Patient-centered medical home technology effects on hypertension and diabetes control

Background: Hypertension and Diabetes is a public health and economic concern in the United States. The utilization of medical home concepts increases the receipt of preventive services, however, do they also increase adherence to treatments? This study examined the effect of patient-centered medical home technologies such as the electronic health record, clinical support system, and web-based care management in improving health outcomes related to hypertension and diabetes. Methods: A systematic review of the literature used a best evidence synthesis approach to address the general question " Do patient-centered medical home technologies have an effect of diabetes and hypertension treatment?" This was followed by an evaluation of specific examples of the technologies utilized such as computer-assisted recommendations and web-based care management provided by the patient's electronic health record. Ebsco host, Ovid host, and Google Scholar were the databases used to conduct the literature search. Results: The initial search identified over 25 studies based on content and quality that implemented technology interventions to improve communication between provider and patient. After further assessing the articles for risk of bias and study design, 13 randomized controlled studies were chosen. All of the studies chosen were conducted in various primary care settings in both private practices and hospitals between the years 2000 and 2007. The sample sizes of the studies ranged from 42 to 2924 participants. The mean age for all of the studies ranged from 56 to 71 years. The percent women in the studies ranged from one to 78 percent. Over one-third of the studies did not provide the racial composition of the participants. For the seven studies that did provide information about the ethnic composition, 64% of the intervention participants were White. All of the studies utilized some type of web-based or computer-based communication to manage hypertension or diabetes care. Findings on outcomes were mixed, with nine out of 13 studies showing no significant effect on outcomes examined, and four of the studies showing significant and positive impact on health outcomes related to hypertension or diabetes Conclusion: Although the technologies improved patient and provider satisfaction, the outcomes measures such as blood pressure control and glucose control were inconclusive. Further research is needed with diverse ethnic and SES population to investigate the role of patient-centered technologies on hypertension and diabetes control. Also, further research is needed to investigate the effects of innovative medical home technologies that can be used by both patients and providers to increase quality of communication concerning adherence to treatments.^

The computer paradigm in vocational guidance

The technological advances in last decades have transformed the external resources of Vocational Counseling, Occupational Information and assessment of clients. Most computer systems follow a behaviorist-cognitive approach. However, the use of vocational counseling software is not exclusive to one conceptual approach. Computers are introduced in education from primary school; counselors and other educators are expected to use those systems. The attitude of counselors ranges from enthusiastic acceptance to complete refusal. Many counselors fear that computers will replace them. An underlying theory holds that counseling is based on the counselor-client interaction. A computer- client interaction cannot be considered vocational counseling. Counseling has five basic aims: prevention, assistance, education and development, service of diverse groups and research. The most relevant trends in computer-based counseling are: tests and questionnaires based on computers, adaptive development, computarized information, vocational counseling systems and research. Basic aims and the potential role of computers in achieving them are discussed. Present vocational counselors can use the technology of computers to link the past of our profession to its promising future. In view of these premises we have developed two computer systems that assist the vocational counseling process: "Professional Interests Questionnaire, Computer Version", and "Computer-based System of Vocational Counseling".

The computer paradigm in vocational guidance

The technological advances in last decades have transformed the external resources of Vocational Counseling, Occupational Information and assessment of clients. Most computer systems follow a behaviorist-cognitive approach. However, the use of vocational counseling software is not exclusive to one conceptual approach. Computers are introduced in education from primary school; counselors and other educators are expected to use those systems. The attitude of counselors ranges from enthusiastic acceptance to complete refusal. Many counselors fear that computers will replace them. An underlying theory holds that counseling is based on the counselor-client interaction. A computer- client interaction cannot be considered vocational counseling. Counseling has five basic aims: prevention, assistance, education and development, service of diverse groups and research. The most relevant trends in computer-based counseling are: tests and questionnaires based on computers, adaptive development, computarized information, vocational counseling systems and research. Basic aims and the potential role of computers in achieving them are discussed. Present vocational counselors can use the technology of computers to link the past of our profession to its promising future. In view of these premises we have developed two computer systems that assist the vocational counseling process: "Professional Interests Questionnaire, Computer Version", and "Computer-based System of Vocational Counseling".

