Roadmap for implementing the Chronic Care Model for weight management: Healthcare Institution's Response to Obesity (HIRO)

Background. Excess weight and obesity are at epidemic proportions in the United States and place individuals at increased risk for a variety of chronic conditions. Rates of diabetes, high blood pressure, coronary artery disease, stroke, cancer, and arthritis are all influenced by the presence of obesity. Small reductions in excess weight can produce significant positive clinical outcomes. Healthcare organizations have a vital role to play in the identification and management of obesity. Currently, healthcare providers do not adequately diagnose and manage excess weight in patients. Lack of skill, time, and knowledge are commonly cited as reasons for non-adherence to recommended standards of care. The Chronic Care Model offers an approach to healthcare organizations for chronic disease management. The model consists of six elements that work together to empower both providers and patients to have more productive interactions: the community, the health system itself, self-management support, delivery system design, decision support, and clinical information systems. The model and its elements may offer a framework through which healthcare organizations can adapt to support, educate, and empower providers and patients in the management of excess weight and obesity. Successful management of excess weight will reduce morbidity and mortality of many chronic conditions. Purpose. The purpose of this review is to synthesize existing research on the effectiveness of the Chronic Care Model and its elements as they relate to weight management and behaviors associated with maintaining a healthy weight. Methods: A narrative review of the literature between November 1998 and November 2008 was conducted. The review focused on clinical trials, systematic reviews, and reports related to the chronic care model or its elements and weight management, physical activity, nutrition, or diabetes. Fifty-nine articles are included in the review. Results. This review highlights the use of the Chronic Care Model and its elements that can result in improved quality of care and clinical outcomes related to weight management, physical activity, nutrition, and diabetes. Conclusions. Healthcare organizations can use the Chronic Care Model framework to implement changes within their systems to successfully address overweight and obesity in their patient populations. Specific recommendations for operationalizing the Chronic Care Model elements for weight management are presented.^

Relating one's social support network to one's mid term grade

Much has been written about the relation of social support to health outcomes. Support networks were found to be predictive of health status. Not so clear was the manner in which social support helped the individual to avoid health complications. Whereas some aspects of the support network were protective, others were burdensome. Duties to one's network could serve as a stressor and duties outside one's network might stress the support system itself. Exposure to one's network was associated with certain health risks while disruption in one's social support network was associated with other health risks.^ Many factors contributed to the impact of a social support network upon the individual member: the characteristics of the individual, the individual's role or position within the network, qualities of the network and duties or indebtedness of the individual to the network. This investigation considered the possibility that performance could serve as a stressor in a fashion similar to an exposure to a health hazard.^ Because the literature includes many examples of studies in which the subjects were college students, academic progress is a performance common to most subjects. A profile of the support networks of successful students was contrasted with those of less successful students in this correlational study.^ What was uncovered in this investigation was a very complex web of interrelated constructs. Most aspects of the social support network did not significantly predict academic performance. Only a limited number of characteristics were associated with academic success: the frequency of support, student age, the existence of a 'mentor' within one' s network, and the extent to which one received a predominant source of support. Other factors had a tendency to be negatively correlated with midterm grade, suggesting those factors may impede academic performance.^ Medical status did not predict grades, but was correlated with many aspects of the network. Disruptions in particular parts of one's network were correlated with particular health categories. In fact, disruption in social support was more predictive of academic outcomes than medical complications. Whereas the individual's values were related to the contributing factors, only the individual's satisfaction with certain aspects of the support network were predictive of higher midterm grades in a psychology class. Dissatisfaction was associated with lower grades, suggesting a disruptive effect within the network. Associations among the features of support networks which predicted academic progress were considered. ^

Errors in the administration of medication in inpatient hospitals: A systematic review of the research literature on commercial computerized physician order entry systems

