Using small area estimation and geographic information systems technology to target health services for the uninsured

The three articles that comprise this dissertation describe how small area estimation and geographic information systems (GIS) technologies can be integrated to provide useful information about the number of uninsured and where they are located. Comprehensive data about the numbers and characteristics of the uninsured are typically only available from surveys. Utilization and administrative data are poor proxies from which to develop this information. Those who cannot access services are unlikely to be fully captured, either by health care provider utilization data or by state and local administrative data. In the absence of direct measures, a well-developed estimation of the local uninsured count or rate can prove valuable when assessing the unmet health service needs of this population. However, the fact that these are “estimates” increases the chances that results will be rejected or, at best, treated with suspicion. The visual impact and spatial analysis capabilities afforded by geographic information systems (GIS) technology can strengthen the likelihood of acceptance of area estimates by those most likely to benefit from the information, including health planners and policy makers. ^ The first article describes how uninsured estimates are currently being performed in the Houston metropolitan region. It details the synthetic model used to calculate numbers and percentages of uninsured, and how the resulting estimates are integrated into a GIS. The second article compares the estimation method of the first article with one currently used by the Texas State Data Center to estimate numbers of uninsured for all Texas counties. Estimates are developed for census tracts in Harris County, using both models with the same data sets. The results are statistically compared. The third article describes a new, revised synthetic method that is being tested to provide uninsured estimates at sub-county levels for eight counties in the Houston metropolitan area. It is being designed to replicate the same categorical results provided by a current U.S. Census Bureau estimation method. The estimates calculated by this revised model are compared to the most recent U.S. Census Bureau estimates, using the same areas and population categories. ^

Houston Rescue and Restore Coalition human trafficking needs assessment

Background. Human trafficking, or "modern day slavery", is a complex public health issue that we must understand more fully before it can be effectively tackled. There have been very few empirical studies on human trafficking and estimates of global and national human trafficking victims vary widely. Free the Slaves, a non-profit organization, estimates that there are at least 27 million people in the world at any given time that can be classified as victims of human trafficking. Houston, Texas has been identified as a place where human trafficking may be more likely to exist due to its close proximity to Mexico and due to economic and population factors. Houston Rescue and Restore Coalition (HRRC) is a local organization that exists to raise awareness of human trafficking in Houston, Texas. To better serve victims of human trafficking, HRRC commissioned a community assessment of the services available to victims of human trafficking in the greater Houston metropolitan area.^ Purpose. The current study assessed the capacity of organizations and agencies within the greater Houston metropolitan area to deal with human trafficking issues; in particular, knowledge regarding human trafficking issues among these organizations and agencies was evaluated.^ Methods. A cross-sectional study design was used to conduct surveys with key informants/stakeholders from organizations and agencies within the greater Houston metropolitan area. The survey instrument included 41 items in three parts, and consisted of multiple choice questions, open-ended essay questions, and closed-ended 5 point Likert questions.^ Results. The findings from this study indicate that efforts must be made to increase comprehensive awareness of the issue of human trafficking, including the federal and state laws that have been enacted to combat this problem. The data also indicate that there are limited services provided to human trafficking victims within the greater Houston metropolitan area.^ Conclusion. The results of the survey will provide Houston Rescue and Restore Coalition with information that will assist them in targeting their efforts to combat human trafficking in Houston, Texas.^

PREPAID MENTAL HEALTH SERVICES: A NATIONAL PERSPECTIVE

The purpose of this 1982 national survey of all operational prepaid health plans, or PHPs (including health maintenance organizations), was to provide information on the current coverage of PHP mental health and substance abuse services, benefits and service provision, general and mental health organization characteristics, mental health service costs, and physical and mental health service utilization.^ Two survey instruments were designed, pretested and distributed to all operational PHPs throughout the United States. A total of 237 PHPs were surveyed, of which 205 (86.50 percent) completed and returned both questionnaires.^ One result of the rapid growth in the PHP field over the past ten years has been the expansion in both the number of PHPs as well as the organizational characteristics of these PHPs. However, little attention in the research literature has been given to the application of empirical results to the PHP arrangements. This project has attempted to contribute to current knowledge regarding prepaid mental health services from a national perspective, and explore, on a preliminary descriptive basis, the variety of potential service delivery arrangements for physical and mental health services (total services) and for mental health services.^ The study emphasized that PHPs must continue to monitor the costs and utilization of mental health services, particularly in light of the apparent elimination of data collection and statistical summary responsibilities within the federal government regarding PHP activities as well as the proposed legislation to eliminate mandated mental health and substance abuse services from basic health plan benefits for federally qualified PHPs. ^

Practice and attitude differences in physician cigarette use: A study of prevalence, physicians' role, and smoking policy awareness in Dubai, UAE