The computer paradigm in vocational guidance

The technological advances in last decades have transformed the external resources of Vocational Counseling, Occupational Information and assessment of clients. Most computer systems follow a behaviorist-cognitive approach. However, the use of vocational counseling software is not exclusive to one conceptual approach. Computers are introduced in education from primary school; counselors and other educators are expected to use those systems. The attitude of counselors ranges from enthusiastic acceptance to complete refusal. Many counselors fear that computers will replace them. An underlying theory holds that counseling is based on the counselor-client interaction. A computer- client interaction cannot be considered vocational counseling. Counseling has five basic aims: prevention, assistance, education and development, service of diverse groups and research. The most relevant trends in computer-based counseling are: tests and questionnaires based on computers, adaptive development, computarized information, vocational counseling systems and research. Basic aims and the potential role of computers in achieving them are discussed. Present vocational counselors can use the technology of computers to link the past of our profession to its promising future. In view of these premises we have developed two computer systems that assist the vocational counseling process: "Professional Interests Questionnaire, Computer Version", and "Computer-based System of Vocational Counseling".

WiMAX,Technology and Market.

Wireless communication is the transfer of information from one place to another without using wires. From the earliest times, humans have felt the need to develop techniques of remote communication. From this need arose the smoke signals, communication by sun reflection in mirrors and so on. But today the telecommunications electronic devices such as telephone, television, radio or computer. Radio and television are used for one-way communication. Telephone and computer are used for two-way communication. In wireless networks there is almost unlimited mobility, we can access the network almost anywhere or anytime. In wired networks we have the restriction of using the services in fixed area services. The demand of the wireless is increasing very fast; everybody wants broadband services anywhere anytime. WiMAX (Worldwide Interoperability for Microwave Access) is a broadband wireless technology based on IEEE 802.16-2004 and IEEE 802.16e-2005 that appears to solve this demand. WIMAX is a system that allows wireless data transmission in areas of up to 48 km of radius. It is designed as a wireless alternative to ADSL and a way to connect nodes in wireless metropolitan areas network. Unlike wireless systems that are limited in most cases, about 100 meter, providing greater coverage and more bandwidth. WIMAX promises to achieve high data transmission rates over large areas with a great amount of users. This alternative to the networks of broadband access common as DSL o Wi-Fi, can give broadband access to places quickly to rural areas and developing areas around the world. This paper is a study of WIMAX technology and market situation. First, the paper is responsible for explaining the technical aspects of WIMAX. For this gives an overview of WIMAX standards, physical layer, MAC layer and WiMAX, Technology and Market Beijing University of Post and Telecommunications 2 WIMAX network architecture. Second, the paper address the issue of market in which provides an overview of development and deployment of WIMAX to end the future development trend of WIMAX is addressed. RESUMEN: Por comunicaciones inalámbricas se entiende la transferencia de información desde un lugar a otro sin la necesidad de un soporte físico como es por ejemplo el cable. Por lo que remontándose a los principios de la existencia del ser humano, nos damos cuenta de que el ser humano siempre ha sentido la necesidad de desarrollar técnicas para lograr comunicarse a distancia con sus semejantes. De dicha necesidad, surgieron técnicas tan ancestrales como puede ser la comunicación mediante señales de humo o por reflexión de los rayos solares en espejos entre otras. La curiosidad del ser humano y la necesidad de comunicarse a distancia fue la que llevó a Alexander Graham Bell a inventar el teléfono en 1876. La aparición de un dispositivo que permitía comunicarse a distancia permitiendo escuchar la voz de aquella persona con la que se quería hablar, supuso una revolución no solo en el panorama tecnológico, si no también en el panorama social. Pues a parte de permitir comunicaciones a larga distancia, solventó el problema de la comunicación en “tiempo real”. A raíz de este invento, la tecnología en materia de comunicación ha ido avanzando significativamente, más concretamente en lo referido a las comunicaciones inalámbricas. En 1973 se realizó la primera llamada desde un terminal móvil aunque no fue hasta 1983 cuando se empezó a comercializar dicho terminal, lo que supuso un cambio de hábitos y costumbres para la sociedad. Desde la aparición del primer móvil el crecimiento del mercado ha sido exponencial, lo que ha repercutido en una demanda impensable de nuevas aplicaciones integradas en dichos dispositivos móviles que satisfagan las necesidades que día a día autogenera la sociedad. Tras conseguir realizar llamadas a larga distancia de forma inalámbrica, el siguiente