Errors in the administration of medication represent a significant loss of medical resources and pose life altering or life threatening risks to patients. This paper considered the question, what impact do Computerized Physician Order Entry (CPOE) systems have on medication errors in the hospital inpatient environment? Previous reviews have examined evidence of the impact of CPOE on medication errors, but have come to ambiguous conclusions as to the impact of CPOE and decision support systems (DSS). Forty-three papers were identified. Thirty-one demonstrated a significant reduction in prescribing error rates for all or some drug types; decreases in minor errors were most often reported. Several studies reported increases in the rate of duplicate orders and failures to remove contraindicated drugs, often attributed to inappropriate design or to an inability to operate the system properly. The evidence on the effectiveness of CPOE to reduce errors in medication administration is compelling though it is limited by modest study sample sizes and designs. ^

Continuous multi-criteria methods for crop and soil conservation planning on La Colacha (Río Cuarto, Province of Cordoba, Argentina)

Agro-areas of Arroyos Menores (La Colacha) west and south of Rand south of R?o Cuarto (Prov. of Cordoba, Argentina) basins are very fertile but have high soil loses. Extreme rain events, inundations and other severe erosions forming gullies demand urgently actions in this area to avoid soil degradation and erosion supporting good levels of agro production. The authors first improved hydrologic data on La Colacha, evaluated the systems of soil uses and actions that could be recommended considering the relevant aspects of the study area and applied decision support systems (DSS) with mathematic tools for planning of defences and uses of soils in these areas. These were conducted here using multi-criteria models, in multi-criteria decision making (MCDM); first of discrete MCDM to chose among global types of use of soils, and then of continuous MCDM to evaluate and optimize combined actions, including repartition of soil use and the necessary levels of works for soil conservation and for hydraulic management to conserve against erosion these basins. Relatively global solutions for La Colacha area have been defined and were optimised by Linear Programming in Goal Programming forms that are presented as Weighted or Lexicographic Goal Programming and as Compromise Programming. The decision methods used are described, indicating algorithms used, and examples for some representative scenarios on La Colacha area are given.

AUTOFLY-Aid: Flight Deck Automation Support with Dynamic 4D Trajectory Management for Responsive and Adaptive Airborne Collision Avoidance

AUTOFLY-Aid Project aims to develop and demonstrate novel automation support algorithms and tools to the flight crew for flight critical collision avoidance using “dynamic 4D trajectory management”. The automation support system is envisioned to improve the primary shortcomings of TCAS, and to aid the pilot through add-on avionics/head-up displays and reality augmentation devices in dynamically evolving collision avoidance scenarios. The main theoretical innovative and novel concepts to be developed by AUTOFLY-Aid project are a) design and development of the mathematical models of the full composite airspace picture from the flight deck’s perspective, as seen/measured/informed by the aircraft flying in SESAR 2020, b) design and development of a dynamic trajectory planning algorithm that can generate at real-time (on the order of seconds) flyable (i.e. dynamically and performance-wise feasible) alternative trajectories across the evolving stochastic composite airspace picture (which includes new conflicts, blunder risks, terrain and weather limitations) and c) development and testing of the Collision Avoidance Automation Support System on a Boeing 737 NG FNPT II Flight Simulator with synthetic vision and reality augmentation while providing the flight crew with quantified and visual understanding of collision risks in terms of time and directions and countermeasures.

Consolidation of a wsn and minimax method to rapidly neutralise intruders in strategic installations

