Reinvigorating and redesigning early intervention in psychosis services for young people in Auckland

RESUMO: Auckland tem sido pioneira na implementação de modelos de Intervenção Precoce em Psicose. No entanto, esta organização do serviço não mudou nos últimos 19 anos. Segundo os dados obtidos da utilização do serviço, no período de 1996 -2012 foram atendidos 997 doentes, que tinham um número médio de 89 contactos (IQR: 36-184), com uma duração média de 62 horas de contactos (IQR: 24-136). Estes doentes passaram um número médio de 338 dias (IQR: 93-757) em contacto com o programa. 517 doentes (52%) não necessitaram de internamento no hospital, e os que foram internados, ficaram uma mediana de 124 dias no hospital (IQR: 40-380). Os doentes asiáticos tiveram um aumento de 50% de probabilidade de serem internados no hospital. Este relatório inclui 15 recomendações para orientar as reformas para o serviço e, nomeadamente, delinear a importância de uma visão organizacional e dos seus componentes-chave. As recomendações incluem o reforço da gestão e da liderança numa estrutura de equipe mais integrada, com recursos dedicados a melhorar a consciencialização da comunidade, a educação e deteção precoce, bem como a capacidade de receber referenciações diretas. Os Indicadores Chave de Desempenho devem ser estabelecidos, mas os Exames de Estado Mental em risco, devem ser removidos. Auckland deve manter a faixa etária alvo atual. A duração do serviço deve ser aumentada para um mínimo de três anos, com a opção de aumentá-la para cinco anos. A proporção de gestor de cuidados para os doentes deve ser preconizada em 1:15, enquanto o pessoal de apoio não-clínico deve ser aumentado. Os psiquiatras devem ter uma carga de trabalho de cerca de 80 doentes por equivalente de tempo completo. Um serviço local de prestação de cuidados deve ser desenvolvido com, nomeadamente, intervenções culturais para responder às necessidades da população multicultural de Auckland. A capacidade de investigação deve ser incorporada no Serviço de Intervenção Precoce em Psicoses. Qualquer alteração deverá envolver contacto com todas as partes interessadas, e a Administração Regional de Saúde deve comprometer-se em tempo, recursos humanos e políticos para apoiar e facilitar a mudança do sistema, investindo de forma significativa para melhor servir a comunidade Auckland.----------------------------------- ABSTRACT: Auckland has been pioneering in the adoption of Early Intervention in Psychosis models but the design of the service has not changed in 19 years. In service utilisation data from 997 patients seen from 1996 -2012, patients had a median number of 89 contacts (IQR: 36-184), with a median duration of 62 hours of contact (IQR: 24-136). Patients spent a median number of 338 days (IQR: 93-757) in contact with the program. 517 patients (52%) did not require admission to hospital, and those who did spent a median of 124 days in hospital (IQR: 40-380). Asian patients had a 50% increased chance of being admitted to hospital. This report includes 15 recommendations to guide reforms to the service, including outlining the importance of vision and key components. It recommends strengthened managerial leadership and a more integrated team structure with dedicated resources for improved community awareness, education and early detection as well as the capacity to take direct referrals. Key Performance Indicators (KPIs) should be established but At Risk Mental States should be excluded. Auckland should maintain the current target age range. The duration of service should be increased to a minimum of three years, with the option to extend this to five years. The ratio of care co-ordinator to patients should be capped at 1:15 whilst non-clinical supporting staff should be increased. Psychiatrists should have a caseload of about 80 per FTE. A local Service Delivery framework should be developed, as should cultural interventions to meet the needs of the multicultural population of Auckland. Research capacity should be incorporated into the fabric of Early Intervention in Psychosis Services. Any changes should involve consultation with all stakeholders, and the DHB should commit to investing time, human and political resources to support and facilitate meaningful system change to best serve the Auckland community.

Definition, implementation and management of m.commerce apps and services

This report aims to analyse the Definition, Implementation and Management of Vodafone Portugal’s Apps and Services, so that possible ways of improvement can be suggested. To do so, Vodafone’s strategy regarding the development/ implementation of specific Apps and Services, as well as the strategy of its competitors are going to be analysed. This analysis is going to be complemented with insights from some key-persons of Vodafone’s Consumer Business Unit team in Portugal. Findings suggest that Vodafone is ahead of its competitors when it comes to developing the most innovative Apps and Services, but there is always room for improvements, especially when it comes to communication.