The use of tobacco products ruins the health of millions of people around the world. On average, tobacco users die nearly seven years earlier than non-tobacco users. n1 Cigarette smoking is a particular concern in the developing countries of the Middle East and Gulf Cooperation Council (GCC) region where smoking prevalence is expected to increase. This is due to the tobacco industry's vigorous commercial and marketing activities. n3 Smoking prevalence among physicians is considered to be an effective indicator of a society's readiness to identify the smoking epidemic and its related health diseases. n4 There is a lack of detailed data on the smoking prevalence among healthcare professionals, particularly physicians, in the United Arab Emirates (UAE). This cross sectional study is the first to address smoking practices among physicians working at the Department of Health and Medical Services (DOHMS); in Dubai, UAE. ^ This study describes the cigarette smoking prevalence among DOHMS Physicians, physician attitudes towards tobacco use and tobacco bans; physician attitudes towards smoking cessation techniques (among smokers and non-smokers); and physician awareness of official anti-smoking policies. Data for the study was collected through the use of an adapted WHO standardized questionnaire, the Global Health Professionals Survey. The questionnaire was administered by the researcher to physicians (n=288) at their work place. Date was analyzed using the SPSS analytic software program. ^ Twelve percent of DOHMS physicians smoked cigarettes. Regardless of smoking status, the majority supported a tobacco ban in hospitals and public places, and a ban on tobacco advertising. There is a significant relationship between physician smoking status and discussing risks of tobacco use (p < 0.05). Non-smoking physicians reported spending more time with patients discussing hazards of smoking (p < 0.01). Non-smokers reported providing more counseling than their smoking colleagues. The majority of DOHMS physicians (63%) reported a lack of knowledge about 5As/ 5Rs. The majority of physicians also reported they are aware of hospital smoking policies that restrict smoking. Regardless of physician smoking status, DOHMS physicians are not very actively involved in smoking cessation activities. This cross sectional study is the first to address smoking programs, policies, and practices among physicians in Dubai, UAE. Findings support the need for increased physical smoking cessation training as well as the development of smoking cessation programs for tobacco control, and programs with a focus on physician participation in reducing tobacco and cigarette use among the general population.^

Increasing awareness of colorectal cancer screening through targeted exam room based video messages

Colorectal cancer (CRC) is the third largest cause of cancer death in the United States. While the disease burden is high, there are proven methods to screen for CRC and detect it at a stage that is amenable to cure. Patients with low health literacy have difficulty navigating the health care system and are at increased risk to not receive preventive care services such as colorectal cancer screening (CRCS). To address this need, an exam-room based video was developed to be played for patients in the privacy of the exam room, while they are waiting to be seen by their medical provider. In roughly 2 minutes, the video informs the patient about CRC and CRCS and how they can successfully complete CRCS. One of the key barriers to completing CRCS is the need to increase patients' knowledge and improve attitudes surrounding CRCS. This study examines the impact of the video on patients' knowledge and attitudes about CRC and CRCS in a medically underserved patient population in Houston, Texas. ^ Sixty-one patients presenting for routine medical care were enrolled in the study. Depending on their randomization, the patients either received routine information about CRC and CRCS or they watched the video. We found that the patients who did watch the video did have improvements in their knowledge and improved attitudes about CRC and CRCS. Future studies will be needed to examine whether the video improves the patients' completion of CRCS.^

Systematic review of current trends of cardiovascular disease (CVD) and association between health insurance coverage and CVD mortality among women aged 60--65 in Texas in 2000--2011

Cardiovascular disease (CVD) is highly preventable, yet it is a leading cause of death among women in Texas. The primary goals of this research were to examine past and current trends of CVD, as well as identify whether there is an association between the insurance coverage and mortality from CVD among women aged 60–65 in Texas between 2000 and 2011. ^ The systematic review of the research is based on the guidelines and recommendations set by the Centre for Reviews and Dissemination for conducting reviews in health care. Over 47 citations of peer-reviewed articles from Ovid MEDLINE and PubMed databases and five websites were identified, of which 7 studies met inclusion criteria for the first systematic review to examine the trends of CVD in Texas. Ten citations of peer-reviewed articles from Ovid MEDLINE and PubMed databases and five web sites were reviewed for the second systematic review (to study the association between insurance coverage and cardiovascular health among Texas women 60–64 years of age), of which 3 studies met inclusion criteria and were included in the research. The results of the study highlighted key gaps in the existing literature and important areas for the further research, as well as determined directions for future public health CVD prevention programs in Texas. ^ Based on the conducted research, the major determinants of premature mortality among women attributed to cardiovascular disease are based on individual level characteristics, more specifically sex, age, race/ethnicity, and education. The results indicate that African American and non-Hispanic white women are more likely to have higher CVD mortality rates than Hispanic women due to higher prevalence of cardiac risk factors. The data also shows higher levels of mortality from CVD in the southeastern United States, with Texas ranking as the third state with the highest prevalence of CVD among women. According to the Texas Department of State Health Services, there are approximately 56,000 deaths caused by CVD annually in Texas, which represents about one death every ten minutes. Coronary artery disease and stroke were the causes of 31.2 percent of all female deaths in Texas in 2009, meaning that approximately 68 women die from any form of cardiac disease in Texas each day. ^ The data of the reviewed studies indicate that women' lack of health insurance was significantly associated with a higher prevalence of cardiovascular disease. The uninsured women were more likely to be unaware of their risk factors and more likely to have undiagnosed diabetes—a co-morbidity factor of CVD. One of the studies also reports strong correlation between state rates of uninsured and lower rates of preventive care. Given these strong correlations, those who were chronically uninsured were at a higher risk of mortality than the insured, due to prolonged periods of time without basic access to preventive and medical care. ^ Suggested recommendations to decrease CVD mortality rates in Texas are consistent with the existing literature and include state policy development that addresses elimination of health disparities, consideration of potential benefits of universal health coverage by the legislative policymakers, and maintenance of solid partnerships between public health agencies and hospitals to educate on, diagnose, and treat CVD among the female population in Texas. ^

