Telehealth system (e-CUIDATE) to improve quality of life in breast cancer survivors: rationale and study protocol for a randomized clinical trial.

BACKGROUND Breast cancer survivors suffer physical impairment after oncology treatment. This impairment reduces quality of life (QoL) and increase the prevalence of handicaps associated to unhealthy lifestyle (for example, decreased aerobic capacity and strength, weight gain, and fatigue). Recent work has shown that exercise adapted to individual characteristics of patients is related to improved overall and disease-free survival. Nowadays, technological support using telerehabilitation systems is a promising strategy with great advantage of a quick and efficient contact with the health professional. It is not known the role of telerehabilitation through therapeutic exercise as a support tool to implement an active lifestyle which has been shown as an effective resource to improve fitness and reduce musculoskeletal disorders of these women. METHODS / DESIGN This study will use a two-arm, assessor blinded, parallel randomized controlled trial design. People will be eligible if: their diagnosis is of stages I, II, or IIIA breast cancer; they are without chronic disease or orthopedic issues that would interfere with ability to participate in a physical activity program; they had access to the Internet and basic knowledge of computer use or living with a relative who has this knowledge; they had completed adjuvant therapy except for hormone therapy and not have a history of cancer recurrence; and they have an interest in improving lifestyle. Participants will be randomized into e-CUIDATE or usual care groups. E-CUIDATE give participants access to a range of contents: planning exercise arranged in series with breathing exercises, mobility, strength, and stretching. All of these exercises will be assigned to women in the telerehabilitation group according to perceived needs. The control group will be asked to maintain their usual routine. Study endpoints will be assessed after 8 weeks (immediate effects) and after 6 months. The primary outcome will be QoL measured by The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 version 3.0 and breast module called The European Organization for Research and Treatment of Cancer Breast Cancer-Specific Quality of Life questionnaire. The secondary outcomes: pain (algometry, Visual Analogue Scale, Brief Pain Inventory short form); body composition; physical measurement (abdominal test, handgrip strength, back muscle strength, and multiple sit-to-stand test); cardiorespiratory fitness (International Fitness Scale, 6-minute walk test, International Physical Activity Questionnaire-Short Form); fatigue (Piper Fatigue Scale and Borg Fatigue Scale); anxiety and depression (Hospital Anxiety and Depression Scale); cognitive function (Trail Making Test and Auditory Consonant Trigram); accelerometry; lymphedema; and anthropometric perimeters. DISCUSSION This study investigates the feasibility and effectiveness of a telerehabilitation system during adjuvant treatment of patients with breast cancer. If this treatment option is effective, telehealth systems could offer a choice of supportive care to cancer patients during the survivorship phase. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01801527.

A simulation-based algorithm for solving the resource-assignment problem in satellite telecommunication networks

This paper proposes an heuristic for the scheduling of capacity requests and the periodic assignment of radio resources in geostationary (GEO) satellite networks with star topology, using the Demand Assigned Multiple Access (DAMA) protocol in the link layer, and Multi-Frequency Time Division Multiple Access (MF-TDMA) and Adaptive Coding and Modulation (ACM) in the physical layer.

Impact of a telenursing service on satisfaction and health outcomes of children with inflammatory rheumatic diseases and their families: a crossover randomized trial study protocol.

