets and to reach new customer groups. However, due to the complexity of the underlying technologies, the last step, i.e., the consumption and integration of the offered services, is a non-trivial and time-consuming task that is still a prerogative of expert developers. Although many approaches to lower the entry barriers for end users exist, little success has been achieved so far. In this paper, we introduce the OMELETTE project and show how it addresses end-user-oriented telco mashup development. We present the goals of the project, describe its contributions, summarize current results, and describe current and future work.

A novel context ontology to facilitate interoperation of semantic services in environments with wearable devices

The LifeWear-Mobilized Lifestyle with Wearables (Lifewear) project attempts to create Ambient Intelligence (AmI) ecosystems by composing personalized services based on the user information, environmental conditions and reasoning outputs. Two of the most important benefits over traditional environments are 1) take advantage of wearable devices to get user information in a nonintrusive way and 2) integrate this information with other intelligent services and environmental sensors. This paper proposes a new ontology composed by the integration of users and services information, for semantically representing this information. Using an Enterprise Service Bus, this ontology is integrated in a semantic middleware to provide context-aware personalized and semantically annotated services, with discovery, composition and orchestration tasks. We show how these services support a real scenario proposed in the Lifewear project.

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.

An Internet of Things approach for managing smart services provided by wearable devices.

The Internet of Things (IoT) is growing at a fast pace with new devices getting connected all the time. A new emerging group of these devices are the wearable devices, and Wireless Sensor Networks are a good way to integrate them in the IoT concept and bring new experiences to the daily life activities. In this paper we present an everyday life application involving a WSN as the base of a novel context-awareness sports scenario where physiological parameters are measured and sent to the WSN by wearable devices. Applications with several hardware components introduce the problem of heterogeneity in the network. In order to integrate different hardware platforms and to introduce a service-oriented semantic middleware solution into a single application, we propose the use of an Enterprise Service Bus (ESB) as a bridge for guaranteeing interoperability and integration of the different environments, thus introducing a semantic added value needed in the world of IoT-based systems. This approach places all the data acquired (e.g., via Internet data access) at application developers disposal, opening the system to new user applications. The user can then access the data through a wide variety of devices (smartphones, tablets, computers) and Operating Systems (Android, iOS, Windows, Linux, etc.).

Analysis, monitoring, and management of quality of experience in video delivery services over IP

Esta tesis estudia la monitorización y gestión de la Calidad de Experiencia (QoE) en los servicios de distribución de vídeo sobre IP. Aborda el problema de cómo prevenir, detectar, medir y reaccionar a las degradaciones de la QoE desde la perspectiva de un proveedor de servicios: la solución debe ser escalable para una red IP extensa que entregue flujos individuales a miles de usuarios simultáneamente. La solución de monitorización propuesta se ha denominado QuEM(Qualitative Experience Monitoring, o Monitorización Cualitativa de la Experiencia). Se basa en la detección de las degradaciones de la calidad de servicio de red (pérdidas de paquetes, disminuciones abruptas del ancho de banda...) e inferir de cada una una descripción cualitativa de su efecto en la Calidad de Experiencia percibida (silencios, defectos en el vídeo...). Este análisis se apoya en la información de transporte y de la capa de abstracción de red de los flujos codificados, y permite caracterizar los defectos más relevantes que se observan en este tipo de servicios: congelaciones, efecto de “cuadros”, silencios, pérdida de calidad del vídeo, retardos e interrupciones en el servicio. Los resultados se han validado mediante pruebas de calidad subjetiva. La metodología usada en esas pruebas se ha desarrollado a su vez para imitar lo más posible las condiciones de visualización de un usuario de este tipo de servicios: los defectos que se evalúan se introducen de forma aleatoria en medio de una secuencia de vídeo continua. Se han propuesto también algunas aplicaciones basadas en la solución de monitorización: un sistema de protección desigual frente a errores que ofrece más protección a las partes del vídeo más sensibles a pérdidas, una solución para minimizar el impacto de la interrupción de la descarga de segmentos de Streaming Adaptativo sobre HTTP, y un sistema de cifrado selectivo que encripta únicamente las partes del vídeo más sensibles. También se ha presentado una solución de cambio rápido de canal, así como el análisis de la aplicabilidad de los resultados anteriores a un escenario de vídeo en 3D. ABSTRACT This thesis proposes a comprehensive approach to the monitoring and management of Quality of Experience (QoE) in multimedia delivery services over IP. It addresses the problem of preventing, detecting, measuring, and reacting to QoE degradations, under the constraints of a service provider: the solution must scale for a wide IP network delivering individual media streams to thousands of users. The solution proposed for the monitoring is called QuEM (Qualitative Experience Monitoring). It is based on the detection of degradations in the network Quality of Service (packet losses, bandwidth drops...) and the mapping of each degradation event to a qualitative description of its effect in the perceived Quality of Experience (audio mutes, video artifacts...). This mapping is based on the analysis of the transport and Network Abstraction Layer information of the coded stream, and allows a good characterization of the most relevant defects that exist in this kind of services: screen freezing, macroblocking, audio mutes, video quality drops, delay issues, and service outages. The results have been validated by subjective quality assessment tests. The methodology used for those test has also been designed to mimic as much as possible the conditions of a real user of those services: the impairments to evaluate are introduced randomly in the middle of a continuous video stream. Based on the monitoring solution, several applications have been proposed as well: an unequal error protection system which provides higher protection to the parts of the stream which are more critical for the QoE, a solution which applies the same principles to minimize the impact of incomplete segment downloads in HTTP Adaptive Streaming, and a selective scrambling algorithm which ciphers only the most sensitive parts of the media stream. A fast channel change application is also presented, as well as a discussion about how to apply the previous results and concepts in a 3D video scenario.

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.

How much energy will your NGN consume? A model for energy consumption in next generation access networks: The case of Spain

The contribution to global energy consumption of the information and communications technology (ICT) sector has increased considerably in the last decade, along with its growing relevance to the overall economy. This trend will continue due to the seemingly ever greater use of these technologies, with broadband data traffic generated by the usage of telecommunication networks as a primary component. In fact, in response to user demand, the telecommunications industry is initiating the deployment of next generation networks (NGNs). However, energy consumption is mostly absent from the debate on these deployments, in spite of the potential impact on both expenses and sustainability. In addition, consumers are unaware of the energy impact of their choices in ultra-broadband services. This paper focuses on forecasting energy consumption in the access part of NGNs by modelling the combined effect of the deployment of two different ultra-broadband technologies (FTTH-GPON and LTE), the evolution of traffic per user, and the energy consumption in each of the networks and user devices. Conclusions are presented on the levels of energy consumption, their cost and the impact of different network design parameters. The effect of technological developments, techno-economic and policy decisions on energy consumption is highlighted. On the consumer side, practical figures and comparisons across technologies are provided. Although the paper focuses on Spain, the analysis can be extended to similar countries.