Use of Mental Health Services by Persons With A Mental Illness in Nursing Facilities: Initial Impacts of OBRA87.

To identify mental health service use patterns in nursing facilities subsequent to nursing home reforms in the Omnibus Budget Reconciliation Act of 1987.

Social support, health status and health services utilization among the noninstitutionalized elderly: An analysis of the Supplement on Aging to the 1984 national health interview survey

The association between Social Support, Health Status, and Health Services Utilization of the elderly, was explored based on the analysis of data from the Supplement on Aging to the National Health Interview Survey, 1984 (N = 11,497) using a modified framework of Aday and Andersen's Expanded Behavioral Model. The results suggested that Social Support as operationalized in this study was an independent determinant of the use of health services. The quantity of social activities and the use of community services were the two most consistent determinants across different types of health services use.^ The effects of social support on the use of health services were broken down into three components to facilitate explanations of the mechanisms through which social support operated. The Predisposing and Enabling component of Social Support had independent, although not uniform, effects on the use of health services. Only slight substitute effects of social support were detected. These included the substitution of the use of senior centers for longer stay in the hospital and the substitution of help with IADL problems for the use of formal home care services.^ The effect of financial support on the use of health services was found to be different for middle and low income populations. This differential effect was also found for the presence of intimate networks, the frequencies of interaction with children and the perceived availability of support among urban/rural, male/female and white/non-white subgroups.^ The study also suggested that the selection of appropriate Health Status measures should be based on the type of Health Services Utilization in which a researcher is interested. The level of physical function limitation and role activity limitation were the two most consistent predictors of the volume of physician visits, number of hospital days, and average length of stay in the hospital during the past year.^ Some alternative hypotheses were also raised and evaluated, when possible. The impacts of the complex sample design, the reliability and validity of the measures and other limitations of this analysis were also discussed. Finally, a revised framework was proposed and discussed based on the analysis. Some policy implications and suggestions for future study were also presented. ^

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).

Personalisation of intelligent homecare services adapted to children with motor impairments

Ambient Intelligence could support innovative application domains like motor impairments' detection at the home environment. This research aims to prevent neurodevelopmental disorders through the natural interaction of the children with embedded intelligence daily life objects, like home furniture and toys. Designed system uses an interoperable platform to provide two intelligent interrelated home healthcare services: monitoring of children¿s abilities and completion of early stimulation activities. A set of sensors, which are embedded within the rooms, toys and furniture, allows private data gathering about the child's interaction with the environment. This information feeds a reasoning subsystem, which encloses an ontology of neurodevelopment items, and adapts the service to the age and acquisition of expected abilities. Next, the platform proposes customized stimulation services by taking advantage of the existing facilities at the child's environment. The result integrates Embedded Sensor Systems for Health at Mälardalen University with UPM Smart Home, for adapted services delivery.

Service capacity reserve under uncertainty by hospital's ER's analogies: a practical model for car services