paso fue la creación de los SMS (Short Message System) lo que supuso una nueva revolución además de abaratar costes al usuario a la hora de comunicarse. Pero el gran reto para la industria de las comunicaciones móviles surgió con la aparición de internet. Todo el mundo sentía la necesidad de poder conectarse a esa gran base de datos que es internet en cualquier parte y en cualquier momento. Las primeras conexiones a internet desde dispositivos móviles se realizaron a través de la tecnología WAP (Wireless Application Protocol) hasta la aparición de la tecnología GPRS que permitía la conexión mediante protocolo TCP/IP. A partir de estas conexiones han surgido otras tecnologías, como EDGE, HSDPA, etc., que permitían y permiten la conexión a internet desde dispositivos móviles. Hoy en día la demanda de servicios de red inalámbrica crece de forma rápida y exponencial, todo el mundo quiere servicios de banda ancha en cualquier lugar y en cualquier momento. En este documento se analiza la tecnología WiMAX ( Worldwide Interoperability for Microwave Access) que es una tecnología de banda ancha basada en el estándar IEEE 802.16 creada para brindar servicios a la demanda emergente en la banda ancha desde un punto de vista tecnológico, donde se da una visión de la parte técnica de la tecnología; y desde el punto de vista del mercado, donde se analiza el despliegue y desarrollo de la tecnología desde el punto de vista de negocio. WiMAX es una tecnología que permite la transmisión inalámbrica de datos en áreas de hasta 48Km de radio y que está diseñada como alternativa inalámbrica para ADSL y para conectar nodos de red inalámbrica en áreas metropolitanas. A diferencia de los sistemas inalámbricos existentes que están limitados en su mayoría a unos cientos de metros, WiMAX ofrece una mayor cobertura y un mayor ancho de banda que permita dar soporte a nuevas aplicaciones, además de alcanzar altas tasas de transmisión de datos en grandes áreas con una gran cantidad de usuarios. Se trata de una alternativa a las redes de acceso de banda ancha como DSL o Wi-Fi, que puede dar acceso de banda ancha a lugares tales como zonas rurales o zonas en vías de desarrollo por todo el mundo con rapidez. Existen dos tecnologías de WiMAX, WiMAX fijo (basado en el estándar IEEE 802.16d-2004) y WiMAX móvil (basado en el estándar IEEE 802.16e-2005). La tecnología fija está diseñada para comunicaciones punto a multipunto, mientras que la fija lo está para comunicaciones multipunto a multipunto. WiMAX móvil se basa en la tecnología OFDM que ofrece ventajas en términos de latencia, eficiencia en el uso del espectro y soporte avanzado para antenas. La modulación OFDM es muy robusta frente al multitrayecto, que es muy habitual en los canales de radiodifusión, frente al desvanecimiento debido a las condiciones meteorológicas y frente a las interferencias de RF. Una vez creada la tecnología WiMAX, poseedora de las características idóneas para solventar la demanda del mercado, ha de darse el siguiente paso, hay que convencer a la industria de las telecomunicaciones de que dicha tecnología realmente es la solución para que apoyen su implantación en el mercado de la banda ancha para las redes inalámbricas. Es aquí donde entra en juego el estudio del mercado que se realiza en este documento. WiMAX se enfrenta a un mercado exigente en el que a parte de tener que dar soporte a la demanda técnica, ha de ofrecer una rentabilidad económica a la industria de las comunicaciones móviles y más concretamente a las operadoras móviles que son quienes dentro del sector de las telecomunicaciones finalmente han de confiar en la tecnología para dar soporte a sus usuarios ya que estos al fin y al cabo lo único que quieren es que su dispositivo móvil satisfaga sus necesidades independientemente de la tecnología que utilicen para tener acceso a la red inalámbrica de banda ancha. Quizás el mayor problema al que se ha enfrentado WiMAX haya sido la situación económica en la que se encuentra el mundo. WiMAX a comenzado su andadura en uno de los peores momentos, pero aun así se presenta como una tecnología capaz de ayudar al mundo a salir hacia delante en estos tiempos tan duros. Finalmente se analiza uno de los debates existentes hoy en día en el sector de las comunicaciones móviles, WiMAX vs. LTE. Como se puede observar en el documento realmente una tecnología no saldrá victoriosa frente a la otra, si no que ambas tecnologías podrán coexistir y trabajar de forma conjunta.

A cybernetic theory about computer interfaces and human factors within a framework of technological innovation

This paper is based on the following postulates taken from a book recently published by this author (Sáez-Vacas, 1990(1)): a) technological innovation in a company is understood to be the process and set of changes that the company undergoes as a result of a specific type of technology; b) the incorporation of technology in the company does not necessarily result in innovation, modernization and progress; c) the very words "modernization" and "progress" are completely bereft of any meaning if isolated from the concept of complexity in its broadest sense, including the human factor. Turning to office technology in specific, the problem of managing office technology for business innovation purposes can be likened to the problem of managing third level complexity, following the guidelines of a three-level complexity model proposed by the author some years ago