BACKGROUND: Pediatric rheumatic diseases have a significant impact on children's quality of life and family functioning. Disease control and management of the symptoms are important to minimize disability and pain. Specialist clinical nurses play a key role in supporting medical teams, recognizing poor disease control and the need for treatment changes, providing a resource to patients on treatment options and access to additional support and advice, and identifying best practices to achieve optimal outcomes for patients and their families. This highlights the importance of investigating follow-up telenursing (TN) consultations with experienced, specialist clinical nurses in rheumatology to provide this support to children and their families. METHODS/DESIGN: This randomized crossover, experimental longitudinal study will compare the effects of standard care against a novel telenursing consultation on children's and family outcomes. It will examine children below 16 years old, recently diagnosed with inflammatory rheumatic diseases, who attend the pediatric rheumatology outpatient clinic of a tertiary referral hospital in western Switzerland, and one of their parents. The telenursing consultation, at least once a month, by a qualified, experienced, specialist nurse in pediatric rheumatology will consist of providing affective support, health information, and aid to decision-making. Cox's Interaction Model of Client Health Behavior serves as the theoretical framework for this study. The primary outcome measure is satisfaction and this will be assessed using mixed methods (quantitative and qualitative data). Secondary outcome measures include disease activity, quality of life, adherence to treatment, use of the telenursing service, and cost. We plan to enroll 56 children. DISCUSSION: The telenursing consultation is designed to support parents and children/adolescents during the course of the disease with regular follow-up. This project is novel because it is based on a theoretical standardized intervention, yet it allows for individualized care. We expect this trial to confirm the importance of support by a clinical specialist nurse in improving outcomes for children and adolescents with inflammatory rheumatisms. TRIAL REGISTRATION: ClinicalTrial.gov identifier: NCT01511341 (December 1st, 2012).

A Secure and Anonymous Cooperative Sensing Protocol for Cognitive Radio Networks

Spectrum is an essential resource for the provision of mobile services. In order to control and delimit its use, governmental agencies set up regulatory policies. Unfortunately, such policies have led to a deficiency of spectrum as only few frequency bands are left unlicensed, and these are used for the majority of new emerging wireless applications. One promising way to alleviate the spectrum shortage problem is adopting a spectrum sharing paradigm in which frequency bands are used opportunistically. Cognitive radio is the key technology to enable this shift of paradigm.Cognitive radio networks are self-organized systems in which devices cooperate to use those spectrum ranges that are not occupied by licensed users. They carry out spectrum sensing in order to detect vacant channels that can be used for communication. Even though spectrum sensing is an active area of research, an important issue remains unsolved: the secure authentication of sensing reports. Not providing security enables the input of false data in the system thus empowering false results. This paper presents a distributed protocol based on wireless physical layer security, symmetric cryptography and one-way functions that allows determining a final sensing decision from multiple sources in a quick and secure way, as well as it preserves users¿ privacy.

Medication incidents in primary care medicine: protocol of a study by the Swiss Federal Sentinel Reporting System.

BACKGROUND/RATIONALE: Patient safety is a major concern in healthcare systems worldwide. Although most safety research has been conducted in the inpatient setting, evidence indicates that medical errors and adverse events are a threat to patients in the primary care setting as well. Since information about the frequency and outcomes of safety incidents in primary care is required, the goals of this study are to describe the type, frequency, seasonal and regional distribution of medication incidents in primary care in Switzerland and to elucidate possible risk factors for medication incidents. Label="METHODS AND ANALYSIS" ="METHODS"/> <AbstractText STUDY DESIGN AND SETTING: We will conduct a prospective surveillance study to identify cases of medication incidents among primary care patients in Switzerland over the course of the year 2015. PARTICIPANTS: Patients undergoing drug treatment by 167 general practitioners or paediatricians reporting to the Swiss Federal Sentinel Reporting System. INCLUSION CRITERIA: Any erroneous event, as defined by the physician, related to the medication process and interfering with normal treatment course. EXCLUSION CRITERIA: Lack of treatment effect, adverse drug reactions or drug-drug or drug-disease interactions without detectable treatment error. PRIMARY OUTCOME: Medication incidents. RISK FACTORS: Age, gender, polymedication, morbidity, care dependency, hospitalisation. STATISTICAL ANALYSIS: Descriptive statistics to assess type, frequency, seasonal and regional distribution of medication incidents and logistic regression to assess their association with potential risk factors. Estimated sample size: 500 medication incidents. LIMITATIONS: We will take into account under-reporting and selective reporting among others as potential sources of bias or imprecision when interpreting the results. ETHICS AND DISSEMINATION: No formal request was necessary because of fully anonymised data. The results will be published in a peer-reviewed journal. TRIAL REGISTRATION NUMBER: NCT0229537.