To fuse or not to fuse? Assessing the case for convergent disciplines on goods and services trade

Think piece by Pierre Sauvé for the E15 Initiative on Strengthening the Global Trade System In his latest essay for the ICTSD-World Economic Forum E15 initiative on Strengthening the Global Trade and Investment System for Sustainable Development, WTI Director of External Programmes and Academic Partnerships and faculty member Pierre Sauvé explores the case for fusing the law of goods with that of services in a world of global value chains. The paper does so by directing attention to the questions of whether the current architectures of multilateral and preferential trade governance are compatible with a world of trade in tasks; whether the existing rules offer globally active firms a coherent structure for doing business in a predictable environment; whether it is feasible to redesign the structure and content of existing trade rules to align them to the reality of production fragmentation; and what steps can be envisaged to better align policy and realities in the marketplace if the prospects for restructuring appear unfavourable. The paper argues that fusing trade disciplines for goods and services is neither needed nor feasible and may actually deflect attention from a number of worthwhile policy initiatives where more realistic (if never easily secured) prospects of generic rule-making may well exist.

Generating Awareness from Collaborative Working Environment using Social Data

Nowadays, Internet is a place where social networks have reached an important impact in collaboration among people over the world in different ways. This article proposes a new paradigm for building CSCW business tools following the novel ideas provided by the social web to collaborate and generate awareness. An implementation of these concepts is described, including the components we provide to collaborate in workspaces, (such as videoconference, chat, desktop sharing, forums or temporal events), and the way we generate awareness from these complex social data structures. Figures and validation results are also presented to stress that this architecture has been defined to support awareness generation via joining current and future social data from business and social networks worlds, based on the idea of using social data stored in the cloud.

A policy-driven architecture for supporting joint degrees through e-learning services

