Feasibility and acceptance of electronic quality of life assessment in general practice: an implementation study

Background Patients' health related quality of life (HRQoL) has rarely been systematically monitored in general practice. Electronic tools and practice training might facilitate the routine application of HRQoL questionnaires. Thorough piloting of innovative procedures is strongly recommended before the conduction of large-scale studies. Therefore, we aimed to assess i) the feasibility and acceptance of HRQoL assessment using tablet computers in general practice, ii) the perceived practical utility of HRQoL results and iii) to identify possible barriers hindering wider application of this approach. Methods Two HRQoL questionnaires (St. George's Respiratory Questionnaire SGRQ and EORTC QLQ-C30) were electronically presented on portable tablet computers. Wireless network (WLAN) integration into practice computer systems of 14 German general practices with varying infrastructure allowed automatic data exchange and the generation of a printout or a PDF file. General practitioners (GPs) and practice assistants were trained in a 1-hour course, after which they could invite patients with chronic diseases to fill in the electronic questionnaire during their waiting time. We surveyed patients, practice assistants and GPs regarding their acceptance of this tool in semi-structured telephone interviews. The number of assessments, HRQoL results and interview responses were analysed using quantitative and qualitative methods. Results Over the course of 1 year, 523 patients filled in the electronic questionnaires (1–5 times; 664 total assessments). On average, results showed specific HRQoL impairments, e.g. with respect to fatigue, pain and sleep disturbances. The number of electronic assessments varied substantially between practices. A total of 280 patients, 27 practice assistants and 17 GPs participated in the telephone interviews. Almost all GPs (16/17 = 94%; 95% CI = 73–99%), most practice assistants (19/27 = 70%; 95% CI = 50–86%) and the majority of patients (240/280 = 86%; 95% CI = 82–91%) indicated that they would welcome the use of electronic HRQoL questionnaires in the future. GPs mentioned availability of local health services (e.g. supportive, physiotherapy) (mean: 9.4 ± 1.0 SD; scale: 1 – 10), sufficient extra time (8.9 ± 1.5) and easy interpretation of HRQoL results (8.6 ± 1.6) as the most important prerequisites for their use. They believed HRQoL assessment facilitated both communication and follow up of patients' conditions. Practice assistants emphasised that this process demonstrated an extra commitment to patient centred care; patients viewed it as a tool, which contributed to the physicians' understanding of their personal condition and circumstances. Conclusion This pilot study indicates that electronic HRQoL assessment is technically feasible in general practices. It can provide clinically significant information, which can either be used in the consultation for routine care, or for research purposes. While GPs, practice assistants and patients were generally positive about the electronic procedure, several barriers (e.g. practices' lack of time and routine in HRQoL assessment) need to be overcome to enable broader application of electronic questionnaires in every day medical practice.

Matching form with content

Successful computer-supported distance education requires that its enabling technologies are accessible and usable anywhere. They should work seamlessly inside and outside the information superhighway, wherever the target learners are located, without obtruding on the learning activity. It has long been recognised that the usability of interactive computer systems is inversely related to the visibility of the implementing technologies. Reducing the visibility of technology is especially challenging in the area of online language learning systems, which require high levels of interactivity and communication along multiple dimensions such as speaking, listening, reading and writing. In this article, the authors review the concept of invisibility as it applies to the design of interactive technologies and appliances. They describe a specialised appliance matched to the requirements for distance second language learning, and report on a successful multi-phase evaluation process, including initial field testing at a Thai open university.

Matching form with content

Successful computer-supported distance education requires that its enabling technologies are accessible and usable anywhere. They should work seamlessly inside and outside the information superhighway, wherever the target learners are located, without obtruding on the learning activity. It has long been recognised that the usability of interactive computer systems is inversely related to the visibility of the implementing technologies. Reducing the visibility of technology is especially challenging in the area of online language learning systems, which require high levels of interactivity and communication along multiple dimensions such as speaking, listening, reading and writing. In this article, the authors review the concept of invisibility as it applies to the design of interactive technologies and appliances. They describe a specialised appliance matched to the requirements for distance second language learning, and report on a successful multi-phase evaluation process, including initial field testing at a Thai open university.

Prometheus Framework for Fuzzy Information Retrieval in Semantic Spaces

This paper introduces a novel vision for further enhanced Internet of Things services. Based on a variety of data (such as location data, ontology-backed search queries, in- and outdoor conditions) the Prometheus framework is intended to support users with helpful recommendations and information preceding a search for context-aware data. Adapted from artificial intelligence concepts, Prometheus proposes user-readjusted answers on umpteen conditions. A number of potential Prometheus framework applications are illustrated. Added value and possible future studies are discussed in the conclusion.

A Web Services architecture for UMLS Knowledge Sources.