Due to the sensitive international situation caused by still-recent terrorist attacks, there is a common need to protect the safety of large spaces such as government buildings, airports and power stations. To address this problem, developments in several research fields, such as video and cognitive audio, decision support systems, human interface, computer architecture, communications networks and communications security, should be integrated with the goal of achieving advanced security systems capable of checking all of the specified requirements and spanning the gap that presently exists in the current market. This paper describes the implementation of a decision system for crisis management in infrastructural building security. Specifically, it describes the implementation of a decision system in the management of building intrusions. The positions of the unidentified persons are reported with the help of a Wireless Sensor Network (WSN). The goal is to achieve an intelligent system capable of making the best decision in real time in order to quickly neutralise one or more intruders who threaten strategic installations. It is assumed that the intruders’ behaviour is inferred through sequences of sensors’ activations and their fusion. This article presents a general approach to selecting the optimum operation from the available neutralisation strategies based on a Minimax algorithm. The distances among different scenario elements will be used to measure the risk of the scene, so a path planning technique will be integrated in order to attain a good performance. Different actions to be executed over the elements of the scene such as moving a guard, blocking a door or turning on an alarm will be used to neutralise the crisis. This set of actions executed to stop the crisis is known as the neutralisation strategy. Finally, the system has been tested in simulations of real situations, and the results have been evaluated according to the final state of the intruders. In 86.5% of the cases, the system achieved the capture of the intruders, and in 59.25% of the cases, they were intercepted before they reached their objective.