En un mercado de educación superior cada vez más competitivo, la colaboración entre universidades es una efectiva estrategia para acceder al mercado global. El desarrollo de titulaciones conjuntas es un importante mecanismo para fortalecer las colaboraciones académicas y diversificar los conocimientos. Las titulaciones conjuntas están siendo cada vez más implementadas en las universidades de todo el mundo. En Europa, el proceso de Bolonia y el programa Erasmus, están fomentado el reconocimiento de titulaciones conjuntas y dobles y promoviendo la colaboración entre las instituciones académicas. En el imparable proceso de la globalización y convergencia educativa, el uso de sistemas de e-learning para soportar cursos tanto semipresencial como online es una tendencia en crecimiento. Dado que los sistemas de e-learning soportan una amplia variedad de cursos, es necesario encontrar una solución adecuada que permita a las universidades soportar y gestionar las titulaciones conjuntas a través de sus sistemas de e-learning en conformidad con los acuerdos de colaboración establecidos por las universidades participantes. Esta tesis doctoral abordará las siguientes preguntas de investigación: 1. ¿Qué factores deben tenerse en cuenta en la implementación y gestión de titulaciones conjuntas? 2. ¿Cómo pueden los sistemas actuales de e-learning soportar el desarrollo de titulaciones conjuntas? 3. ¿Qué otros servicios y sistemas necesitan ser adaptados por las universidades interesadas en participar en una titulación conjunta a través de sus sistemas de e-learning? La implementación de titulaciones conjuntas a través de sistemas de e-learning es compleja e implica retos técnicos, administrativos, culturales, financieros, jurídicos y de seguridad. Esta tesis doctoral propone una serie de contribuciones que pueden ayudar a resolver algunos de los retos identificados. En primer lugar se ha elaborado un modelo conceptual que incluye la información del contexto de las titulaciones conjuntas que es relevante para la implementación de estas titulaciones en los sistemas de e-learning. Después de definir el modelo conceptual, se ha propuesto una arquitectura basada en políticas para la implementación de titulaciones interinstitucionales a través de sistemas de e-learning de acuerdo a los términos estipulados en los acuerdos de colaboración que son firmados por las universidades participantes. El autor se ha centrado en el componente de gestión de flujos de trabajo de esta arquitectura. Por último y con el fin de permitir la interoperabilidad de repositorios de objetos educativos, los componentes básicos a implementar han sido identificados y validados. El uso de servicios multimedia en educación es una tendencia creciente, proporcionando servicios de e-learning que permiten mejorar la comunicación y la interacción entre profesores y alumnos. Dentro de estos servicios, nos hemos centrado en el uso de la videoconferencia y la grabación de clases como servicios adecuados para el desarrollo de cursos impartidos en escenarios de educación colaborativos. Las contribuciones han sido validadas en proyectos de investigación de ámbito nacional y europeo en los que el autor ha participado. Abstract In an increasingly competitive higher education market, collaboration between universities is an effective strategy for gaining access to the global market. The development of joint degrees is an important mechanism for strengthening academic research collaborations and diversifying knowledge. Joint degrees are becoming increasingly implemented in universities around the world. In Europe, the Bologna process and the Erasmus programme have encouraged both the global recognition of joint and double degrees and promoted close collaboration between academic institutions. In the unstoppable process of globalization and educational convergence, the use of e-learning systems for supporting both blended and online courses is becoming a growing trend. Since e-learning systems covers a wide range of courses, it becomes necessary to find a suitable solution that enables universities to support and manage joint degrees through their e-learning systems in accordance with the collaboration agreements established by the universities involved. This dissertation will address the following research questions: 1. What factors need to be considered in the implementation and management of joint degrees? 2. How can the current e-learning systems support the development of joint degrees? 3. What other services and systems need to be adapted by universities interested in participating in a joint degree through their e-learning systems? The implementation of joint degrees using e-learning systems is complex and involves technical, administrative, security, cultural, financial and legal challenges. This dissertation proposes a series of contributions to help solve some of the identified challenges. One of the cornerstones of this proposal is a conceptual model of all the relevant issues related to the support of joint degrees by means of e-learning systems. After defining the conceptual model, this dissertation proposes a policy-driven architecture for implementing inter-institutional degree collaborations through e-learning systems as stipulated by a collaboration agreement signed by two universities. The author has focused on the workflow management component of this architecture. Finally, the building blocks for achieving interoperability of learning object repositories have been identified and validated. The use of multimedia services in education is a growing trend, providing rich e-learning services that improve the communication and interaction between teachers and students. Within these e-learning services, we have focused on the use of videoconferencing and lecture recording as the best-suited services to support collaborative learning scenarios. The contributions have been validated within national and European research projects that the author has been involved in.

Explicitly Context-Aware Publish/Subscribe with Context-Invariant Subscriptions

Although context could be exploited to improve the performance, elasticity and adaptation in most distributed systems that adopt the publish/subscribe (P/S) model of communication, only very few works have explored domains with highly dynamic context, whereas most adopted models are context agnostic. In this paper, we present the key design principles underlying a novel context-aware content-based P/S (CA-CBPS) model of communication, where the context is explicitly managed, focusing on the minimization of network overhead in domains with recurrent context changes thanks to contextual scoping. We highlight how we dealt with the main shortcomings of most of the current approaches. Our research is some of the first to study the problem of explicitly introducing context-awareness into the P/S model to capitalize on contextual information. The envisioned CA-CBPS middleware enables the cloud ecosystem of services to communicate very efficiently, in a decoupled, but contextually scoped fashion.

