Reinvigorating and redesigning early intervention in psychosis services for young people in Auckland

RESUMO: Auckland tem sido pioneira na implementação de modelos de Intervenção Precoce em Psicose. No entanto, esta organização do serviço não mudou nos últimos 19 anos. Segundo os dados obtidos da utilização do serviço, no período de 1996 -2012 foram atendidos 997 doentes, que tinham um número médio de 89 contactos (IQR: 36-184), com uma duração média de 62 horas de contactos (IQR: 24-136). Estes doentes passaram um número médio de 338 dias (IQR: 93-757) em contacto com o programa. 517 doentes (52%) não necessitaram de internamento no hospital, e os que foram internados, ficaram uma mediana de 124 dias no hospital (IQR: 40-380). Os doentes asiáticos tiveram um aumento de 50% de probabilidade de serem internados no hospital. Este relatório inclui 15 recomendações para orientar as reformas para o serviço e, nomeadamente, delinear a importância de uma visão organizacional e dos seus componentes-chave. As recomendações incluem o reforço da gestão e da liderança numa estrutura de equipe mais integrada, com recursos dedicados a melhorar a consciencialização da comunidade, a educação e deteção precoce, bem como a capacidade de receber referenciações diretas. Os Indicadores Chave de Desempenho devem ser estabelecidos, mas os Exames de Estado Mental em risco, devem ser removidos. Auckland deve manter a faixa etária alvo atual. A duração do serviço deve ser aumentada para um mínimo de três anos, com a opção de aumentá-la para cinco anos. A proporção de gestor de cuidados para os doentes deve ser preconizada em 1:15, enquanto o pessoal de apoio não-clínico deve ser aumentado. Os psiquiatras devem ter uma carga de trabalho de cerca de 80 doentes por equivalente de tempo completo. Um serviço local de prestação de cuidados deve ser desenvolvido com, nomeadamente, intervenções culturais para responder às necessidades da população multicultural de Auckland. A capacidade de investigação deve ser incorporada no Serviço de Intervenção Precoce em Psicoses. Qualquer alteração deverá envolver contacto com todas as partes interessadas, e a Administração Regional de Saúde deve comprometer-se em tempo, recursos humanos e políticos para apoiar e facilitar a mudança do sistema, investindo de forma significativa para melhor servir a comunidade Auckland.----------------------------------- ABSTRACT: Auckland has been pioneering in the adoption of Early Intervention in Psychosis models but the design of the service has not changed in 19 years. In service utilisation data from 997 patients seen from 1996 -2012, patients had a median number of 89 contacts (IQR: 36-184), with a median duration of 62 hours of contact (IQR: 24-136). Patients spent a median number of 338 days (IQR: 93-757) in contact with the program. 517 patients (52%) did not require admission to hospital, and those who did spent a median of 124 days in hospital (IQR: 40-380). Asian patients had a 50% increased chance of being admitted to hospital. This report includes 15 recommendations to guide reforms to the service, including outlining the importance of vision and key components. It recommends strengthened managerial leadership and a more integrated team structure with dedicated resources for improved community awareness, education and early detection as well as the capacity to take direct referrals. Key Performance Indicators (KPIs) should be established but At Risk Mental States should be excluded. Auckland should maintain the current target age range. The duration of service should be increased to a minimum of three years, with the option to extend this to five years. The ratio of care co-ordinator to patients should be capped at 1:15 whilst non-clinical supporting staff should be increased. Psychiatrists should have a caseload of about 80 per FTE. A local Service Delivery framework should be developed, as should cultural interventions to meet the needs of the multicultural population of Auckland. Research capacity should be incorporated into the fabric of Early Intervention in Psychosis Services. Any changes should involve consultation with all stakeholders, and the DHB should commit to investing time, human and political resources to support and facilitate meaningful system change to best serve the Auckland community.

Definition, implementation and management of m.commerce apps and services

This report aims to analyse the Definition, Implementation and Management of Vodafone Portugal’s Apps and Services, so that possible ways of improvement can be suggested. To do so, Vodafone’s strategy regarding the development/ implementation of specific Apps and Services, as well as the strategy of its competitors are going to be analysed. This analysis is going to be complemented with insights from some key-persons of Vodafone’s Consumer Business Unit team in Portugal. Findings suggest that Vodafone is ahead of its competitors when it comes to developing the most innovative Apps and Services, but there is always room for improvements, especially when it comes to communication.