Thin Client Technology in the Academic Environment

From research groups at the universities of developed countries there is a growing interest in providing solutions to problems of developing countries. In this context we have studied typical problems in many (educational) institutions, such as the lack of technicians who repair the computers, the administration of the machines, and also the difficulty to maintain and configure the old hardware available due to the variety of characteristics of the different machines and the amount of hardware breakdowns and software issues (viruses, administration issues) that the local staff has to face up to with their equipments. We propose a thin client approach that takes into account the human, hardware and software characteristics of developing institutions to provide a complete service for a computer network. The network administration is reduced to the administration of one server only. The maintenance of the machines is simplified and old computers can simulate the running of a powerful computer. Our proposal results in a cheap, simple (from the support point of view) and powerful (in terms of achieved functionalities) design.

Context modelling for natural Human Computer Interaction applications in e-health

The conception of IoT (Internet of Things) is accepted as the future tendency of Internet among academia and industry. It will enable people and things to be connected at anytime and anyplace, with anything and anyone. IoT has been proposed to be applied into many areas such as Healthcare, Transportation，Logistics, and Smart environment etc. However, this thesis emphasizes on the home healthcare area as it is the potential healthcare model to solve many problems such as the limited medical resources, the increasing demands for healthcare from elderly and chronic patients which the traditional model is not capable of. A remarkable change in IoT in semantic oriented vision is that vast sensors or devices are involved which could generate enormous data. Methods to manage the data including acquiring, interpreting, processing and storing data need to be implemented. Apart from this, other abilities that IoT is not capable of are concluded, namely, interoperation, context awareness and security & privacy. Context awareness is an emerging technology to manage and take advantage of context to enable any type of system to provide personalized services. The aim of this thesis is to explore ways to facilitate context awareness in IoT. In order to realize this objective, a preliminary research is carried out in this thesis. The most basic premise to realize context awareness is to collect, model, understand, reason and make use of context. A complete literature review for the existing context modelling and context reasoning techniques is conducted. The conclusion is that the ontology-based context modelling and ontology-based context reasoning are the most promising and efficient techniques to manage context. In order to fuse ontology into IoT, a specific ontology-based context awareness framework is proposed for IoT applications. In general, the framework is composed of eight components which are hardware, UI (User Interface), Context modelling, Context fusion, Context reasoning, Context repository, Security unit and Context dissemination. Moreover, on the basis of TOVE (Toronto Virtual Enterprise), a formal ontology developing methodology is proposed and illustrated which consists of four stages: Specification & Conceptualization, Competency Formulation, Implementation and Validation & Documentation. In addition, a home healthcare scenario is elaborated by listing its well-defined functionalities. Aiming at representing this specific scenario, the proposed ontology developing methodology is applied and the ontology-based model is developed in a free and open-source ontology editor called Protégé. Finally, the accuracy and completeness of the proposed ontology are validated to show that this proposed ontology is able to accurately represent the scenario of interest.

Computer speech synthesis: its status and prospects.

Computer speech synthesis has reached a high level of performance, with increasingly sophisticated models of linguistic structure, low error rates in text analysis, and high intelligibility in synthesis from phonemic input. Mass market applications are beginning to appear. However, the results are still not good enough for the ubiquitous application that such technology will eventually have. A number of alternative directions of current research aim at the ultimate goal of fully natural synthetic speech. One especially promising trend is the systematic optimization of large synthesis systems with respect to formal criteria of evaluation. Speech recognition has progressed rapidly in the past decade through such approaches, and it seems likely that their application in synthesis will produce similar improvements.

Commercial applications of speech interface technology: an industry at the threshold.

Speech interface technology, which includes automatic speech recognition, synthetic speech, and natural language processing, is beginning to have a significant impact on business and personal computer use. Today, powerful and inexpensive microprocessors and improved algorithms are driving commercial applications in computer command, consumer, data entry, speech-to-text, telephone, and voice verification. Robust speaker-independent recognition systems for command and navigation in personal computers are now available; telephone-based transaction and database inquiry systems using both speech synthesis and recognition are coming into use. Large-vocabulary speech interface systems for document creation and read-aloud proofing are expanding beyond niche markets. Today's applications represent a small preview of a rich future for speech interface technology that will eventually replace keyboards with microphones and loud-speakers to give easy accessibility to increasingly intelligent machines.

The future of voice-processing technology in the world of computers and communications.

This talk, which was the keynote address of the NAS Colloquium on Human-Machine Communication by Voice, discusses the past, present, and future of human-machine communications, especially speech recognition and speech synthesis. Progress in these technologies is reviewed in the context of the general progress in computer and communications technologies.