Intelligent context-aware services based on internet of things architectures

La Internet de las Cosas (IoT), como parte de la Futura Internet, se ha convertido en la actualidad en uno de los principales temas de investigación; en parte gracias a la atención que la sociedad está poniendo en el desarrollo de determinado tipo de servicios (telemetría, generación inteligente de energía, telesanidad, etc.) y por las recientes previsiones económicas que sitúan a algunos actores, como los operadores de telecomunicaciones (que se encuentran desesperadamente buscando nuevas oportunidades), al frente empujando algunas tecnologías interrelacionadas como las comunicaciones Máquina a Máquina (M2M). En este contexto, un importante número de actividades de investigación a nivel mundial se están realizando en distintas facetas: comunicaciones de redes de sensores, procesado de información, almacenamiento de grandes cantidades de datos (big--‐data), semántica, arquitecturas de servicio, etc. Todas ellas, de forma independiente, están llegando a un nivel de madurez que permiten vislumbrar la realización de la Internet de las Cosas más que como un sueño, como una realidad tangible. Sin embargo, los servicios anteriormente mencionados no pueden esperar a desarrollarse hasta que las actividades de investigación obtengan soluciones holísticas completas. Es importante proporcionar resultados intermedios que eviten soluciones verticales realizadas para desarrollos particulares. En este trabajo, nos hemos focalizado en la creación de una plataforma de servicios que pretende facilitar, por una parte la integración de redes de sensores y actuadores heterogéneas y geográficamente distribuidas, y por otra lado el desarrollo de servicios horizontales utilizando dichas redes y la información que proporcionan. Este habilitador se utilizará para el desarrollo de servicios y para la experimentación en la Internet de las Cosas. Previo a la definición de la plataforma, se ha realizado un importante estudio focalizando no sólo trabajos y proyectos de investigación, sino también actividades de estandarización. Los resultados se pueden resumir en las siguientes aseveraciones: a) Los modelos de datos definidos por el grupo “Sensor Web Enablement” (SWE™) del “Open Geospatial Consortium (OGC®)” representan hoy en día la solución más completa para describir las redes de sensores y actuadores así como las observaciones. b) Las interfaces OGC, a pesar de las limitaciones que requieren cambios y extensiones, podrían ser utilizadas como las bases para acceder a sensores y datos. c) Las redes de nueva generación (NGN) ofrecen un buen sustrato que facilita la integración de redes de sensores y el desarrollo de servicios. En consecuencia, una nueva plataforma de Servicios, llamada Ubiquitous Sensor Networks (USN), se ha definido en esta Tesis tratando de contribuir a rellenar los huecos previamente mencionados. Los puntos más destacados de la plataforma USN son: a) Desde un punto de vista arquitectónico, sigue una aproximación de dos niveles (Habilitador y Gateway) similar a otros habilitadores que utilizan las NGN (como el OMA Presence). b) Los modelos de datos están basado en los estándares del OGC SWE. iv c) Está integrado en las NGN pero puede ser utilizado sin ellas utilizando infraestructuras IP abiertas. d) Las principales funciones son: Descubrimiento de sensores, Almacenamiento de observaciones, Publicacion--‐subscripcion--‐notificación, ejecución remota homogénea, seguridad, gestión de diccionarios de datos, facilidades de monitorización, utilidades de conversión de protocolos, interacciones síncronas y asíncronas, soporte para el “streaming” y arbitrado básico de recursos. Para demostrar las funcionalidades que la Plataforma USN propuesta pueden ofrecer a los futuros escenarios de la Internet de las Cosas, se presentan resultados experimentales de tres pruebas de concepto (telemetría, “Smart Places” y monitorización medioambiental) reales a pequeña escala y un estudio sobre semántica (sistema de información vehicular). Además, se está utilizando actualmente como Habilitador para desarrollar tanto experimentación como servicios reales en el proyecto Europeo SmartSantander (que aspira a integrar alrededor de 20.000 dispositivos IoT). v Abstract Internet of Things, as part of the Future Internet, has become one of the main research topics nowadays; in part thanks to the pressure the society is putting on the development of a particular kind of services (Smart metering, Smart Grids, eHealth, etc.), and by the recent business forecasts that situate some players, like Telecom Operators (which are desperately seeking for new opportunities), at the forefront pushing for some interrelated technologies like Machine--‐to--‐Machine (M2M) communications. Under this context, an important number of research activities are currently taking place worldwide at different levels: sensor network communications, information processing, big--‐ data storage, semantics, service level architectures, etc. All of them, isolated, are arriving to a level of maturity that envision the achievement of Internet of Things (IoT) more than a dream, a tangible goal. However, the aforementioned services cannot wait to be developed until the holistic research actions bring complete solutions. It is important to come out with intermediate results that avoid vertical solutions tailored for particular deployments. In the present work, we focus on the creation of a Service--‐level platform intended to facilitate, from one side the integration of heterogeneous and geographically disperse Sensors and Actuator Networks (SANs), and from the other the development of horizontal services using them and the information they provide. This enabler will be used for horizontal service development and for IoT experimentation. Prior to the definition of the platform, we have realized an important study targeting not just research works and projects, but also standardization topics. The results can be summarized in the following assertions: a) Open Geospatial Consortium (OGC®) Sensor Web Enablement (SWE™) data models today represent the most complete solution to describe SANs and observations. b) OGC interfaces, despite the limitations that require changes and extensions, could be used as the bases for accessing sensors and data. c) Next Generation Networks (NGN) offer a good substrate that facilitates the integration of SANs and the development of services. Consequently a new Service Layer platform, called Ubiquitous Sensor Networks (USN), has been defined in this Thesis trying to contribute to fill in the previous gaps. The main highlights of the proposed USN Platform are: a) From an architectural point of view, it follows a two--‐layer approach (Enabler and Gateway) similar to other enablers that run on top of NGN (like the OMA Presence). b) Data models and interfaces are based on the OGC SWE standards. c) It is integrated in NGN but it can be used without it over open IP infrastructures. d) Main functions are: Sensor Discovery, Observation Storage, Publish--‐Subscribe--‐Notify, homogeneous remote execution, security, data dictionaries handling, monitoring facilities, authorization support, protocol conversion utilities, synchronous and asynchronous interactions, streaming support and basic resource arbitration. vi In order to demonstrate the functionalities that the proposed USN Platform can offer to future IoT scenarios, some experimental results have been addressed in three real--‐life small--‐scale proofs--‐of concepts (Smart Metering, Smart Places and Environmental monitoring) and a study for semantics (in--‐vehicle information system). Furthermore we also present the current use of the proposed USN Platform as an Enabler to develop experimentation and real services in the SmartSantander EU project (that aims at integrating around 20.000 IoT devices).

