Service user and carer participation in an endoscopy nursing programme

This article reports an initiative to improve students' insight into service user and carer experience of endoscopy, particularly those with severe disability, such as spinal cord injury. This insight has the potential to improve the information provided and level of person-centred care in an endoscopy service. It was evident in the feedback from the classroom encounter that the teaching and learning strategy had a positive outcome, which will allow us to integrate the approach into future curriculum development and delivery, bringing the lived experience from the service user and carer perspective into the classroom. Students engaged in discussion and used their reflective skills to develop sensitivity to those with physical disability and complex needs requiring endoscopy procedures.

Service user perspectives on palliative care education for health and social care professionals supporting people with learning disabilities

Background and objectives
Evidence from European and American studies indicates limited referrals of people with learning (intellectual) disabilities to palliative care services. Although professionals’ perceptions of their training needs in this area have been studied, the perceptions of people with learning disabilities and family carers are not known. This study aimed to elicit the views of people with learning disabilities, and their family carers concerning palliative care, to inform healthcare professional education and training.

Methods
A qualitative, exploratory design was used. A total of 17 people with learning disabilities were recruited to two focus groups which took place within an advocacy network. Additionally, three family carers of someone with a learning disability, requiring palliative care, and two family carers who had been bereaved recently were also interviewed.

Results
Combined data identified the perceived learning needs for healthcare professionals. Three subthemes emerged: ‘information and preparation’, ‘provision of care’ and ‘family-centred care’.

Conclusions
This study shows that people with learning disabilities can have conversations about death and dying, and their preferred end-of-life care, but require information that they can understand. They also need to have people around familiar to them and with them. Healthcare professionals require skills and knowledge to effectively provide palliative care for people with learning disabilities and should also work in partnership with their family carers who have expertise from their long-term caring role. These findings have implications for educators and clinicians.

Falls prevention and support:: translating research, integrating services and promoting the contribution of service users for quality and innovative programmes of care

Falls are a significant threat to the safety, health and independence of older citizens. Despite the substantial evidence that is available around effective falls prevention programmes and interventions, their translation into falls reduction programmes and policies has yet to be fully realised. While hip fracture rates are decreasing, the number and incidence of fall-related hospital admissions among older people continue to rise. Given the demographic trends that highlight increasing numbers of older people in the UK, which is broadly reflected internationally, there is a financial and social imperative to minimise the rate of falls and associated injuries. Falling is closely aligned to growing older (Slips, Trips and Falls Update: From Acute and Community Hospitals and Mental Health Units in England and Wales, Department of Health, HMSO, London, 2010). According to the World Health Organization, around 30% of older people aged over 65 and 50% of those over 80 will fall each year (Falls Fact Sheet Number 344, WHO, Geneva, 2010). Falls happen as a result of many reasons and can have harmful consequences, including loss of mobility and independence, confidence and in many cases even death (Cochrane Database Syst Rev 15, 2009, 146; Slips, Trips and Falls Update: From Acute and Community Hospitals and Mental Health Units in England and Wales, Department of Health, HMSO, London, 2010; Falling Standards, Broken Promises: Report of the National
Audit of Falls and Bone Health in Older People 2010, Health Care Quality
Improvement Partnership, London, 2011). What is neither fair nor correct is the
common belief by old and young alike that falls are just another inconvenience to put up with. The available evidence justifiably supports the view that well-organised services, based upon national standards and expert guidance, can prevent future falls among older people and reduce death and disability from fractures. This paper will draw from the UK, as an exemplar for policy and practice, to discuss the strategic direction of falls prevention programmes for older people and the partnerships that need to exist between researchers, service providers and users of services to translate evidence to the clinical setting. Second, it will propose some mechanisms for disseminating evidence to healthcare professionals and other stakeholders, to improve the quality and capacity of the clinical workforce.

Service User Involvement in Assessments:

Increasingly providers of mental health nurse education are required to demonstrate user involvement in all aspects of these programmes including student selection, programme design and student assessment. There has been limited analysis of how nursing students perceive user involvement in nurse education programmes. The aim of this study has been to explore mental health nursing student’s perceptions of involving users in all aspects of pre-registration mental health nursing programme. Researchers completed a number of focus group interviews with 12 ex-mental health nursing students who had been recruited by purposeful sampling. Each focus group interview was recorded and analysed using a series of data reduction, data display and verification
methods. The study confirms many of the findings reported in earlier user participation in education studies. Three main themes related to user involvement have been identified: the protection of users, enhanced student learning and the added value benefits associated with user involvement.