Propuesta de algoritmos de predicción de glucosa en pacientes diabéticos

La diabetes mellitus es el conjunto de alteraciones provocadas por un defecto en la cantidad de insulina secretada o por un aprovechamiento deficiente de la misma. Es causa directa de complicaciones a corto, medio y largo plazo que disminuyen la calidad y las expectativas de vida de las personas con diabetes. La diabetes mellitus es en la actualidad uno de los problemas más importantes de salud. Ha triplicado su prevalencia en los últimos 20 anos y para el año 2025 se espera que existan casi 300 millones de personas con diabetes. Este aumento de la prevalencia junto con la morbi-mortalidad asociada a sus complicaciones micro y macro-vasculares convierten la diabetes en una carga para los sistemas sanitarios, sus recursos económicos y sus profesionales, haciendo de la enfermedad un problema individual y de salud pública de enormes proporciones. De momento no existe cura a esta enfermedad, de modo que el objetivo terapéutico del tratamiento de la diabetes se centra en la normalización de la glucemia intentando minimizar los eventos de hiper e hipoglucemia y evitando la aparición o al menos retrasando la evolución de las complicaciones vasculares, que constituyen la principal causa de morbi-mortalidad de las personas con diabetes. Un adecuado control diabetológico implica un tratamiento individualizado que considere multitud de factores para cada paciente (edad, actividad física, hábitos alimentarios, presencia de complicaciones asociadas o no a la diabetes, factores culturales, etc.). Sin embargo, a corto plazo, las dos variables más influyentes que el paciente ha de manejar para intervenir sobre su nivel glucémico son la insulina administrada y la dieta. Ambas presentan un retardo entre el momento de su aplicación y el comienzo de su acción, asociado a la absorción de los mismos. Por este motivo la capacidad de predecir la evolución del perfil glucémico en un futuro cercano, ayudara al paciente a tomar las decisiones adecuadas para mantener un buen control de su enfermedad y evitar situaciones de riesgo. Este es el objetivo de la predicción en diabetes: adelantar la evolución del perfil glucémico en un futuro cercano para ayudar al paciente a adaptar su estilo de vida y sus acciones correctoras, con el propósito de que sus niveles de glucemia se aproximen a los de una persona sana, evitando así los síntomas y complicaciones de un mal control. La aparición reciente de los sistemas de monitorización continua de glucosa ha proporcionado nuevas alternativas. La disponibilidad de un registro exhaustivo de las variaciones del perfil glucémico, con un periodo de muestreo de entre uno y cinco minutos, ha favorecido el planteamiento de nuevos modelos que tratan de predecir la glucemia utilizando tan solo las medidas anteriores de glucemia o al menos reduciendo significativamente la información de entrada a los algoritmos. El hecho de requerir menor intervención por parte del paciente, abre nuevas posibilidades de aplicación de los predictores de glucemia, haciéndose viable su uso en tiempo real, como sistemas de ayuda a la decisión, como detectores de situaciones de riesgo o integrados en algoritmos automáticos de control. En esta tesis doctoral se proponen diferentes algoritmos de predicción de glucemia para pacientes con diabetes, basados en la información registrada por un sistema de monitorización continua de glucosa así como incorporando la información de la insulina administrada y la ingesta de carbohidratos. Los algoritmos propuestos han sido evaluados en simulación y utilizando datos de pacientes registrados en diferentes estudios clínicos. Para ello se ha desarrollado una amplia metodología, que trata de caracterizar las prestaciones de los modelos de predicción desde todos los puntos de vista: precisión, retardo, ruido y capacidad de detección de situaciones de riesgo. Se han desarrollado las herramientas de simulación necesarias y se han analizado y preparado las bases de datos de pacientes. También se ha probado uno de los algoritmos propuestos para comprobar la validez de la predicción en tiempo real en un escenario clínico. Se han desarrollado las herramientas que han permitido llevar a cabo el protocolo experimental definido, en el que el paciente consulta la predicción bajo demanda y tiene el control sobre las variables metabólicas. Este experimento ha permitido valorar el impacto sobre el control glucémico del uso de la predicción de glucosa. ABSTRACT Diabetes mellitus is the set of alterations caused by a defect in the amount of secreted insulin or a suboptimal use of insulin. It causes complications in the short, medium and long term that affect the quality of life and reduce the life expectancy of people with diabetes. Diabetes mellitus is currently one of the most important health problems. Prevalence has tripled in the past 20 years and estimations point out that it will affect almost 300 million people by 2025. Due to this increased prevalence, as well as to morbidity and mortality associated with micro- and macrovascular complications, diabetes has become a burden on health systems, their financial resources and their professionals, thus making the disease a major individual and a public health problem. There is currently no cure for this disease, so that the therapeutic goal of diabetes treatment focuses on normalizing blood glucose events. The aim is to minimize hyper- and hypoglycemia and to avoid, or at least to delay, the appearance and development of vascular complications, which are the main cause of morbidity and mortality among people with diabetes. A suitable, individualized and controlled treatment for diabetes involves many factors that need to be considered for each patient: age, physical activity, eating habits, presence of complications related or unrelated to diabetes, cultural factors, etc. However, in the short term, the two most influential variables that the patient has available in order to manage his/her glycemic levels are administered insulin doses and diet. Both suffer from a delay between their time of application and the onset of the action associated with their absorption. Therefore, the ability to predict the evolution of the glycemic profile in the near future could help the patient to make appropriate decisions on how to maintain good control of his/her disease and to avoid risky situations. Hence, the main goal of glucose prediction in diabetes consists of advancing the evolution of glycemic profiles in the near future. This would assist the patient in adapting his/her lifestyle and in taking corrective actions in a way that blood glucose levels approach those of a healthy person, consequently avoiding the symptoms and complications of a poor glucose control. The recent emergence of continuous glucose monitoring systems has provided new alternatives in this field. The availability of continuous records of changes in glycemic profiles (with a sampling period of one or five minutes) has enabled the design of new models which seek to predict blood glucose by using automatically read glucose measurements only (or at least, reducing significantly the data input manually to the algorithms). By requiring less intervention by the patient, new possibilities are open for the application of glucose predictors, making its use feasible in real-time applications, such as: decision support systems, hypo- and hyperglycemia detectors, integration into automated control algorithms, etc. In this thesis, different glucose prediction algorithms are proposed for patients with diabetes. These are based on information recorded by a continuous glucose monitoring system and incorporate information of the administered insulin and carbohydrate intakes. The proposed algorithms have been evaluated in-silico and using patients’ data recorded in different clinical trials. A complete methodology has been developed to characterize the performance of predictive models from all points of view: accuracy, delay, noise and ability to detect hypo- and hyperglycemia. In addition, simulation tools and patient databases have been deployed. One of the proposed algorithms has additionally been evaluated in terms of real-time prediction performance in a clinical scenario in which the patient checked his/her glucose predictions on demand and he/she had control on his/her metabolic variables. This has allowed assessing the impact of using glucose prediction on glycemic control. The tools to carry out the defined experimental protocols were also developed in this thesis.