Contributions to the contextualization of human-machine spoken interaction systems

The design and development of spoken interaction systems has been a thoroughly studied research scope for the last decades. The aim is to obtain systems with the ability to interact with human agents with a high degree of naturalness and efficiency, allowing them to carry out the actions they desire using speech, as it is the most natural means of communication between humans. To achieve that degree of naturalness, it is not enough to endow systems with the ability to accurately understand the user’s utterances and to properly react to them, even considering the information provided by the user in his or her previous interactions. The system has also to be aware of the evolution of the conditions under which the interaction takes place, in order to act the most coherent way as possible at each moment. Consequently, one of the most important features of the system is that it has to be context-aware. This context awareness of the system can be reflected in the modification of the behaviour of the system taking into account the current situation of the interaction. For instance, the system should decide which action it has to carry out, or the way to perform it, depending on the user that requests it, on the way that the user addresses the system, on the characteristics of the environment in which the interaction takes place, and so on. In other words, the system has to adapt its behaviour to these evolving elements of the interaction. Moreover that adaptation has to be carried out, if possible, in such a way that the user: i) does not perceive that the system has to make any additional effort, or to devote interaction time to perform tasks other than carrying out the requested actions, and ii) does not have to provide the system with any additional information to carry out the adaptation, which could imply a lesser efficiency of the interaction, since users should devote several interactions only to allow the system to become adapted. In the state-of-the-art spoken dialogue systems, researchers have proposed several disparate strategies to adapt the elements of the system to different conditions of the interaction (such as the acoustic characteristics of a specific user’s speech, the actions previously requested, and so on). Nevertheless, to our knowledge there is not any consensus on the procedures to carry out these adaptation. The approaches are to an extent unrelated from one another, in the sense that each one considers different pieces of information, and the treatment of that information is different taking into account the adaptation carried out. In this regard, the main contributions of this Thesis are the following ones: Definition of a contextualization framework. We propose a unified approach that can cover any strategy to adapt the behaviour of a dialogue system to the conditions of the interaction (i.e. the context). In our theoretical definition of the contextualization framework we consider the system’s context as all the sources of variability present at any time of the interaction, either those ones related to the environment in which the interaction takes place, or to the human agent that addresses the system at each moment. Our proposal relies on three aspects that any contextualization approach should fulfill: plasticity (i.e. the system has to be able to modify its behaviour in the most proactive way taking into account the conditions under which the interaction takes place), adaptivity (i.e. the system has also to be able to consider the most appropriate sources of information at each moment, both environmental and user- and dialogue-dependent, to effectively adapt to the conditions aforementioned), and transparency (i.e. the system has to carry out the contextualizaton-related tasks in such a way that the user neither perceives them nor has to do any effort in providing the system with any information that it needs to perform that contextualization). Additionally, we could include a generality aspect to our proposed framework: the main features of the framework should be easy to adopt in any dialogue system, regardless of the solution proposed to manage the dialogue. Once we define the theoretical basis of our contextualization framework, we propose two cases of study on its application in a spoken dialogue system. We focus on two aspects of the interaction: the contextualization of the speech recognition models, and the incorporation of user-specific information into the dialogue flow. One of the modules of a dialogue system that is more prone to be contextualized is the speech recognition system. This module makes use of several models to emit a recognition hypothesis from the user’s speech signal. Generally speaking, a recognition system considers two types of models: an acoustic one (that models each of the phonemes that the recognition system has to consider) and a linguistic one (that models the sequences of words that make sense for the system). In this work we contextualize the language model of the recognition system in such a way that it takes into account the information provided by the user in both his or her current utterance and in the previous ones. These utterances convey information useful to help the system in the recognition of the next utterance. The contextualization approach that we propose consists of a dynamic adaptation of the language model that is used by the recognition system. We carry out this adaptation by means of a linear interpolation between several models. Instead of training the best interpolation weights, we make them dependent on the conditions of the dialogue. In our approach, the system itself will obtain these weights as a function of the reliability of the different elements of information