Contributo para a validação da versão portuguesa do instrumento de avaliação VOICE (service users perceptions of impatient care, Views on Inpatient Care)

RESUMO: Nos últimos anos assistiu-se a um reposicionamento das pessoas portadoras de doença mental na sociedade, no sentido de viverem em pleno os seus direitos, sem restrições. Esta tendência acompanhou as transformações que se têm vivido na forma como os utentes dos serviços de saúde interagem com os mesmos e com os profissionais de saúde, de forma a permitir uma maior autonomização e responsabilização no que concerne ao tratamento da sua doença, a relação que estabelecem com o seu médico, e a participação na avaliação e monitorização da qualidade dos serviços. Mais recentemente, também no mundo científico, esta afirmação se fez sentir, com o surgimento de investigação liderada por utentes, no sentido de estudar de forma adequada questões que partem do seu ponto de vista, e que possibilitem a produção de conhecimento significativa no contexto das suas experiências. Com o presente trabalho pretende-se contribuir para a validação da versão portuguesa do VOICE (Service Users’ Perceptions of Inpatient Care, Views on Inpatient Care) (Evans et al., 2012), instrumento para a avaliação dos serviços de internamento de agudos em psiquiatria, construído a partir de um investigação liderado por utentes e partindo das suas perspectiva. O VOICE é constituído por 19 questões, agrupadas em sete domínios: admissão; cuidados e tratamento; medicação; equipa de técnicos do internamento; terapia e atividades; ambiente e diferenças. O presente estudo envolveu uma amostra de 85 utentes de um serviço de internamento de agudos de uma instituição psiquiátrica do Norte de Portugal. A versão portuguesa do VOICE apresentou boa aceitação por parte dos utentes e boas características psicométricas - a consistência interna foi alta (α = 0,87) e todos, exceto um item (item 6), apresentam elevadas correlações item-total (variando de 0,18 - item 6 a 0,71 - item 11; M = 0,54, DP = 0,15), sugerindo ser um instrumento útil na avaliação dos serviços de internamento de agudos. No futuro torna-se necessário alargar o estudo a outros contextos de internamento e envolvendo amostras mais alargadas.-------------- ABSTRACT: In recent years there has been a gradual process to help people with the experience of mental illness regaining their full rights. Following the advances in the understanding of mental health problems, and the use of medication to help patients overcome symptoms, service-users have become more autonomous and responsible in the way they deal with health professionals, and are now called to participate in assessing and monitoring mental health services and policies. In the context of these transformations we have assisted to the emergence of research led by service-users (in this case of psychiatric and mental health services) in order to emphasize their point of view, and to enable the production of significant knowledge resulting from their experiences, and perceptions. The present study aims to contribute to the dissemination of service-user led research, based on the adaptation and validation of the Portuguese version of the VOICE - Service Users' Perceptions Questionnaire, Views on Inpatient Care. (Evans et al., 2012). The VOICE is composed of 19 questions, grouped in seven domains: admissions, care and treatment, medication, team of technicians during hospitalization, therapy and activities, environment and diversity. The present study involved a sample of 85 inpatient of a psychiatric institution in Northern Portugal. The Portuguese version of the VOICE showed good psychometric properties and was well accepted by patients [high internal consistency (α = 0,87); and high correlation of each item, except item 6, with the total score (ranging from 0.18 on item 6 to 0.71 on item 11; average=0,54; SD=0,15), suggesting it to be a useful tool for assessing inpatient services. In the future there is a need to extend the study to other contexts and include larger samples.

Principles of Personalisation of Service Discovery

We define personalisation as the set of capabilities that enables a user or an organisation to customise their working environment to suit their specific needs, preferences and circumstances. In the context of service discovery on the Grid, the demand for personalisation comes from individual users, who want their preferences to be taken into account during the search and selection of suitable services. These preferences can express, for example, the reliability of a service, quality of results, functionality, and so on. In this paper, we identify the problems related to personalising service discovery and present our solution: a personalised service registry or View. We describe scenarios in which personsalised service discovery would be useful and describe how our technology achieves them.