Ideation at Canon business services

Digitalisation, globalisation, and evolving customer demands are only a few of the factors that are bound to transform the business process services industry for CBS. By investigating new ways to address these imminent challenges, this thesis explores the feasibility of implementing a formal approach to ideation to complement CBS’ service innovation practice. Two workshops were therefore conducted to put theory into action by generating new service ideas in a multifunctional team. Applying both divergent and convergent ideation techniques revealed that the latter improved an idea’s novelty and creativity as opposed to the expected increase in workability and relevance. Additionally, further analysis sheds light into the potential influence of individual characteristics and group dynamics on creativity. The thesis concludes with a discussion on the organisational implications of the findings and recommendations for future research.

Community indentification in peer-t-peer collaborative consumption services

Even though collaborative consumption (CC) is gaining economic importance, research in CC is still in its infancy. Consumers’ reasons for participating have already been investigated but little research on consequences of participation has been conducted. This article examines whether interactions between customers in peer-to-peer CC services influence the willingness to coproduce service outcomes. Drawing on social exchange theory, it is proposed that this effect is mediated by consumers’ identification with the brand community. Furthermore, continuance intention in CC is introduced as a second stage moderator. In a cross-sectional study, customers of peer-to-peer accommodation sharing are surveyed. While customer-to-customer interactions were found to have a positive effect on brand community identification, brand community identification did not positively affect co-production intention. Surprisingly, the effect of brand community identification on co-production intention was negative. Moreover, continuance intention of customers did not moderate this relationship. Bearing in mind current challenges for researchers and companies, theoretical and managerial implications are discussed.

Dynamic range prediction for an electric vehicle

Electric Vehicles (EVs) have limited energy storage capacity and the maximum autonomy range is strongly dependent of the driver's behaviour. Due to the fact of that batteries cannot be recharged quickly during a journey, it is essential that a precise range prediction is available to the driver of the EV. With this information, it is possible to check if the desirable destination is achievable without a stop to charge the batteries, or even, if to reach the destination it is necessary to perform an optimized driving (e.g., cutting the air-conditioning, among others EV parameters). The outcome of this research work is the development of an Electric Vehicle Assistant (EVA). This is an application for mobile devices that will help users to take efficient decisions about route planning, charging management and energy efficiency. Therefore, it will contribute to foster EVs adoption as a new paradigm in the transportation sector.

On-board electric vehicle battery charger with enhanced V2H operation mode

This paper proposes an on-board Electric Vehicle (EV) battery charger with enhanced Vehicle-to-Home (V2H) operation mode. For such purpose was adapted an on-board bidirectional battery charger prototype to allow the Grid-to-Vehicle (G2V), Vehicle-to-Grid (V2G) and V2H operation modes. Along the paper are presented the hardware topology and the control algorithms of this battery charger. The idea underlying to this paper is the operation of the on-board bidirectional battery charger as an energy backup system when occurs a power outages. For detecting the power outage were compared two strategies, one based on the half-cycle rms calculation of the power grid voltage, and another in the determination of the rms value based in a Kalman filter. The experimental results were obtained considering the on-board EV battery charger under the G2V, V2G, and V2H operation modes. The results show that the power outage detection is faster using a Kalman filter, up to 90% than the other strategy. This also enables a faster transition between operation modes when a power outage occurs.

Electric vehicle assistant based in driver profile

This paper presents the outcomes of a research work consisting in the development of an Electric Vehicle Assistant (EVA), which creates and stores a driver profile where are contained the driving behaviours related with the EV energy consumption, the EV battery charging information, and the performed routes. This is an application for mobile devices that is able to passively track the driver behaviour and to access several information related with the EV in real time. It is also proposed a range prediction approach based on probability to take into account unpredictable effects of personal driving style, traffic or weather.

Vehicle-to-anything application (v2anything app) for electric vehicles

This paper presents a mobile information system denominated as Vehicle-to-Anything Application (V2Anything App), and explains its conceptual aspects. This application is aimed at giving relevant information to Full Electric Vehicle (FEV) drivers, by supporting the integration of several sources of data in a mobile application, thus contributing to the deployment of the electric mobility process. The V2Anything App provides recommendations to the drivers about the FEV range autonomy, location of battery charging stations, information of the electricity market, and also a route planner taking into account public transportations and car or bike sharing systems. The main contributions of this application are related with the creation of an Information and Communication Technology (ICT) platform, recommender systems, data integration systems, driver profile, and personalized range prediction. Thus, it is possible to deliver relevant information to the FEV drivers related with the electric mobility process, electricity market, public transportation, and the FEV performance.