available, such as the semantic concepts extracted from the user’s utterance, the actions that he or she wants to carry out, the information provided in the previous interactions, and so on. One of the aspects more frequently addressed in Human-Computer Interaction research is the inclusion of user specific characteristics into the information structures managed by the system. The idea is to take into account the features that make each user different from the others in order to offer to each particular user different services (or the same service, but in a different way). We could consider this approach as a user-dependent contextualization of the system. In our work we propose the definition of a user model that contains all the information of each user that could be potentially useful to the system at a given moment of the interaction. In particular we will analyze the actions that each user carries out throughout his or her interaction. The objective is to determine which of these actions become the preferences of that user. We represent the specific information of each user as a feature vector. Each of the characteristics that the system will take into account has a confidence score associated. With these elements, we propose a probabilistic definition of a user preference, as the action whose likelihood of being addressed by the user is greater than the one for the rest of actions. To include the user dependent information into the dialogue flow, we modify the information structures on which the dialogue manager relies to retrieve information that could be needed to solve the actions addressed by the user. Usage preferences become another source of contextual information that will be considered by the system towards a more efficient interaction (since the new information source will help to decrease the need of the system to ask users for additional information, thus reducing the number of turns needed to carry out a specific action). To test the benefits of the contextualization framework that we propose, we carry out an evaluation of the two strategies aforementioned. We gather several performance metrics, both objective and subjective, that allow us to compare the improvements of a contextualized system against the baseline one. We will also gather the user’s opinions as regards their perceptions on the behaviour of the system, and its degree of adaptation to the specific features of each interaction. Resumen El diseño y el desarrollo de sistemas de interacción hablada ha sido objeto de profundo estudio durante las pasadas décadas. El propósito es la consecución de sistemas con la capacidad de interactuar con agentes humanos con un alto grado de eficiencia y naturalidad. De esta manera, los usuarios pueden desempeñar las tareas que deseen empleando la voz, que es el medio de comunicación más natural para los humanos. A fin de alcanzar el grado de naturalidad deseado, no basta con dotar a los sistemas de la abilidad de comprender las intervenciones de los usuarios y reaccionar a ellas de manera apropiada (teniendo en consideración, incluso, la información proporcionada en previas interacciones). Adicionalmente, el sistema ha de ser consciente de las condiciones bajo las cuales transcurre la interacción, así como de la evolución de las mismas, de tal manera que pueda actuar de la manera más coherente en cada instante de la interacción. En consecuencia, una de las características primordiales del sistema es que debe ser sensible al contexto. Esta capacidad del sistema de conocer y emplear el contexto de la interacción puede verse reflejada en la modificación de su comportamiento debida a las características actuales de la interacción. Por ejemplo, el sistema debería decidir cuál es la acción más apropiada, o la mejor manera de llevarla a término, dependiendo del usuario que la solicita, del modo en el que lo hace, etcétera. En otras palabras, el sistema ha de adaptar su comportamiento a tales elementos mutables (o dinámicos) de la interacción. Dos características adicionales son requeridas a dicha adaptación: i) el usuario no ha de percibir que el sistema dedica recursos (temporales o computacionales) a realizar tareas distintas a las que aquél le solicita, y ii) el usuario no ha de dedicar esfuerzo alguno a proporcionar al sistema información adicional para llevar a cabo la interacción. Esto último implicaría una menor eficiencia de la interacción, puesto que los usuarios deberían dedicar parte de la misma a proporcionar información al sistema para su adaptación, sin ningún beneficio inmediato. En los sistemas de diálogo hablado propuestos en la literatura, se han propuesto diferentes estrategias para llevar a cabo la adaptación de los elementos del sistema a las diferentes condiciones de la interacción (tales como las características acústicas del habla de un usuario particular, o a las acciones a las que se ha referido con anterioridad). Sin embargo, no existe una estrategia fija para proceder a dicha adaptación, sino que las mismas no suelen guardar una relación entre sí. En este sentido, cada una de ellas tiene en cuenta distintas fuentes de información, la cual es tratada de manera diferente en función de las características de la adaptación buscada. Teniendo en cuenta lo anterior, las contribuciones principales de esta Tesis son las siguientes: Definición de un marco de contextualización. Proponemos un criterio unificador que pueda cubrir cualquier estrategia de adaptación del comportamiento de un sistema de diálogo a las condiciones de la interacción (esto es, el contexto de la misma). En nuestra definición teórica del marco de contextualización consideramos el contexto del sistema como todas aquellas fuentes de variabilidad presentes en cualquier instante de la interacción, ya estén relacionadas con el entorno