The settlement and social inclusion of immigrant youth in New Zealand

The immigrant population of Aotearoa New Zealand has increased significantly over recent years. This rise in ethnic minority populations, especially from non-English speaking countries, has significant social implications for the country. Anecdotal and empirical evidence in New Zealand show that many immigrant youth are not socially included, and that this compromises their ability to settle successfully in New Zealand. This study investigates the settlement and social inclusion of immigrant youth in New Zealand. It investigates the significant/actors that act as barriers to their settlement and social inclusion. The study gathers data through face to face and telephone interviews from key informants who are service providers and experts in six cities in New Zealand. Data is analysed using an inductive approach to produce primarily qualitative data which identifies key themes and issues for different age groups, genders, migrant and refugee groups. It supplements this data with some quantitative data on frequency, duration and intensity. Findings reveal that most immigrant youth generally do not feel well settled and socially included in New Zealand, and that some may suffer psychological and social consequences due to this.

An analytical model for optimal spectrum leasing under constraints of quality of service in CRNs

Cognitive radio improves spectrum efficiency and mitigates spectrum scarcity by allowing cognitive users to opportunistically access idle chunks of the spectrum owned by licensed users. In long-term spectrum leasing markets, secondary network operators make a decision about how much spectrum is optimal to fulfill their users' data transmission requirements. We study this optimization problem in multiple channel scenarios. Under the constrains of expected user admission rate and quality of service, we model the secondary network into a dynamic data transportation system. In this system, the spectrum accesses of both primary users and secondary users are in accordance with stochastic processes, respectively. The main metrics of quality of service we are concerned with include user admission rate, average transmission delay and stability of the delay. To quantify the relationship between spectrum provisioning and quality of service, we propose an approximate analytical model. We use the model to estimate the lower and upper bounds of the optimal amount of the spectrum. The distance between the bounds is relatively narrow. In addition, we design a simple algorithm to compute the optimum by using the bounds. We conduct numerical simulations on a slotted multiple channel dynamic spectrum access network model. Simulation results demonstrate the preciseness of the proposed model. Our work sheds light on the design of game and auction based dynamic spectrum sharing mechanisms in cognitive radio networks.

On the potential for psychological researchers and psychologists to promote the social inclusion of people with disability: A review

© 2015 Australian Psychological Society. Objective: This paper outlines different approaches to understanding disability and describes ways in which psychological researchers and psychologists can promote the social inclusion of people with disability. Method: Narrative review drawing on writings and research from psychology and disability studies. Results: Five prominent models of disability appear in the literature (moral, medical, social, biopsychosocial, and post-modern), all of which have relevance to the lives of people with disability. Conceptualisations commonly used to understand the experience of disability from a psychological perspective include stigma and psycho-emotional disablism. There is evidence that people with disability wish to have greater involvement in research (e.g., as consultants and partners in research about them, and as participants in mainstream research) and to see research findings translated into practice. Evidence is emerging that can be used to underpin psychologists work with (a) communities (to foster social change and social justice, and to reduce stigma); (b) organisations, such as schools, workplaces, and disability service providers (to help develop inclusive and supportive environments); (c) families (to promote optimism, alternative understandings of disability, and a sense of control, as well as developing behaviour support plans and providing referrals to other sources of practical support); and (d) people with disability (to assist them with the issues they bring to therapy while being mindful of the potential for psycho-emotional disablism to colour the material presented). Conclusion: Psychological researchers and psychologists have significant potential to contribute to the social inclusion of people with disability.