The Design and Implementation of Loudspeaker Control Network Protocols

The networking and digitalization of audio equipment has created a need for control protocols. These protocols offer new services to customers and ensure that the equipment operates correctly. The control protocols used in the computer networks are not directly applicable since embedded systems have resource and cost limitations. In this master's thesis the design and implementation of new loudspeaker control network protocols are presented. The protocol stack was required to be reliable, have short response times, configure the network automatically and support the dynamic addition and removal of loudspeakers. The implemented protocol stack was also required to be as efficient and lightweight as possible because the network nodes are fairly simple and lack processing power. The protocol stack was thoroughly tested, validated and verified. The protocols were formally described using LOTOS (Language of Temporal Ordering Specifications) and verified using reachability analysis. A prototype of the loudspeaker network was built and used for testing the operation and the performance of the control protocols. The implemented control protocol stack met the design specifications and proved to be highly reliable and efficient.

Radio Resource Management across UMTS Radio Network Subsystems

UMTS (Universal Mobile Telecommunication System), esimerkkinä kolmannen sukupolven matkapuhelinjärjestelmästä pyrkii toistamaan GSM:n (Global System for Mobile Communications) menestyksen. UMTS:n kaupallinen toiminta on parhaillaan alkamassa ja ensimmäinen kaupallinen verkko on jo aloittanut toimintansa Japanissa. Tämä diplomityö antaa yleiskuvan UMTS:stä keskittyen radioverkkojärjestelmän (UMTS Terrestrial Radio Access Network,UTRAN) radioresurssien hallintaan (Radio Resource Management, RRM). Työssä kuvataan radiorajapintojen toimintaa, mutta diplomityön pääaiheena on kuitenkin radioresurssien hallinta UMTS radioaliverkkojärjestelmien ylitse. Radioresurssien hallinta pitää sisällään joukon proseduureja, jotka vaikuttavat koko UTRAN:in rakenteen lävitse. On hyvin tärkeää saavuttaa oikea toiminnallisuus hajautettujen radioresurssien hallintaan jotta voitaisiin saavuttaa paras yhteyden laatu loppukäyttäjälle. Työssä käydään yksityiskohtaisesti lävitse radioresurssien hallinnan perusperiaatteet ja joukko proseduureja. RNSAP (Radio Network Subsystem Application Part) protokollaa tarkastellaan työssä esimerkkinä protokollasta joka osallistuu radioresurssien hallintaprosessiin.

Transport Resource Management within UMTS Radio Network Subsystem

Tällä hetkellä haastavin telekommunikaatioteollisuuden tutkimus – ja kehitystoiminta on keskittynyt kolmannen sukupolven matkapuhelinjärjestelmien ympärille. Järjestelmien standardointityössä on saatu aikaiseksi ensimmäiset vakaat spesifikaatioversiot ja kaupallista toimintaa ollaan parhaillaan aloittelemassa Japanissa ja Euroopassa. Eräs kolmannen sukupolven järjestelmistä on UMTS (Universal Mobile Telecommunications System). Tämä diplomityö antaa yleiskuvan UMTS järjestelmästä ja sen eri verkkoelementtien toiminnallisuuksista. Päähuomio on kiinnitetty radioverkkojärjestelmään (UMTS Terrestrial Radio Access Network) ja erityisesti sen radioaliverkkojärjestelmään (Radio Network Subsystem), joka koostuu radioverkonohjaimesta (Radio Network Controller) ja joukosta siihen kuuluvia tukiasemia (Node B). Radioverkonohjain ja tukiasemat on yhdistetty avoimen rajapinnan kautta jota kutsutaan Iub -rajapinnaksi. Rajapinta tarjoaa radioverkonohjaimelle mahdollisuuden kontrolloida tukiasemia signalointiviestien avulla ja mahdollistaa tehokkaan ja luotettavan käyttäjätiedon siirron radioaliverkkojärjestelmän sisällä. Tämän diplomityön pääasiallinen sisältö on siirtoresurssien hallinta Iub -rajapinnan ylitse. Työssä esitellään ja selitetään siirtoverkon arkkitehtuuri. Myös kaikki Iub:ssä sijaitsevat protokollat ja toiminnalliset yksiköt jotka vaikuttavat siirtoresurssien hallintaan esitellään ja kuvataan yksityiskohtaisesti. Päähuomio on kiinnitetty sovellusprotokolliin sekä rajapinnan siirtoverkko- että radioverkkokerroksella sekä näiden protokollien väliseen vuorovaikutukseen. Kyseiset protokollat ovat Node B Application Part (NBAP) ja Access Link Control Application Part (ALCAP). Työn toteutusosassa käydään lävitse NBAP –protokollan prototyypin ja Node B Manager –toiminnallisen yksikön prototyypin implementaatio.