en el que tiene lugar la interacción, ya dependan del agente humano que se dirige al sistema en cada momento. Nuestra propuesta se basa en tres aspectos que cualquier estrategia de contextualización debería cumplir: plasticidad (es decir, el sistema ha de ser capaz de modificar su comportamiento de la manera más proactiva posible, teniendo en cuenta las condiciones en las que tiene lugar la interacción), adaptabilidad (esto es, el sistema ha de ser capaz de considerar la información oportuna en cada instante, ya dependa del entorno o del usuario, de tal manera que adecúe su comportamiento de manera eficaz a las condiciones mencionadas), y transparencia (que implica que el sistema ha de desarrollar las tareas relacionadas con la contextualización de tal manera que el usuario no perciba la manera en que dichas tareas se llevan a cabo, ni tampoco deba proporcionar al sistema con información adicional alguna). De manera adicional, incluiremos en el marco propuesto el aspecto de la generalidad: las características del marco de contextualización han de ser portables a cualquier sistema de diálogo, con independencia de la solución propuesta en los mismos para gestionar el diálogo. Una vez hemos definido las características de alto nivel de nuestro marco de contextualización, proponemos dos estrategias de aplicación del mismo a un sistema de diálogo hablado. Nos centraremos en dos aspectos de la interacción a adaptar: los modelos empleados en el reconocimiento de habla, y la incorporación de información específica de cada usuario en el flujo de diálogo. Uno de los módulos de un sistema de diálogo más susceptible de ser contextualizado es el sistema de reconocimiento de habla. Este módulo hace uso de varios modelos para generar una hipótesis de reconocimiento a partir de la señal de habla. En general, un sistema de reconocimiento emplea dos tipos de modelos: uno acústico (que modela cada uno de los fonemas considerados por el reconocedor) y uno lingüístico (que modela las secuencias de palabras que tienen sentido desde el punto de vista de la interacción). En este trabajo contextualizamos el modelo lingüístico del reconocedor de habla, de tal manera que tenga en cuenta la información proporcionada por el usuario, tanto en su intervención actual como en las previas. Estas intervenciones contienen información (semántica y/o discursiva) que puede contribuir a un mejor reconocimiento de las subsiguientes intervenciones del usuario. La estrategia de contextualización propuesta consiste en una adaptación dinámica del modelo de lenguaje empleado en el reconocedor de habla. Dicha adaptación se lleva a cabo mediante una interpolación lineal entre diferentes modelos. En lugar de entrenar los mejores pesos de interpolación, proponemos hacer los mismos dependientes de las condiciones actuales de cada diálogo. El propio sistema obtendrá estos pesos como función de la disponibilidad y relevancia de las diferentes fuentes de información disponibles, tales como los conceptos semánticos extraídos a partir de la intervención del usuario, o las acciones que el mismo desea ejecutar. Uno de los aspectos más comúnmente analizados en la investigación de la Interacción Persona-Máquina es la inclusión de las características específicas de cada usuario en las estructuras de información empleadas por el sistema. El objetivo es tener en cuenta los aspectos que diferencian a cada usuario, de tal manera que el sistema pueda ofrecer a cada uno de ellos el servicio más apropiado (o un mismo servicio, pero de la manera más adecuada a cada usuario). Podemos considerar esta estrategia como una contextualización dependiente del usuario. En este trabajo proponemos la definición de un modelo de usuario que contenga toda la información relativa a cada usuario, que pueda ser potencialmente utilizada por el sistema en un momento determinado de la interacción. En particular, analizaremos aquellas acciones que cada usuario decide ejecutar a lo largo de sus diálogos con el sistema. Nuestro objetivo es determinar cuáles de dichas acciones se convierten en las preferencias de cada usuario. La información de cada usuario quedará representada mediante un vector de características, cada una de las cuales tendrá asociado un valor de confianza. Con ambos elementos proponemos una definición probabilística de una preferencia de uso, como aquella acción cuya verosimilitud es mayor que la del resto de acciones solicitadas por el usuario. A fin de incluir la información dependiente de usuario en el flujo de diálogo, llevamos a cabo una modificación de las estructuras de información en las que se apoya el gestor de diálogo para recuperar información necesaria para resolver ciertos diálogos. En dicha modificación las preferencias de cada usuario pasarán a ser una fuente adicional de información contextual, que será tenida en cuenta por el sistema en aras de una interacción más eficiente (puesto que la nueva fuente de información contribuirá a reducir la necesidad del sistema de solicitar al usuario información adicional, dando lugar en consecuencia a una reducción del número de intervenciones necesarias para llevar a cabo una acción determinada). Para determinar los beneficios de las aplicaciones del marco de contextualización propuesto, llevamos a cabo una evaluación de un sistema de diálogo que incluye las estrategias mencionadas. Hemos recogido diversas métricas, tanto objetivas como subjetivas, que nos permiten determinar las mejoras aportadas por un sistema contextualizado en comparación con el sistema sin contextualizar. De igual manera, hemos recogido las opiniones de los participantes en la evaluación acerca de su percepción del comportamiento del sistema, y de su capacidad de adaptación a las condiciones concretas de cada interacción.

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.