Inclusion of the European Nordic model in the debate concerning social protection reform: the long-term development of Nordic welfare systems (1890-2005) and their transferability to Latin America in the twenty-first century

Includes bibliography

Quality of Service (QoS) in MPLS networks

Telecommunications networks have been always expanding and thanks to it, new services have appeared. The old mechanisms for carrying packets have become obsolete due to the new service requirements, which have begun working in real time. Real time traffic requires strict service guarantees. When this traffic is sent through the network, enough resources must be given in order to avoid delays and information losses. When browsing through the Internet and requesting web pages, data must be sent from a server to the user. If during the transmission there is any packet drop, the packet is sent again. For the end user, it does not matter if the webpage loads in one or two seconds more. But if the user is maintaining a conversation with a VoIP program, such as Skype, one or two seconds of delay in the conversation may be catastrophic, and none of them can understand the other. In order to provide support for this new services, the networks have to evolve. For this purpose MPLS and QoS were developed. MPLS is a packet carrying mechanism used in high performance telecommunication networks which directs and carries data using pre-established paths. Now, packets are forwarded on the basis of labels, making this process faster than routing the packets with the IP addresses. MPLS also supports Traffic Engineering (TE). This refers to the process of selecting the best paths for data traffic in order to balance the traffic load between the different links. In a network with multiple paths, routing algorithms calculate the shortest one, and most of the times all traffic is directed through it, causing overload and packet drops, without distributing the packets in the other paths that the network offers and do not have any traffic. But this is not enough in order to provide the real time traffic the guarantees it needs. In fact, those mechanisms improve the network, but they do not make changes in how the traffic is treated. That is why Quality of Service (QoS) was developed. Quality of service is the ability to provide different priority to different applications, users, or data flows, or to guarantee a certain level of performance to a data flow. Traffic is distributed into different classes and each of them is treated differently, according to its Service Level Agreement (SLA). Traffic with the highest priority will have the preference over lower classes, but this does not mean it will monopolize all the resources. In order to achieve this goal, a set policies are defined to control and alter how the traffic flows. Possibilities are endless, and it depends in how the network must be structured. By using those mechanisms it is possible to provide the necessary guarantees to the real-time traffic, distributing it between categories inside the network and offering the best service for both real time data and non real time data. Las Redes de Telecomunicaciones siempre han estado en expansión y han propiciado la aparición de nuevos servicios. Los viejos mecanismos para transportar paquetes se han quedado obsoletos debido a las exigencias de los nuevos servicios, que han comenzado a operar en tiempo real. El tráfico en tiempo real requiere de unas estrictas garantías de servicio. Cuando este tráfico se envía a través de la red, necesita disponer de suficientes recursos para evitar retrasos y pérdidas de información. Cuando se navega por la red y se solicitan páginas web, los datos viajan desde un servidor hasta el usuario. Si durante la transmisión se pierde algún paquete, éste se vuelve a mandar de nuevo. Para el usuario final, no importa si la página tarda uno o dos segundos más en cargar. Ahora bien, si el usuario está manteniendo una conversación usando algún programa de VoIP (como por ejemplo Skype) uno o dos segundos de retardo en la conversación podrían ser catastróficos, y ninguno de los interlocutores sería capaz de entender al otro. Para poder dar soporte a estos nuevos servicios, las redes deben evolucionar. Para este propósito se han concebido MPLS y QoS MPLS es un mecanismo de transporte de paquetes que se usa en redes de telecomunicaciones de alto rendimiento que dirige y transporta los datos de acuerdo a caminos preestablecidos. Ahora los paquetes se encaminan en función de unas etiquetas, lo cual hace que sea mucho más rápido que encaminar los paquetes usando las direcciones IP. MPLS también soporta Ingeniería de Tráfico (TE). Consiste en seleccionar los mejores caminos para el tráfico de datos con el objetivo de balancear la carga entre los diferentes enlaces. En una red con múltiples caminos, los algoritmos de enrutamiento actuales calculan el camino más corto, y muchas veces el tráfico se dirige sólo por éste, saturando el canal, mientras que otras rutas se quedan completamente desocupadas. Ahora bien, esto no es suficiente para ofrecer al tráfico en tiempo real las garantías que necesita. De hecho, estos mecanismos mejoran la red, pero no realizan cambios a la hora de tratar el tráfico. Por esto es por lo que se ha desarrollado el concepto de Calidad de Servicio (QoS). La calidad de servicio es la capacidad para ofrecer diferentes prioridades a las diferentes aplicaciones, usuarios o flujos de datos, y para garantizar un cierto nivel de rendimiento en un flujo de datos. El tráfico se distribuye en diferentes clases y cada una de ellas se trata de forma diferente, de acuerdo a las especificaciones que se indiquen en su Contrato de Tráfico (SLA). EL tráfico con mayor prioridad tendrá preferencia sobre el resto, pero esto no significa que acapare la totalidad de los recursos. Para poder alcanzar estos objetivos se definen una serie de políticas para controlar y alterar el comportamiento del tráfico. Las posibilidades son inmensas dependiendo de cómo se quiera estructurar la red. Usando estos mecanismos se pueden proporcionar las garantías necesarias al tráfico en tiempo real, distribuyéndolo en categorías dentro de la red y ofreciendo el mejor servicio posible tanto a los datos en tiempo real como a los que no lo son.