Adaptive Protocol Stacks for Mobile Devices

Tulevaisuudessa siirrettävät laitteet, kuten matkapuhelimet ja kämmenmikrot, pystyvät muodostamaan verkkoyhteyden käyttäen erilaisia yhteysmenetelmiä eri tilanteissa. Yhteysmenetelmillä on toisistaan poikkeavat viestintäominaisuudet mm. latenssin, kaistanleveyden, virhemäärän yms. suhteen. Langattomille yhteysmenetelmille on myös ominaista tietoliikenneyhteyden ominaisuuksien voimakas muuttuminen ympäristön suhteen. Parhaan suorituskyvyn ja käytettävyyden saavuttamiseksi, on siirrettävän laitteen pystyttävä mukautumaan käytettyyn viestintämenetelmään ja viestintäympäristössä tapahtuviin muutoksiin. Olennainen osa tietoliikenteessä ovat protokollapinot, jotka mahdollistavat tietoliikenneyhteyden järjestelmien välillä tarjoten verkkopalveluita päätelaitteen käyttäjäsovelluksille. Jotta protokollapinot pystyisivät mukautumaan tietyn viestintäympäristön ominaisuuksiin, on protokollapinon käyttäytymistä pystyttävä muuttamaan ajonaikaisesti. Perinteisesti protokollapinot ovat kuitenkin rakennettu muuttumattomiksi niin, että mukautuminen tässä laajuudessa on erittäin vaikeaa toteuttaa, ellei jopa mahdotonta. Tämä diplomityö käsittelee mukautuvien protokollapinojen rakentamista käyttäen komponenttipohjaista ohjelmistokehystä joka mahdollistaa protokollapinojen ajonaikaisen muuttamisen. Toteuttamalla esimerkkijärjestelmän, ja mittaamalla sen suorituskykyä vaihtelevassa tietoliikenneympäristössä, osoitamme, että mukautuvat protokollapinot ovat mahdollisia rakentaa ja ne tarjoavat merkittäviä etuja erityisesti tulevaisuuden siirrettävissä laitteissa.

Investigation of interface between Multimedia IP Network and Call Processing Server in 3G IP Telephony Core Network

The thesis presents an overview of third generation of IP telephony. The architecture of 3G IP Telephony and its components are described. The main goal of the thesis is to investigate the interface between the Call Processing Server and Multimedia IP Networks. The interface functionality, proposed protocol stack and a general description are presented in the thesis. To provide useful services, 3G IP Telephony requires a set of control protocols for connection establishment, capabilities exchange and conference control. The Session Initiation Protocol (SIP) and the H.323 are two protocols that meet these needs. In the thesis these two protocols are investigated and compared in terms of Complexity, Extensibility, Scalability, Services, Resource Utilization and Management.

