Policy-centric integration and dynamic composition of autonomic computing techniques

This paper presents innovative work in the development of policy-based autonomic computing. The core of the work is a powerful and flexible policy-expression language AGILE, which facilitates run-time adaptable policy configuration of autonomic systems. AGILE also serves as an integrating platform for other self-management technologies including signal processing, automated trend analysis and utility functions. Each of these technologies has specific advantages and applicability to different types of dynamic adaptation. The AGILE platform enables seamless interoperability of the different technologies to each perform various aspects of self-management within a single application. The various technologies are implemented as object components. Self-management behaviour is specified using the policy language semantics to bind the various components together as required. Since the policy semantics support run-time re-configuration, the self-management architecture is dynamically composable. Additional benefits include the standardisation of the application programmer interface, terminology and semantics, and only a single point of embedding is required.

A versatile policy toolkit supporting run-time policy reconfiguration

This paper describes an autonomics development tool which serves as both a powerful and flexible policy-expression language and a policy-based framework that supports the integration and dynamic composition of several autonomic computing techniques including signal processing, automated trend analysis and utility functions. Each of these technologies has specific advantages and applicability to different types of dynamic adaptation. The AGILE platform enables seamless interoperability of the different technologies to each perform various aspects of self-management within a single application. Self-management behaviour is specified using the policy language semantics to bind the various technologies together as required. Since the policy semantics support run-time re-configuration, the self-management architecture is dynamically composable. The policy language and implementation library have integrated support for self-stabilising behaviour, enabling oscillation and other forms of instability to be handled at the policy level with very little effort on the part of the application developer. Example applications are presented to illustrate the integration of different autonomics techniques, and the achievement of dynamic composition.

Social economy and economic crisis in the basque country abstract

This article examines the socio-economic evolution of the social economy sector in the Basque Country during the 2008-2014 period of economic crisis. Data have been obtained within a framework of collaboration between university, Basque Government and private sector of the social economy. The results suggest that such entities have evolved better, both in terms of number of enterprises and employment, than the general economy of the Basque Country, while the context of public policies aimed at social economy has worsened over the years. However, in economic terms (measured through the Gross Value Added generated), they have not been able to cope with the crisis in equal conditions to the general economy. The main contribution of this research lies in that, unlike similar studies, it discusses the evolution of the whole sector of the social economy, taking as reference a broad period of the current economic crisis.

Do non-native invasive fish support elevated lamprey populations?

Summary
1: Managing populations of predators and their prey to achieve conservation or resource management goals is usually technically challenging and frequently socially controversial. This is true even in the simplest ecosystems but can be made much worse when predator–prey relationships are in?uenced by complex interactions, such as biological invasions, population trends or animal movements.
2: Lough Neagh in Northern Ireland is a European stronghold for pollan Coregonus autumnalis, a coregonine ?sh and for river lampreyLampetra ?uviatilis, which feeds parasitically as an adult. Both species are of high conservation importance. Lampreys are known to consume pollan but detailed knowledge of their interactions is scant. While pollan is well known to be a landlocked species in Ireland, the life cycle of normally anadromous river lamprey in Lough Neagh has been unclear. The Lough is also a highly perturbed ecosystem, supporting several invasive, non-native ?sh species that have the potential to in?uence lamprey–pollan interactions.
3: We applied stable isotope techniques to resolve both the movement patterns of lamprey and trophic interactions in this complex community. Recognizing that stable isotope studies are often hampered by high-levels of variability and uncertainty in the systems of interest, we employed novel Bayesian mixing models, which incorporate variability and uncertainty.
4: Stable isotope analyses identi?ed troutSalmo trutta and non-native breamAbramis brama as the main items in lamprey diet. Pollan only represented a major food source for lamprey between May and July.
5: Stable isotope ratios of carbon in tissues from 71 adult lamprey showed no evidence of marine carbon sources, strongly suggesting that Lough Neagh is host to a highly unusual, nonanadromous freshwater population. This ?nding marks out the Lough’s lamprey population as of particular scienti?c interest and enhances the conservation signi?cance of this feature of the Lough.
6: Synthesis and applications.Our Bayesian isotopic mixing models illustrate an unusual pattern of animal movement, enhancing conservation interest in an already threatened population. We have also revealed a complex relationship between lamprey and their food species that is suggestive of hyperpredation, whereby non-native species may sustain high lamprey populations that may in turn be detrimental to native pollan.Long-term conservation of lamprey and pollan in this system is likely to require management intervention, but in light of this exceptional complexity, no simple management options are currently supported. Conservation plans will require better characterization ofpopulation-level interactions and simulation modelling of interventions. More generally, our study demonstrates the importance of considering a full range of possible trophic interactions, particularly in complex ecosystems, and highlights Bayesian isotopic mixing models as powerful tools in resolving trophic relationships.
Key-words: Bayesian, conservation dilemma, Coregonus autumnalis, hyperpredation, Lampetra ?uviatilis, pollan, potamodromous, River lamprey, stable isotope analysis in R, stable isotope