Open educational resources: the role of OCW, blogs and videos in computer network classrooms

This paper analyzes the learning experiences and opinions obtained from a group of undergraduate students in their interaction with several on-line multimedia resources included in a free on-line course about Computer Networks. These new educational resources employed are based on the Web 2.0 approach such as blogs, videos and virtual labs which have been added in a web-site for distance self-learning.

A Survey on FPGA-Based Sensor Systems: Towards Intelligent and Reconfigurable Low-Power Sensors for Computer Vision, Control and Signal Processing

The current trend in the evolution of sensor systems seeks ways to provide more accuracy and resolution, while at the same time decreasing the size and power consumption. The use of Field Programmable Gate Arrays (FPGAs) provides specific reprogrammable hardware technology that can be properly exploited to obtain a reconfigurable sensor system. This adaptation capability enables the implementation of complex applications using the partial reconfigurability at a very low-power consumption. For highly demanding tasks FPGAs have been favored due to the high efficiency provided by their architectural flexibility (parallelism, on-chip memory, etc.), reconfigurability and superb performance in the development of algorithms. FPGAs have improved the performance of sensor systems and have triggered a clear increase in their use in new fields of application. A new generation of smarter, reconfigurable and lower power consumption sensors is being developed in Spain based on FPGAs. In this paper, a review of these developments is presented, describing as well the FPGA technologies employed by the different research groups and providing an overview of future research within this field.

Experiences Using an Open Source Sofware Library to Teach Computer Vision Subjects

Machine vision is an important subject in computer science and engineering degrees. For laboratory experimentation, it is desirable to have a complete and easy-to-use tool. In this work we present a Java library, oriented to teaching computer vision. We have designed and built the library from the scratch with enfasis on readability and understanding rather than on efficiency. However, the library can also be used for research purposes. JavaVis is an open source Java library, oriented to the teaching of Computer Vision. It consists of a framework with several features that meet its demands. It has been designed to be easy to use: the user does not have to deal with internal structures or graphical interface, and should the student need to add a new algorithm it can be done simply enough. Once we sketch the library, we focus on the experience the student gets using this library in several computer vision courses. Our main goal is to find out whether the students understand what they are doing, that is, find out how much the library helps the student in grasping the basic concepts of computer vision. In the last four years we have conducted surveys to assess how much the students have improved their skills by using this library.

Quantifying epistemic actions in human-computer interaction

As digital systems move away from traditional desktop setups, new interaction paradigms are emerging that better integrate with users’ realworld surroundings, and better support users’ individual needs. While promising, these modern interaction paradigms also present new challenges, such as a lack of paradigm-specific tools to systematically evaluate and fully understand their use. This dissertation tackles this issue by framing empirical studies of three novel digital systems in embodied cognition – an exciting new perspective in cognitive science where the body and its interactions with the physical world take a central role in human cognition. This is achieved by first, focusing the design of all these systems on a contemporary interaction paradigm that emphasizes physical interaction on tangible interaction, a contemporary interaction paradigm; and second, by comprehensively studying user performance in these systems through a set of novel performance metrics grounded on epistemic actions, a relatively well established and studied construct in the literature on embodied cognition. The first system presented in this dissertation is an augmented Four-in-a-row board game. Three different versions of the game were developed, based on three different interaction paradigms (tangible, touch and mouse), and a repeated measures study involving 36 participants measured the occurrence of three simple epistemic actions across these three interfaces. The results highlight the relevance of epistemic actions in such a task and suggest that the different interaction paradigms afford instantiation of these actions in different ways. Additionally, the tangible version of the system supports the most rapid execution of these actions, providing novel quantitative insights into the real benefits of tangible systems. The second system presented in this dissertation is a tangible tabletop scheduling application. Two studies with single and paired users provide several insights into the impact of epistemic actions on the user experience when these are performed outside of a system’s sensing boundaries. These insights are clustered by the form, size and location of ideal interface areas for such offline epistemic actions to occur, as well as how can physical tokens be designed to better support them. Finally, and based on the results obtained to this point, the last study presented in this dissertation directly addresses the lack of empirical tools to formally evaluate tangible interaction. It presents a video-coding framework grounded on a systematic literature review of 78 papers, and evaluates its value as metric through a 60 participant study performed across three different research laboratories. The results highlight the usefulness and power of epistemic actions as a performance metric for tangible systems. In sum, through the use of such novel metrics in each of the three studies presented, this dissertation provides a better understanding of the real impact and benefits of designing and developing systems that feature tangible interaction.