Contributions towards smart cities : exploring block level census data for the characterization of change in Lisbon

The interest in using information to improve the quality of living in large urban areas and its governance efficiency has been around for decades. Nevertheless, the improvements in Information and Communications Technology has sparked a new dynamic in academic research, usually under the umbrella term of Smart Cities. This concept of Smart City can probably be translated, in a simplified version, into cities that are lived, managed and developed in an information-saturated environment. While it makes perfect sense and we can easily foresee the benefits of such a concept, presently there are still several significant challenges that need to be tackled before we can materialize this vision. In this work we aim at providing a small contribution in this direction, which maximizes the relevancy of the available information resources. One of the most detailed and geographically relevant information resource available, for the study of cities, is the census, more specifically the data available at block level (Subsecção Estatística). In this work, we use Self-Organizing Maps (SOM) and the variant Geo-SOM to explore the block level data from the Portuguese census of Lisbon city, for the years of 2001 and 2011. We focus on gauging change, proposing ways that allow the comparison of the two time periods, which have two different underlying geographical bases. We proceed with the analysis of the data using different SOM variants, aiming at producing a two-fold portrait: one, of the evolution of Lisbon during the first decade of the XXI century, another, of how the census dataset and SOM’s can be used to produce an informational framework for the study of cities.

Ideation at Canon business services

Digitalisation, globalisation, and evolving customer demands are only a few of the factors that are bound to transform the business process services industry for CBS. By investigating new ways to address these imminent challenges, this thesis explores the feasibility of implementing a formal approach to ideation to complement CBS’ service innovation practice. Two workshops were therefore conducted to put theory into action by generating new service ideas in a multifunctional team. Applying both divergent and convergent ideation techniques revealed that the latter improved an idea’s novelty and creativity as opposed to the expected increase in workability and relevance. Additionally, further analysis sheds light into the potential influence of individual characteristics and group dynamics on creativity. The thesis concludes with a discussion on the organisational implications of the findings and recommendations for future research.

Community indentification in peer-t-peer collaborative consumption services

Even though collaborative consumption (CC) is gaining economic importance, research in CC is still in its infancy. Consumers’ reasons for participating have already been investigated but little research on consequences of participation has been conducted. This article examines whether interactions between customers in peer-to-peer CC services influence the willingness to coproduce service outcomes. Drawing on social exchange theory, it is proposed that this effect is mediated by consumers’ identification with the brand community. Furthermore, continuance intention in CC is introduced as a second stage moderator. In a cross-sectional study, customers of peer-to-peer accommodation sharing are surveyed. While customer-to-customer interactions were found to have a positive effect on brand community identification, brand community identification did not positively affect co-production intention. Surprisingly, the effect of brand community identification on co-production intention was negative. Moreover, continuance intention of customers did not moderate this relationship. Bearing in mind current challenges for researchers and companies, theoretical and managerial implications are discussed.

Operation modes of battery chargers for electric vehicles in the future smart grids

This paper presents an on-board bidirectional battery charger for Electric Vehicles (EVs), which operates in three different modes: Grid-to- Vehicle (G2V), Vehicle-to-Grid (V2G), and Vehicle-to-Home (V2H). Through these three operation modes, using bidirectional communications based on Information and Communication Technologies (ICT), it will be possible to exchange data between the EV driver and the future smart grids. This collaboration with the smart grids will strengthen the collective awareness systems, contributing to solve and organize issues related with energy resources and power grids. This paper presents the preliminary studies that results from a PhD work related with bidirectional battery chargers for EVs. Thus, in this paper is described the topology of the on-board bidirectional battery charger and the control algorithms for the three operation modes. To validate the topology it was developed a laboratory prototype, and were obtained experimental results for the three operation modes.

Smart platform towards batteries analysis based on internet-of-things

This paper presents a new approach of pre-defined profiles, based in different voltage and current values, to control the charging and discharging processes of batteries in order to assess their performance. This new approach was implemented in a prototype that was specially developed for such purpose. This prototype is a smart power electronics platform that allows to perform batteries analysis and to control the charging and discharging processes through a web application using pre-defined profiles. This platform was developed aiming to test different batteries technologies. Considering the relevance of the energy storage area based in batteries, especially for the batteries applied to electric mobility systems, this platform allows to perform controlled tests to the batteries, in order to analyze the batteries performance under different scenarios of operation. Besides the results obtained with the batteries, this work also intends to produce results that can contribute to an involvement in the strengthening of the Internet-of-Things.

Smart charging management for electric vehicle battery chargers

This paper proposes a smart battery charging strategy for Electric Vehicles (EVs) targeting the future smart homes. The proposed strategy consists in regulate the EV battery charging current in function of the total home current, aiming to prevent overcurrent trips in the main switch breaker. Computational and experimental results were obtained under real-time conditions to validate the proposed strategy. For such purpose was adapted a bidirectional EV battery charger prototype to operate in accordance with the aforementioned strategy. The proposed strategy was validated through experimental results obtained both in steady and transient states. The results show the correct operation of the EV battery charger even under heavy load variations.