Psychological adjustment to Type 2 Diabetes and relationship quality

Aims To examine the associations between psychological adjustment to Type 2 diabetes and the reported quality and type of relationships with partners. Methods All participants (n = 88) completed a number of questionnaires, including twomeasures of relationship quality: the Dyadic Adjustment Scale and the PersonalAssessment of Intimacy inRelationships Scale, theDiabetesQuality of Life Scale and the ATT-19 (which assesses personal integration of diabetes). Additionally, HbA1c levels were obtained from medical notes. Results Measures of relationship quality significantly contributed to the explanation of two outcomes: personal integration of diabetes and satisfaction with the burden of self-management behaviours. More specifically, the findings demonstrate that a specific aspect of relationship quality—intimacy in recreational activities—is positively associated with the outcomesmentioned above. Conclusions People with Type 2 diabetes who are not taking insulin, who share engagement in physical activities with their partner are more likely to be psychologically well-adjusted to their diagnosis of diabetes.

Condition Assessment and Preservation of Open-Air Rock Art Panels During Climate Change

Thousands of Neolithic and Bronze Age open-air rock art panels exist across the countryside in northern England. However, desecration, pollution, and other factors are threatening the survival of these iconic stone monuments. Evidence suggest that rates of panel deterioration may be increasing, although it is not clear whether this is due to local factors or wider environmental influences accelerated by environmental change. To examine this question, 18 rock art panels with varied art motifs were studied at two major panel locations at Lordenshaw and Weetwood Moor in Northumberland. A condition assessment
tool was used to first quantify the level of deterioration of each panel (called “staging”). Stage estimates then were compared statistically with 27 geochemical and physical descriptors of local environments, such as soil moisture, salinity, pH, lichen coverage, soil anions and cation levels, and panel orientation, slope, and standing height. In parallel, climate modelling was performed using UKCP09 to assess how projected climatic conditions (to 2099) might affect the environmental descriptors most correlated with elevated stone deterioration. Only two descriptors significantly correlated (P < 0.05) with increased stage: the standing height of the panel and the exchangeable cation content of the local soils, although moisture conditions also were potentially influential at some panels. Climate modelling predicts warming temperatures, more seasonally variable precipitation, and increased wind speeds, which hint stone deterioration could accelerate in the future due to increased physiochemical weathering. We recommend key panels be targeted for immediate management intervention, focusing on reducing wind exposures, improving site drainage, and potentially immobilizing soil salts.

Living with and beyond cancer: the role of Holistic Needs Assessment and care planning.

Due to earlier diagnosis and more effective treatment, increasing numbers of people can be expected to live with and beyond cancer. Yet for many, survival might be characterised by physical and psychological morbidity, decreased functional status and disability, which may increase as the length of time from the completion of treatment extends. However, careful integrated assessment and relevant and acceptable care planning can mitigate these effects; people can be helped and supported in self-management and ultimately enabled to live full and productive lives in a manner that is acceptable to them.

Understanding the practice nurse’s role in the cancer care tapestry

Background: The are currently 2 million people in the UK living with or
after cancer, and this number is expected to double by 2030 (Maddams et
al, 2012). However, many report unmet physical and psychological needs.

Aim: To determine the learning needs of practice nurses to take on an
enhanced role with people affected by cancer, particularly after primary
treatment, and to develop a course to meet these needs.

Method: The Macmillan Steering Group designed and developed a course for practice
nurses to identify their learning needs, enabling participating practice
nurses to work collaboratively with each other and the course facilitator.
There was strong patient involvement throughout. The course was
evaluated by self-assessment of knowledge, skills and confidence, patient
satisfaction questionnaires and in-depth, qualitative telephone interviews
with the participants and their supporting GPs.