A web service is a collection of industry standards to enable reusability of services and interoperability of heterogeneous applications. The UMLS Knowledge Source (UMLSKS) Server provides remote access to the UMLSKS and related resources. We propose a Web Services Architecture that encapsulates UMLSKS-API and makes it available in distributed and heterogeneous environments. This is the first step towards intelligent and automatic UMLS services discovery and invocation by computer systems in distributed environments such as web.

Simulation of SLA-based VM-scaling algorithms for cloud-distributed applications

Cloud Computing has evolved to become an enabler for delivering access to large scale distributed applications running on managed network-connected computing systems. This makes possible hosting Distributed Enterprise Information Systems (dEISs) in cloud environments, while enforcing strict performance and quality of service requirements, defined using Service Level Agreements (SLAs). {SLAs} define the performance boundaries of distributed applications, and are enforced by a cloud management system (CMS) dynamically allocating the available computing resources to the cloud services. We present two novel VM-scaling algorithms focused on dEIS systems, which optimally detect most appropriate scaling conditions using performance-models of distributed applications derived from constant-workload benchmarks, together with SLA-specified performance constraints. We simulate the VM-scaling algorithms in a cloud simulator and compare against trace-based performance models of dEISs. We compare a total of three SLA-based VM-scaling algorithms (one using prediction mechanisms) based on a real-world application scenario involving a large variable number of users. Our results show that it is beneficial to use autoregressive predictive SLA-driven scaling algorithms in cloud management systems for guaranteeing performance invariants of distributed cloud applications, as opposed to using only reactive SLA-based VM-scaling algorithms.

Cognitive Cities: An Application for Nairobi. Text Message Participation of Slum Inhabitants to Improve Sanitary Facilities

Population growth is always increasing, and thus the concept of smart and cognitive cities is becoming more important. Developed countries are aware of and working towards needed changes in city management. However, emerging countries require the optimization of their own city management. This chapter illustrates, based on a use case, how a city in an emerging country can quickly progress using the concept of smart and cognitive cities. Nairobi, the capital of Kenya, is chosen for the test case. More than half of the population of Nairobi lives in slums with poor sanitation, and many slum inhabitants often share a single toilet, so the proper functioning and reliable maintenance of toilets are crucial. For this purpose, an approach for processing text messages based on cognitive computing (using soft computing methods) is introduced. Slum inhabitants can inform the responsible center via text messages in cases when toilets are not functioning properly. Through cognitive computer systems, the responsible center can fix the problem in a quick and efficient way by sending repair workers to the area. Focusing on the slum of Kibera, an easy-to-handle approach for slum inhabitants is presented, which can make the city more efficient, sustainable and resilient (i.e., cognitive).

De los registros a los objetos : Semántica y comportamiento de los documentos: el desafío de la Web 3.0

Se presenta un panorama y los interrogantes fundamentales de la etapa de la Web 3.0. Se analizan las características actuales de los sistemas bibliográficos estructurados con el modelo entidad-relación. Se definen los niveles conceptual, lógico y físico en los sistemas informáticos; consecuentemente se presentan las características de los FRBR y se obervan las relaciones entre obra y documento en el modelo conceptual FRBR. Se describen los FRBRoo como una interpretación con una lógica de objetos de los mismos requerimientos funcionales. Finalmente se plantean las tendencias a futuro, tales como pasar de las modelizaciones de entidad-relación a la de objetos, la explicitación con anotación semántica consistente, el mapeo de bases bibliográficas existentes y el desarrollo de ontologías para que los sistemas documentales se integren en la Web Semática

De los registros a los objetos : Semántica y comportamiento de los documentos: el desafío de la Web 3.0

Se presenta un panorama y los interrogantes fundamentales de la etapa de la Web 3.0. Se analizan las características actuales de los sistemas bibliográficos estructurados con el modelo entidad-relación. Se definen los niveles conceptual, lógico y físico en los sistemas informáticos; consecuentemente se presentan las características de los FRBR y se obervan las relaciones entre obra y documento en el modelo conceptual FRBR. Se describen los FRBRoo como una interpretación con una lógica de objetos de los mismos requerimientos funcionales. Finalmente se plantean las tendencias a futuro, tales como pasar de las modelizaciones de entidad-relación a la de objetos, la explicitación con anotación semántica consistente, el mapeo de bases bibliográficas existentes y el desarrollo de ontologías para que los sistemas documentales se integren en la Web Semática

De los registros a los objetos : Semántica y comportamiento de los documentos: el desafío de la Web 3.0

Se presenta un panorama y los interrogantes fundamentales de la etapa de la Web 3.0. Se analizan las características actuales de los sistemas bibliográficos estructurados con el modelo entidad-relación. Se definen los niveles conceptual, lógico y físico en los sistemas informáticos; consecuentemente se presentan las características de los FRBR y se obervan las relaciones entre obra y documento en el modelo conceptual FRBR. Se describen los FRBRoo como una interpretación con una lógica de objetos de los mismos requerimientos funcionales. Finalmente se plantean las tendencias a futuro, tales como pasar de las modelizaciones de entidad-relación a la de objetos, la explicitación con anotación semántica consistente, el mapeo de bases bibliográficas existentes y el desarrollo de ontologías para que los sistemas documentales se integren en la Web Semática