El objetivo de esta investigación consiste en definir un modelo de reserva de capacidad, por analogías con emergencias hospitalarias, que pueda ser implementado en el sector de servicios. Este está específicamente enfocado a su aplicación en talleres de servicio de automóviles. Nuestra investigación incorpora la incertidumbre de la demanda en un modelo singular diseñado en etapas que agrupa técnicas ARIMA, teoría de colas y simulación Monte Carlo para definir los conceptos de capacidad y ocupación de servicio, que serán utilizados para minimizar el coste implícito de la reserva capacidad necesaria para atender a clientes que carecen de cita previa. Habitualmente, las compañías automovilísticas estiman la capacidad de sus instalaciones de servicio empíricamente, pero los clientes pueden llegar bajo condiciones de incertidumbre que no se tienen en cuenta en dichas estimaciones, por lo que existe una diferencia entre lo que el cliente realmente demanda y la capacidad que ofrece el servicio. Nuestro enfoque define una metodología válida para el sector automovilístico que cubre la ausencia genérica de investigaciones recientes y la habitual falta de aplicación de técnicas estadísticas en el sector. La equivalencia con la gestión de urgencias hospitalarias se ha validado a lo largo de la investigación en la se definen nuevos indicadores de proceso (KPIs) Tal y como hacen los hospitales, aplicamos modelos estocásticos para dimensionar las instalaciones de servicio de acuerdo con la distribución demográfica del área de influencia. El modelo final propuesto integra la predicción del coste implícito en la reserva de capacidad para atender la demanda no prevista. Asimismo, se ha desarrollado un código en Matlab que puede integrarse como un módulo adicional a los sistemas de información (DMS) que se usan actualmente en el sector, con el fin de emplear los nuevos indicadores de proceso definidos en el modelo. Los resultados principales del modelo son nuevos indicadores de servicio, tales como la capacidad, ocupación y coste de reserva de capacidad, que nunca antes han sido objeto de estudio en la industria automovilística, y que están orientados a gestionar la operativa del servicio. ABSTRACT Our aim is to define a Capacity Reserve model to be implemented in the service sector by hospital's emergency room (ER) analogies, with a practical approach to passenger car services. A stochastic model has been implemented using R and a Monte Carlo simulation code written in Matlab and has proved a very useful tool for optimal decision making under uncertainty. The research integrates demand uncertainty in a unique model which is built in stages by implementing ARIMA forecasting, Queuing Theory and a Monte Carlo simulation to define the concepts of service capacity and occupancy, minimizing the implicit cost of the capacity that must be reserved to service unexpected customers. Usually, passenger car companies estimate their service facilities capacity using empirical methods, but customers arrive under uncertain conditions not included in the estimations. Thus, there is a gap between customer’s real demand and the dealer’s capacity. This research sets a valid methodology for the passenger car industry to cover the generic absence of recent researches and the generic lack of statistical techniques implementation. The hospital’s emergency room (ER) equalization has been confirmed to be valid for the passenger car industry and new process indicators have been defined to support the study. As hospitals do, we aim to apply stochastic models to dimension installations according to the demographic distribution of the area to be serviced. The proposed model integrates the prediction of the cost implicit in the reserve capacity to serve unexpected demand. The Matlab code could be implemented as part of the existing information technology systems (ITs) to support the existing service management tools, creating a set of new process indicators. Main model outputs are new indicators, such us Capacity, Occupancy and Cost of Capacity Reserve, never studied in the passenger car service industry before, and intended to manage the service operation.

La conduite avec facultés affaiblies : les contrevenants et les services offerts dans les établissements de détention du Québec

Rapport de stage présenté à la Faculté des études supérieures en vue de l’obtention du grade de Maître ès science (M. Sc.) en criminologie Option stage en analyse criminologique

La conduite avec facultés affaiblies : les contrevenants et les services offerts dans les établissements de détention du Québec

Rapport de stage présenté à la Faculté des études supérieures en vue de l’obtention du grade de Maître ès science (M. Sc.) en criminologie Option stage en analyse criminologique

National Survey of Substance Abuse Treatment Services (N-SSATS) : 2000 data on substance abuse treatment facilities.

"June 2002"--T.p. verso."

Remote storage, facilities, materials selection, and user services /

"May 1990.

Report on the inspection of military facilities in Panama and Bermuda of the Committee on Armed Services, House of Representatives, Ninety-seventh Congress, first session.

Mode of access: Internet.

Section recommendations on facilities, programs, and services; with related recommendations from other sections and special concerns sessions /

Cover title: "Recommended for action: facilities, programs and services."

Michigan tax survey 1952; the support of State services in Michigan.

Mode of access: Internet.

The nature and level of federal support for museums in fiscal years 1985 and 1986 : a federal study mandated by Congress and conducted by the Institute of Museum Services on behalf of the Federal Council on the Arts and the Humanities, submitted to Congress February 1988.

Cover title.

Deliberation Support Division products and services.

Cover title: Deliberation Support Division (DSD) products and services.

Hearings on H.R. 2920 (H.R. 3455) : to authorize certain construction ... : before the Military Installations and Facilities Subcommittee of the Committee on Armed Services, House of Representatives, Ninety-seventh Congress, first session, hearings held March 5, 25, 26, 27, April 1, 2, 3, 8, and 29, 1981.

Mode of access: Internet.