Results: The practice nurses reported changed practice, with increased confidence in discussing
issues relating to cancer and its treatment with patients and relatives.
They understood the importance of supported self-management and were
able to signpost patients to appropriate sources of information and
support. Many of the practice nurses started initiating and undertaking
Cancer Care Reviews, both as planned appointments and opportunistically.
Over the past year, a further nine pilots have been completed throughout
the UK, demonstrating that these results are reproducible in other settings.

Conclusions: With appropriate support and training and protected time
to include cancer care into their everyday work, practice nurses can take
on an important role in the support and care of people affected by cancer

“If I Were Nick”: Men’s Responses to an Interactive Video Drama Series to Support Smoking Cessation

Background: Men continue to smoke in greater numbers than women; however, few interventions have been developed and tested to support men’s cessation. Men also tend to rely on quitting strategies associated with stereotypical manliness, such as willpower, stoicism and independence, but may lack the self‐efficacy skills required to sustain a quit. In this article we describe the development of and reception to an interactive video drama (IVD) series, composed of 7 brief scenarios, to support and strengthen men’s smoking cessation efforts. The value of IVD in health promotion is predicated on the evidence that viewers engage with the material when they are presented characters with whom they can personally identify. The video dramatizes the challenges unfolding in the life of the main character, Nick, on the first day of his quit and models the skills necessary to embark upon a sustainable quit. 
Objective: The objective was to describe men’s responses to the If I were Nick IVD series as part of a pilot study of QuitNow MenTM, an innovative smoking cessation website designed for men. Specific objectives were to explore the resonance of the main character of the IVD series with end‐users, and men’s perceptions of the effectiveness of the IVD series for supporting their quit self‐management. 
Methods: Seven brief IVD scenarios were developed, filmed with a professional actor and uploaded to a new online smoking cessation website, QuitNow MenTM.  A sample of 117 men who smoked were recruited into the study and provided baseline data prior to access to the QuitNow MenTM website for a 6 month period. During this time, 47 men chose to view the IVDs. Their responses to questions about the IVDs were collected in 3‐month and 6‐month online follow‐up surveys and analyzed using descriptive statistics. 
Findings: The majority of participants indicated they related to the main character, Nick. Participants who “strongly agreed” they could relate to Nick perceived significantly higher levels of support from the IVDs than the “neutral” and “disagree” groups (P <.001, d =2.0, P <.001 d =3.1). The “agree” and “neutral” groups were significantly higher on rated support from the videos than the “disagree” (P <.001 d =2.2, P =.01 d = 1.5). Participants’ perception of the main character was independent of participant age, education attainment or previous quit attempts. 
Conclusions: The findings suggest that IVD interventions may be an important addition to men’s smoking cessation programs. Given that the use of IVD scenarios in health promotion is in its infancy, the positive outcomes from this pilot study signal the potential for IVD and warrant ongoing evaluation in smoking cessation and, more generally, men’s health promotion.  

Seamless integration of heterogeneous networks in multicast environments

Nowadays, communication environments are already characterized by a myriad of competing and complementary technologies that aim to provide an ubiquitous connectivity service. Next Generation Networks need to hide this heterogeneity by providing a new abstraction level, while simultaneously be aware of the underlying technologies to deliver richer service experiences to the end-user. Moreover, the increasing interest for group-based multimedia services followed by their ever growing resource demands and network dynamics, has been boosting the research towards more scalable and exible network control approaches. The work developed in this Thesis enables such abstraction and exploits the prevailing heterogeneity in favor of a context-aware network management and adaptation. In this scope, we introduce a novel hierarchical control framework with self-management capabilities that enables the concept of Abstract Multiparty Trees (AMTs) to ease the control of multiparty content distribution throughout heterogeneous networks. A thorough evaluation of the proposed multiparty transport control framework was performed in the scope of this Thesis, assessing its bene ts in terms of network selection, delivery tree recon guration and resource savings. Moreover, we developed an analytical study to highlight the scalability of the AMT concept as well as its exibility in large scale networks and group sizes. To prove the feasibility and easy deployment characteristic of the proposed control framework, we implemented a proof-of-concept demonstrator that comprehends the main control procedures conceptually introduced. Its outcomes highlight a good performance of the multiparty content distribution tree control, including its local and global recon guration. In order to endow the AMT concept with the ability to guarantee the best service experience by the end-user, we integrate in the control framework two additional QoE enhancement approaches. The rst employs the concept of Network Coding to improve the robustness of the multiparty content delivery, aiming at mitigating the impact of possible packet losses in the end-user service perception. The second approach relies on a machine learning scheme to autonomously determine at each node the expected QoE towards a certain destination. This knowledge is then used by di erent QoE-aware network management schemes that, jointly, maximize the overall users' QoE. The performance and scalability of the control procedures developed, aided by the context and QoE-aware mechanisms, show the advantages of the AMT concept and the proposed hierarchical control strategy for the multiparty content distribution with enhanced service experience. Moreover we also prove the feasibility of the solution in a practical environment, and provide future research directions that bene t the evolved control framework and make it commercially feasible.