Using Clouds to Scale Grid Resources: An Economic Model

Infrastructure as a Service clouds are a flexible and fast way to obtain (virtual) resources as demand varies. Grids, on the other hand, are middleware platforms able to combine resources from different administrative domains for task execution. Clouds can be used by grids as providers of devices such as virtual machines, so they only use the resources they need. But this requires grids to be able to decide when to allocate and release those resources. Here we introduce and analyze by simulations an economic mechanism (a) to set resource prices and (b) resolve when to scale resources depending on the users’ demand. This system has a strong emphasis on fairness, so no user hinders the execution of other users’ tasks by getting too many resources. Our simulator is based on the well-known GridSim software for grid simulation, which we expand to simulate infrastructure clouds. The results show how the proposed system can successfully adapt the amount of allocated resources to the demand, while at the same time ensuring that resources are fairly shared among users.

Recomputation based implementation of and-or parallel prolog

We argüe that in order to exploit both Independent And- and Or-parallelism in Prolog programs there is advantage in recomputing some of the independent goals, as opposed to all their solutions being reused. We present an abstract model, called the Composition- Tree, for representing and-or parallelism in Prolog Programs. The Composition-tree closely mirrors sequential Prolog execution by recomputing some independent goals rather than fully re-using them. We also outline two environment representation techniques for And-Or parallel execution of full Prolog based on the Composition-tree model abstraction. We argüe that these techniques have advantages over earlier proposals for exploiting and-or parallelism in Prolog.

A dual-band priority assignment algorithm for dynamic QoS resource management

Future high-quality consumer electronics will contain a number of applications running in a highly dynamic environment, and their execution will need to be efficiently arbitrated by the underlying platform software. The multimedia applications that currently execute in such similar contexts face frequent run-time variations in their resource demands, originated by the greedy nature of the multimedia processing itself. Changes in resource demands are triggered by numerous reasons (e.g. a switch in the input media compression format). Such situations require real-time adaptation mechanisms to adjust the system operation to the new requirements, and this must be done seamlessly to satisfy the user experience. One solution for efficiently managing application execution is to apply quality of service resource management techniques, based on assigning and enforcing resource contracts to applications. Most resource management solutions provide temporal isolation by enforcing resource assignments and avoiding any resource overruns. However, this has a clear limitation over the cost-effective resource usage. This paper presents a simple priority assignment scheme based on uniform priority bands to allow that greedy multimedia tasks incur in safe overruns that increase resource usage and do not threaten the timely execution of non-overrunning tasks. Experimental results show that the proposed priority assignment scheme in combination with a resource accounting mechanism preserves timely multimedia execution and delivery, achieves a higher cost-effective processor usage, and guarantees the execution isolation of non-overrunning tasks.

An autonomic framework for enhancing the quality of data grid services

Data grid services have been used to deal with the increasing needs of applications in terms of data volume and throughput. The large scale, heterogeneity and dynamism of grid environments often make management and tuning of these data services very complex. Furthermore, current high-performance I/O approaches are characterized by their high complexity and specific features that usually require specialized administrator skills. Autonomic computing can help manage this complexity. The present paper describes an autonomic subsystem intended to provide self-management features aimed at efficiently reducing the I/O problem in a grid environment, thereby enhancing the quality of service (QoS) of data access and storage services in the grid. Our proposal takes into account that data produced in an I/O system is not usually immediately required. Therefore, performance improvements are related not only to current but also to any future I/O access, as the actual data access usually occurs later on. Nevertheless, the exact time of the next I/O operations is unknown. Thus, our approach proposes a long-term prediction designed to forecast the future workload of grid components. This enables the autonomic subsystem to determine the optimal data placement to improve both current and future I/O operations.

Improving Hardware Reuse through XML-based Interface Encapsulation

This work proposes an encapsulation scheme aimed at simplifying the reuse process of hardware cores. This hardware encapsulation approach has been conceived with a twofold objective. First, we look for the improvement of the reuse interface associated with the hardware core description. This is carried out in a first encapsulation level by improving the limited types and configuration options available in the conventional HDLs interface, and also providing information related to the implementation itself. Second, we have devised a more generic interface focused on describing the function avoiding details from a particular implementation, what corresponds to a second encapsulation level. This encapsulation allows the designer to define how to configure and use the design to implement a given functionality. The proposed encapsulation schemes help improving the amount of information that can be supplied with the design, and also allow to automate the process of searching, configuring and implementing diverse alternatives.