Multifunctional converter to interface renewable energy sources and electric vehicles with the power grid in smart grids context

This paper proposes a multifunctional converter to interface renewable energy sources (e.g., solar photovoltaic panels) and electric vehicles (EVs) with the power grid in smart grids context. This multifunctional converter allows deliver energy from the solar photovoltaic panels to an EV or to the power grid, and exchange energy in bidirectional mode between the EV and the power grid. Using this multifunctional converter are not required multiple conversion stages, as occurs with the traditional solutions, where are necessary two power converters to integrate the solar photovoltaic system in the power grid and also two power converters to integrate an off-board EV battery charger in the power grid (dc-dc and dc-ac power converters in both cases). Taking into account that the energy provided (or delivered) from the power grid in each moment is function of the EV operation mode and also of the energy produced from the solar photovoltaic system, it is possible to define operation strategies and control algorithms in order to increase the energy efficiency of the global system and to improve the power quality of the electrical system. The proposed multifunctional converter allows the operation in four distinct cases: (a) Transfer of energy from the solar photovoltaic system to the power grid; (b) Transfer of energy from the solar photovoltaic system and from the EV to the power grid; (c) Transfer of energy from the solar photovoltaic system to the EV or to the power grid; (d) Transfer of energy between the EV and the power grid. Along the paper are described the system architecture and the control algorithms, and are also presented some computational simulation results for the four aforementioned cases. It is also presented a comparative analysis between the traditional and the proposed solution in terms of operation efficiency and estimated cost of implementation.

Aggregating community resources of care and assistance services for the elderly population

Changes in population age structure are a major concern and represent a priority in the agendas and policies of the developed world, which are demanding for renewed models of social and healthcare as well as assistance services to the elderly population. Studies indicate that as far as possible these types of services should desirably be provided at the user’s home, and that ICT-based solutions can have tremendous impact on the delivery of new services. This paper highlight and discusses some of the main results of a project undertaken in a Portuguese Municipality that demonstrates the potential contribution of an e-Marketplace of care and assistance services to the well-being of elderly people. Studies undertaken allowed identifying the main services that should be provided by such e-Marketplace (termed GuiMarket), the relevance that the population grant to this platform and, conversely, the fact that the Digital Divide phenomena influences the potential utilization of this project (and alike projects). The findings support that there is a strong relation between age and qualifications, and between access to ICT and the intended use of GuiMarket.

Detection of dangerous situations using a smart internet of things system

The Internet of Things (IoT) is a concept that can foster the emergence of innovative applications. In order to minimize parents’s concerns about their children’s safety, this paper presents the design of a smart Internet of Things system for identifying dangerous situations. The system will be based on real time collection and analysis of physiological signals monitored by non-invasive and non-intrusive sensors, Frequency IDentification (RFID) tags and a Global Positioning System (GPS) to determine when a child is in danger. The assumption of a state of danger is made taking into account the validation of a certain number of biometric reactions to some specific situations and according to a self-learning algorithm developed for this architecture. The results of the analysis of data collected and the location of the child will be able in real time to child’s care holders in a web application.

An automated framework for the management of P2P traffic in ISP infrastructures

Peer-to-Peer (P2P) is nowadays a widely used paradigm underpinning the deployment of several Internet services and applications. However, the management of P2P traffic aggregates is not an easy task for Internet Service Providers (ISPs). In this perspective, and considering an expectable proliferation in the use of such ap- plications, future networks require the development of smart mechanisms fostering an easier coexistence between P2P applications and ISP infrastructures. This paper aims to contribute for such research efforts presenting a framework incorporating useful mechanisms to be activated by network administrators, being also able to operate as an automated management tool dealing with P2P traffic aggregates.

Towards "green" smart materials for force and strain sensors: The case of polyaniline

Stress/strain sensors constitute a class of devices with a global ever-growing market thanks to their use in many fields of modern life. They are typically constituted by thin metal foils deposited on flexible supports. However, the low inherent resistivity and limited flexibility of their constituents make them inadequate for several applications, such as measuring large movements in robotic systems and biological tissues. As an alternative to the traditional compounds, in the present work we will show the advantages to employ a smart material, polyaniline (PANI), prepared by an innovative environmentally friendly route, for force/strain sensor applications wherein simple processing, environmental friendliness and sensitivity are particularly required.

Spousal support and satisfaction with healthcare services as moderators between psychological morbidity and adherence to diet in Type 2 Diabetes patients

Objectives: This study analyzed the moderating role of partners’ support and satisfaction with healthcare services in the relationship between psychological morbidity and adherence to diet in patients with type 2 diabetes (T2DM). Methods: Participants were 387 recently diagnosed T2DM patients that answered the following instruments: Revised Summary of Diabetes Self- Care Activities Measure, Hospital Anxiety and Depression Scales, Multidimensional Diabetes Questionnaire and Patient Satisfaction Questionnaire. Results: Partners’ positive and negative support moderated the relationship between psychological morbidity and adherence to diet. Satisfaction with healthcare services also moderated the relationship between psychological morbidity and adherence to diet. Conclusions: Intervention programs to promote adherence to diet in patients with type 2 diabetes should focus on partners’ support and patient satisfaction with healthcare services.

Gestão e instalação de redes de sensores sem fios (domótica)

Dissertação de mestrado integrado em Engenharia Eletrónica Industrial e Computadores