Analysis of service-oriented computing systems

La computación basada en servicios (Service-Oriented Computing, SOC) se estableció como un paradigma ampliamente aceptado para el desarollo de sistemas de software flexibles, distribuidos y adaptables, donde las composiciones de los servicios realizan las tareas más complejas o de nivel más alto, frecuentemente tareas inter-organizativas usando los servicios atómicos u otras composiciones de servicios. En tales sistemas, las propriedades de la calidad de servicio (Quality of Service, QoS), como la rapídez de procesamiento, coste, disponibilidad o seguridad, son críticas para la usabilidad de los servicios o sus composiciones en cualquier aplicación concreta. El análisis de estas propriedades se puede realizarse de una forma más precisa y rica en información si se utilizan las técnicas de análisis de programas, como el análisis de complejidad o de compartición de datos, que son capables de analizar simultáneamente tanto las estructuras de control como las de datos, dependencias y operaciones en una composición. El análisis de coste computacional para la composicion de servicios puede ayudar a una monitorización predictiva así como a una adaptación proactiva a través de una inferencia automática de coste computacional, usando los limites altos y bajos como funciones del valor o del tamaño de los mensajes de entrada. Tales funciones de coste se pueden usar para adaptación en la forma de selección de los candidatos entre los servicios que minimizan el coste total de la composición, basado en los datos reales que se pasan al servicio. Las funciones de coste también pueden ser combinadas con los parámetros extraídos empíricamente desde la infraestructura, para producir las funciones de los límites de QoS sobre los datos de entrada, cuales se pueden usar para previsar, en el momento de invocación, las violaciones de los compromisos al nivel de servicios (Service Level Agreements, SLA) potenciales or inminentes. En las composiciones críticas, una previsión continua de QoS bastante eficaz y precisa se puede basar en el modelado con restricciones de QoS desde la estructura de la composition, datos empiricos en tiempo de ejecución y (cuando estén disponibles) los resultados del análisis de complejidad. Este enfoque se puede aplicar a las orquestaciones de servicios con un control centralizado del flujo, así como a las coreografías con participantes multiples, siguiendo unas interacciones complejas que modifican su estado. El análisis del compartición de datos puede servir de apoyo para acciones de adaptación, como la paralelización, fragmentación y selección de los componentes, las cuales son basadas en dependencias funcionales y en el contenido de información en los mensajes, datos internos y las actividades de la composición, cuando se usan construcciones de control complejas, como bucles, bifurcaciones y flujos anidados. Tanto las dependencias funcionales como el contenido de información (descrito a través de algunos atributos definidos por el usuario) se pueden expresar usando una representación basada en la lógica de primer orden (claúsulas de Horn), y los resultados del análisis se pueden interpretar como modelos conceptuales basados en retículos. ABSTRACT Service-Oriented Computing (SOC) is a widely accepted paradigm for development of flexible, distributed and adaptable software systems, in which service compositions perform more complex, higher-level, often cross-organizational tasks using atomic services or other service compositions. In such systems, Quality of Service (QoS) properties, such as the performance, cost, availability or security, are critical for the usability of services and their compositions in concrete applications. Analysis of these properties can become more precise and richer in information, if it employs program analysis techniques, such as the complexity and sharing analyses, which are able to simultaneously take into account both the control and the data structures, dependencies, and operations in a composition. Computation cost analysis for service composition can support predictive monitoring and proactive adaptation by automatically inferring computation cost using the upper and lower bound functions of value or size of input messages. These cost functions can be used for adaptation by selecting service candidates that minimize total cost of the composition, based on the actual data that is passed to them. The cost functions can also be combined with the empirically collected infrastructural parameters to produce QoS bounds functions of input data that can be used to predict potential or imminent Service Level Agreement (SLA) violations at the moment of invocation. In mission-critical applications, an effective and accurate continuous QoS prediction, based on continuations, can be achieved by constraint modeling of composition QoS based on its structure, known data at runtime, and (when available) the results of complexity analysis. This approach can be applied to service orchestrations with centralized flow control, and choreographies with multiple participants with complex stateful interactions. Sharing analysis can support adaptation actions, such as parallelization, fragmentation, and component selection, which are based on functional dependencies and information content of the composition messages, internal data, and activities, in presence of complex control constructs, such as loops, branches, and sub-workflows. Both the functional dependencies and the information content (described using user-defined attributes) can be expressed using a first-order logic (Horn clause) representation, and the analysis results can be interpreted as a lattice-based conceptual models.