O efeito das ações de educação na doença pulmonar obstrutiva crónica nos recursos de saúde, exacerbações e na autoeficácia: revisão sistemática

Introdução: A doença pulmonar obstrutiva crónica (DPOC) é considerada uma das principais causas de morbilidade e mortalidade em todo o mundo, atingindo substancialmente o contexto económico e social. As ações de educação permitem capacitar o doente na gestão e controlo da sua doença, no desenvolvimento do empowerment e na aquisição de estratégias para melhorar os vários outcomes da doença crónica. Têm sido propostas como medidas para limitar a crescente carga e custos de saúde. Contudo, ainda se encontra incerta a sua eficácia nesta patologia. Objetivo: Analisar as implicações das ações educativas de self-management sobre a DPOC, nomeadamente ao nível da recorrência aos serviços de saúde, nas exacerbações, na autoeficácia e na medicação. Métodos: Estudos controlados e randomizados, escritos em inglês, que incluíram ações de educação de selfmanagement foram pesquisados em bases de dados MEDLINE, CINAHL, ScienceDirect. Outcomes analisados: número de exacerbações, recorrência aos serviços de saúde, autoeficácia e conhecimento da DPOC, recurso a antibiótico e/ou corticosteróides. Resultados: 12 artigos foram incluídos na revisão sistemática. O período de intervenção variou entre 3 a 18 meses e o número de participantes randomizados de 40 a 743. Foi observada uma diminuição da recorrência aos serviços de saúde e no aumento da autoeficácia e conhecimento da DPOC. Não foram observadas alterações na frequência de exacerbações nem no recurso a antibióticos e/ou corticosteróides. Conclusão: A implementação de ações de educação na DPOC mostrou trazer benefícios a nível da recorrência dos serviços de saúde e na autoeficácia e conhecimento acerca da DPOC. Contudo, mais estudos controlados e randomizados rigorosos são necessários.

Tradução e validação para Portugal do Patient Activation Measure 13 : em pessoas com Diabetes Mellitus tipo 2

RESUMO - Introdução: A Diabetes Mellitus Tipo 2 (DM2) tem uma elevada prevalência em todo o mundo, com impacto significativo a nível de Saúde Pública, na vida dos doentes e nos custos que lhe são associados. O Patiente Activation Measure 13 (PAM13) é um questionário que possibilita a avaliação das crenças, conhecimentos, motivação e capacidades de uma pessoa em relação à sua saúde; pelo que a sua utilização na DM2 é pertinente. Objetivos: Traduzir o PAM 13, versão curta, para Português de Portugal; Estabelecer as propriedades psicométricas da versão Portuguesa do PAM 13 (PAM13-P); Validar a PAM 13-P num grupo de pessoas com DM2. Material e métodos: O processo de tradução e adaptação cultural do questionário foi composto pelas fases: 1-Tradução, 2-Reconciliação e síntese, 3-Back translation, 4-Rever e sintetizar a Back translation, 5-Harmonização, 6-Revisão do comité de peritos, 7-Cognitive debriefing e 8-Avaliação final. Para validar o PAM13-P realizou-se um estudo observacional transversal analítico com uma amostra de conveniência, de pessoas com DM2, seguidas na Associação Protectora dos Diabéticos de Portugal. O questionário foi de autopreenchimento e foi consultado o processo clínico para obtenção da HbA1c. O tratamento estatístico foi realizado através do SPSS 21® e Winsteps v3.8.1®. Resultados e discussão: O processo de tradução e adaptação cultural foi realizado de acordo com as guidelines. Foram realizados 3 painéis de e-Delphi, com 21 participantes de áreas distintas, tendo-se obtido bons níveis de concordância. As principais modificações realizadas ao questionário foram a simplificação da linguagem e dos itens, obtendo-se as equivalências necessárias. O PAM13-P foi aplicado a 201 pessoas, sendo que a taxa de resposta foi de 83%. Na amostra analisada 57.3% eram homens. Obtiveram-se as médias de idade 67.1 anos e de duração de diabetes 17.3 anos. A média do score do PAM foi 58.5±10.1(41.8-90.5) pontos e 49,7% da amostra estava no nível 3 de ativação. Relativamente aos itens verificou-se que os itens mais difíceis foram o 13(56.1) e o 8(55.4) e o com menor dificuldade foi 4(38.5). As categorias de resposta tiveram um bom ajuste ao Modelo de Rasch. O ajustamento dos itens foi infit entre 0.779-1.177 e outfit entre 0.794-1.315. A fiabilidade dos indivíduos variou entre 0.77(real) e 0.83(modelo) e dos itens foi de 0.97 (real e modelo). O Alfa de Cronbach foi bom (α=0.82). Estas estatísticas foram semelhantes aos da validação do PAM13. Existiu uma relação entre o score do PAM e os itens de validação em 51%. Das variáveis analisadas, existia um relação do nível de ativação com a idade e com a HbA1c. Conclusões: O PAM13-P foi traduzido e adaptado culturalmente para Português e foi validado em pessoas com DM2, sendo as propriedades psicométricas boas.