Smart charging management for electric vehicle battery chargers

This paper proposes a smart battery charging strategy for Electric Vehicles (EVs) targeting the future smart homes. The proposed strategy consists in regulate the EV battery charging current in function of the total home current, aiming to prevent overcurrent trips in the main switch breaker. Computational and experimental results were obtained under real-time conditions to validate the proposed strategy. For such purpose was adapted a bidirectional EV battery charger prototype to operate in accordance with the aforementioned strategy. The proposed strategy was validated through experimental results obtained both in steady and transient states. The results show the correct operation of the EV battery charger even under heavy load variations.

A case study on the conversion of an internal combustion engine vehicle into an electric vehicle

This paper presents the conversion process of a traditional Internal Combustion Engine vehicle into an Electric Vehicle. The main constitutive elements of the Electric Vehicle are presented. The developed powertrain uses a three-phase inverter with Field Oriented Control and space vector modulation. The developed on-board batteries charging system can operate in Grid-to-Vehicle and Vehicle-to-Grid modes. The implemented prototypes were tested, and experimental results are presented. The assembly of these prototypes in the vehicle was made in accordance with the Portuguese legislation about vehicles conversion, and the main adopted solutions are presented.

A decision support system for a waste collection vehicle routing problem

The selective collection of municipal solid waste for recycling is a very complex and expensive process, where a major issue is to perform cost-efficient waste collection routes. Despite the abundance of commercially available software for fleet management, they often lack the capability to deal properly with sequencing problems and dynamic revision of plans and schedules during process execution. Our approach to achieve better solutions for the waste collection process is to model it as a vehicle routing problem, more specifically as a team orienteering problem where capacity constraints on the vehicles are considered, as well as time windows for the waste collection points and for the vehicles. The final model is called capacitated team orienteering problem with double time windows (CTOPdTW).We developed a genetic algorithm to solve routing problems in waste collection modelled as a CTOPdTW. The results achieved suggest possible reductions of logistic costs in selective waste collection.

Aggregating community resources of care and assistance services for the elderly population

Changes in population age structure are a major concern and represent a priority in the agendas and policies of the developed world, which are demanding for renewed models of social and healthcare as well as assistance services to the elderly population. Studies indicate that as far as possible these types of services should desirably be provided at the user’s home, and that ICT-based solutions can have tremendous impact on the delivery of new services. This paper highlight and discusses some of the main results of a project undertaken in a Portuguese Municipality that demonstrates the potential contribution of an e-Marketplace of care and assistance services to the well-being of elderly people. Studies undertaken allowed identifying the main services that should be provided by such e-Marketplace (termed GuiMarket), the relevance that the population grant to this platform and, conversely, the fact that the Digital Divide phenomena influences the potential utilization of this project (and alike projects). The findings support that there is a strong relation between age and qualifications, and between access to ICT and the intended use of GuiMarket.

A proactive intelligent decision support system for predicting the popularity of online news

"Lecture notes in computer science series, ISSN 0302-9743, vol. 9273"

Bidirectional battery charger with grid-to-vehicle, vehicle-to-grid and vehicle-to-home technologies

This paper presents the development of na on-board bidirectional battery charger for Electric Vehicles (EVs) targeting Grid-to-Vehicle (G2V), Vehicle-to-Grid (V2G), and Vehicle-to-Home (V2H) technologies. During the G2V operation mode the batteries are charged from the power grid with sinusoidal current and unitary power factor. During the V2G operation mode the energy stored in the batteries can be delivered back to the power grid contributing to the power system stability. In the V2H operation mode the energy stored in the batteries can be used to supply home loads during power outages, or to supply loads in places without connection to the power grid. Along the paper the hardware topology of the bidirectional battery charger is presented and the control algorithms are explained. Some considerations about the sizing of the AC side passive filter are taken into account in order to improve the performance in the three operation modes. The adopted topology and control algorithms are accessed through computer simulations and validated by experimental results achieved with a developed laboratory prototype operating in the different scenarios.

Spousal support and satisfaction with healthcare services as moderators between psychological morbidity and adherence to diet in Type 2 Diabetes patients

Objectives: This study analyzed the moderating role of partners’ support and satisfaction with healthcare services in the relationship between psychological morbidity and adherence to diet in patients with type 2 diabetes (T2DM). Methods: Participants were 387 recently diagnosed T2DM patients that answered the following instruments: Revised Summary of Diabetes Self- Care Activities Measure, Hospital Anxiety and Depression Scales, Multidimensional Diabetes Questionnaire and Patient Satisfaction Questionnaire. Results: Partners’ positive and negative support moderated the relationship between psychological morbidity and adherence to diet. Satisfaction with healthcare services also moderated the relationship between psychological morbidity and adherence to diet. Conclusions: Intervention programs to promote adherence to diet in patients with type 2 diabetes should focus on partners’ support and patient satisfaction with healthcare services.