Quality of service in flexible workflows through process constraints

Workflow technology has delivered effectively for a large class of business processes, providing the requisite control and monitoring functions. At the same time, this technology has been the target of much criticism due to its limited ability to cope with dynamically changing business conditions which require business processes to be adapted frequently, and/or its limited ability to model business processes which cannot be entirely predefined. Requirements indicate the need for generic solutions where a balance between process control and flexibility may be achieved. In this paper we present a framework that allows the workflow to execute on the basis of a partially specified model where the full specification of the model is made at runtime, and may be unique to each instance. This framework is based on the notion of process constraints. Where as process constraints may be specified for any aspect of the workflow, such as structural, temporal, etc. our focus in this paper is on a constraint which allows dynamic selection of activities for inclusion in a given instance. We call these cardinality constraints, and this paper will discuss their specification and validation requirements.

Pragmatic development of service based real-time change data capture

This thesis makes a contribution to the Change Data Capture (CDC) field by providing an empirical evaluation on the performance of CDC architectures in the context of realtime data warehousing. CDC is a mechanism for providing data warehouse architectures with fresh data from Online Transaction Processing (OLTP) databases. There are two types of CDC architectures, pull architectures and push architectures. There is exiguous data on the performance of CDC architectures in a real-time environment. Performance data is required to determine the real-time viability of the two architectures. We propose that push CDC architectures are optimal for real-time CDC. However, push CDC architectures are seldom implemented because they are highly intrusive towards existing systems and arduous to maintain. As part of our contribution, we pragmatically develop a service based push CDC solution, which addresses the issues of intrusiveness and maintainability. Our solution uses Data Access Services (DAS) to decouple CDC logic from the applications. A requirement for the DAS is to place minimal overhead on a transaction in an OLTP environment. We synthesize DAS literature and pragmatically develop DAS that eciently execute transactions in an OLTP environment. Essentially we develop effeicient RESTful DAS, which expose Transactions As A Resource (TAAR). We evaluate the TAAR solution and three pull CDC mechanisms in a real-time environment, using the industry recognised TPC-C benchmark. The optimal CDC mechanism in a real-time environment, will capture change data with minimal latency and will have a negligible affect on the database's transactional throughput. Capture latency is the time it takes a CDC mechanism to capture a data change that has been applied to an OLTP database. A standard definition for capture latency and how to measure it does not exist in the field. We create this definition and extend the TPC-C benchmark to make the capture latency measurement. The results from our evaluation show that pull CDC is capable of real-time CDC at low levels of user concurrency. However, as the level of user concurrency scales upwards, pull CDC has a significant impact on the database's transaction rate, which affirms the theory that pull CDC architectures are not viable in a real-time architecture. TAAR CDC on the other hand is capable of real-time CDC, and places a minimal overhead on the transaction rate, although this performance is at the expense of CPU resources.

A Framework for Design-Time Testing of Service-Based Applications at BPEL Level

Software applications created on top of the service-oriented architecture (SOA) are increasingly popular but testing them remains a challenge. In this paper a framework named TASSA for testing the functional and non-functional behaviour of service-based applications is presented. The paper focuses on the concept of design time testing, the corresponding testing approach and architectural integration of the consisting TASSA tools. The individual TASSA tools with sample validation scenarios were already presented with a general view of their relation. This paper’s contribution is the structured testing approach, based on the integral use of the tools and their architectural integration. The framework is based on SOA principles and is composable depending on user requirements.