Embedded Service Bus for Internet of Things Interoperability

Internet of Things (IoT) technologies are developing rapidly, and therefore there exist several standards of interconnection protocols and platforms. The existence of heterogeneous protocols and platforms has become a critical challenge for IoT system developers. To mitigate this challenge, few alliances and organizations have taken the initiative to build a framework that helps to integrate application silos. Some of these frameworks focus only on a specific domain like home automation. However, the resource constraints in the large proportion of connected devices make it difficult to build an interoperable system using such frameworks. Therefore, a general purpose, lightweight interoperability framework that can be used for a range of devices is required. To tackle the heterogeneous nature, this work introduces an embedded, distributed and lightweight service bus, Lightweight IoT Service bus Architecture (LISA), which fits inside the network stack of a small real-time operating system for constrained nodes. LISA provides a uniform application programming interface for an IoT system on a range of devices with variable resource constraints. It hides platform and protocol variations underneath it, thus facilitating interoperability in IoT implementations. LISA is inspired by the Network on Terminal Architecture, a service centric open architecture by Nokia Research Center. Unlike many other interoperability frameworks, LISA is designed specifically for resource constrained nodes and it provides essential features of a service bus for easy service oriented architecture implementation. The presented architecture utilizes an intermediate computing layer, a Fog layer, between the small nodes and the cloud, thereby facilitating the federation of constrained nodes into subnetworks. As a result of a modular and distributed design, the part of LISA running in the Fog layer handles the heavy lifting to assist the lightweight portion of LISA inside the resource constrained nodes. Furthermore, LISA introduces a new networking paradigm, Node Centric Networking, to route messages across protocol boundaries to facilitate interoperability. This thesis presents a concept implementation of the architecture and creates a foundation for future extension towards a comprehensive interoperability framework for IoT.

Routing protocol enhancement for handling node mobility in wireless sensor networks

In wireless sensor networks, the routing algorithms currently available assume that the sensor nodes are stationary. Therefore when mobility modulation is applied to the wireless sensor networks, most of the current routing algorithms suffer from performance degradation. The path breaks in mobile wireless networks are due to the movement of mobile nodes, node failure, channel fading and shadowing. It is desirable to deal with dynamic topology changes with optimal effort in terms of resource and channel utilization. As the nodes in wireless sensor medium make use of wireless broadcast to communicate, it is possible to make use of neighboring node information to recover from path failure. Cooperation among the neighboring nodes plays an important role in the context of routing among the mobile nodes. This paper proposes an enhancement to an existing protocol for accommodating node mobility through neighboring node information while keeping the utilization of resources to a minimum.

Routing Protocol Enhancement for handling Node Mobility in Wireless Sensor Networks

In wireless sensor networks, the routing algorithms currently available assume that the sensor nodes are stationary. Therefore when mobility modulation is applied to the wireless sensor networks, most of the current routing algorithms suffer from performance degradation. The path breaks in mobile wireless networks are due to the movement of mobile nodes, node failure, channel fading and shadowing. It is desirable to deal with dynamic topology changes with optimal effort in terms of resource and channel utilization. As the nodes in wireless sensor medium make use of wireless broadcast to communicate, it is possible to make use of neighboring node information to recover from path failure. Cooperation among the neighboring nodes plays an important role in the context of routing among the mobile nodes. This paper proposes an enhancement to an existing protocol for accommodating node mobility through neighboring node information while keeping the utilization of resources to a minimum.

Routing Protocol Enhancement for handling Node Mobility in Wireless Sensor Networks

In wireless sensor networks, the routing algorithms currently available assume that the sensor nodes are stationary. Therefore when mobility modulation is applied to the wireless sensor networks, most of the current routing algorithms suffer from performance degradation. The path breaks in mobile wireless networks are due to the movement of mobile nodes, node failure, channel fading and shadowing. It is desirable to deal with dynamic topology changes with optimal effort in terms of resource and channel utilization. As the nodes in wireless sensor medium make use of wireless broadcast to communicate, it is possible to make use of neighboring node information to recover from path failure. Cooperation among the neighboring nodes plays an important role in the context of routing among the mobile nodes. This paper proposes an enhancement to an existing protocol for accommodating node mobility through neighboring node information while keeping the utilization of resources to a minimum.