An examination of outdoor experience in the development of character in young adults with Type 1 Diabetes

Connected in Motion is a not for profit organization serving young adults with Type 1 diabetes. The organization hosted outdoor and experiential Type 1 diabetes education programs in January of2009 and 2010. The weekends provided non-clinical alternative Type 1 diabetes education to the underserved population of young adults within Canada. Six women living with Type I diabetes and between the ages of 22 and 30 participated in the Winter Slipstream weekends participated in this phenomenological research study. Through semi-structured interviews and artifact-elicitation interviews, ,{ the lived experiences of the participants were examined. Data analysis indicated that the sense of community created through outdoor programming and experiential education for young adults with Type I diabetes stimulated the development of self-efficacy and participant-perceived improvement in Type 1 diabetes self-management. There was no indication that outdoor and experiential Type I diabetes education had any impact on the development of autonomy among participants. Recommendations are made to encourage the successful implementation of further alternative (non-clinical) Type 1 diabetes education programs for young adults living with Type 1 diabetes.

The meaning of multiple medication use in adults: A qualitative study

Over half of prescribed medications are not taken as prescribed, resulting in health and economic consequences. Using constructivist grounded theory, 15 interviews were conducted to develop a theory on understanding the medication adherence choices of individuals, who were between the ages of 40 to 55, were diagnosed with a chronic condition, and taking three or more medications. The results indicate that participants are engaging in self-management strategies, with massive variance in adherence behaviours. Medications are sacrificed for personal and financial reasons, resonating with feelings of fear for the person’s current situation and future. Individuals are struggling with who they have become to who they once were, which becomes related to their medications. Finally, individuals are citing the impact of their physician; citing barriers to communication and Canada’s health care system. Participants’ experiences provided an understanding of the meanings individuals associate with their medications and how this impacts their decision-making.

Argentina’s Worker-Recovered Factories : strategies and survival

Les usines récupérées par les ouvriers en Argentine sont devenues un mouvement social emblématique symbolisant l'un des aspects de la révolte sociale entourant la crise économique de 2001-2002. Les usines récupérées sont des entreprises abandonnées par leurs propriétaires originaux ou déclarées faillite, laissant derrières elles des salaires et des dettes impayés. Par conséquence, les ouvriers ont commencé à récupérer leurs usines; reprenant la production sans leurs anciens patrons, sous, et au profit de la gestion collective des ouvriers. Le mouvement est remarquable pour sa rémunération égalitaire et sa gestion horizontale. Ce travail examine la continuité des usines récupérées et ceci à travers l'évolution sociale, politique et économique du paysage de l'Argentine. Il évalue également l'impact du mouvement en tant que défi aux modes économiques de production hégémoniques et orientés vers le marché. En supposant que l'avenir du mouvement dépend de deux ensembles de facteurs, le rapport analyse les facteurs internes à travers le prisme de la théorie de mobilisation des ressources, ainsi que les facteurs externes à travers la perspective de la théorie de la structure de l'opportunité politique. Le travail conclut que la situation actuelle se trouve dans une impasse dans laquelle le mouvement a gagné l'acceptation institutionnelle, mais a échoué d'effectuer le changement structurel favorisant ses pratiques et garantissant la sécurité à long terme. Il argumente que le mouvement doit consolider certains aspects combatifs. Il doit consolider sa nouvelle identité en tant que mouvement social et forger des alliances stratégiques et tactiques tout en préservant son autonomie.