Parallel workflows to personalize clinical guidelines recommendations: application to gestational diabetes mellitus

The MobiGuide system provides patients with personalized decision support tools, based on computerized clinical guidelines, in a mobile environment. The generic capabilities of the system will be demonstrated applied to the clinical domain of Gestational Diabetes (GD). This paper presents a methodology to identify personalized recommendations, obtained from the analysis of the GD guideline. We added a conceptual parallel part to the formalization of the GD guideline called "parallel workflow" that allows considering patient?s personal context and preferences. As a result of analysing the GD guideline and eliciting medical knowledge, we identified three different types of personalized advices (therapy, measurements and upcoming events) that will be implemented to perform patients? guiding at home, supported by the MobiGuide system. These results will be essential to determine the distribution of functionalities between mobile and server decision support capabilities.

Automatic blood glucose classification for gestational diabetes with feature selection: decision trees vs neural networks

Automatic blood glucose classification may help specialists to provide a better interpretation of blood glucose data, downloaded directly from patients glucose meter and will contribute in the development of decision support systems for gestational diabetes. This paper presents an automatic blood glucose classifier for gestational diabetes that compares 6 different feature selection methods for two machine learning algorithms: neural networks and decision trees. Three searching algorithms, Greedy, Best First and Genetic, were combined with two different evaluators, CSF and Wrapper, for the feature selection. The study has been made with 6080 blood glucose measurements from 25 patients. Decision trees with a feature set selected with the Wrapper evaluator and the Best first search algorithm obtained the best accuracy: 95.92%.

Plataforma de conocimiento evolutivo para detección temprana de transtornos del lenguaje

Este Proyecto Fin de Grado, es el primer paso para abordar la construcción de una plataforma de conocimiento evolutivo para dos sistemas que facilitan la detección precoz de trastornos del lenguaje en niños de 0 a 6 años. Concretamente, el objetivo principal de este proyecto es el diseño, desarrollo y puesta en explotación de un sistema de recogida de propuestas de mejora sobre la base de conocimiento de los sistemas de ayuda a la toma de decisiones Gades y Pegaso. Este sistema está formado fundamentalmente por una aplicación diseñada y construida mediante una arquitectura de componentes de software modular y reutilizable. La aplicación será usada por los usuarios de las plataformas Pegaso y Gades para realizar las propuestas de cambio sobre la base de conocimiento de dichos sistemas. El sistema es accesible vía web y almacena toda la información que maneja en una base de datos. Asimismo, expone un estudio de aplicaciones orientadas al trabajo colaborativo (CSCW) y a la toma de decisiones colaborativa, como paso previo al desarrollo de una funcionalidad futura del propio sistema. ABSTRACT. This Final Degree Project, is the first step to address the construction of a platform for two evolutionary knowledge systems that facilitate early detection of language disorders in children aged 0-6 years. Specifically, the main objective of this project is the design, development and start-up of a system that collect improvement proposals about the knowledge of decision support systems Gades and Pegaso. This system consists mainly of an application designed and built by a modular component architecture and reusable software. The application will be used by users of the Pegaso and Gades platforms for change proposals on the basis of knowledge of such systems. The system is accessible via web and stores all the information managed in a database. It also presents a study of collaborative work oriented applications (CSCW) and collaborative decision making, prior to the development of a future system functionality.

Propuesta de un sistema para detección precoz de trastornos del lenguaje en niños de 0 a 6 años

Las Tecnologías de la Información y las Comunicaciones han propiciado avances en el contexto de la salud tanto en la gestión efectiva de información socio‐sanitaria de forma electrónica, como en la provisión de servicios de e‐salud y telemedicina. Los antecedentes de investigación publicados en esta área corroboran este hecho presentando las mejoras experimentadas en la atención de la población y en la provisión de servicios sanitarios. La atención temprana, cuyos principios científicos se fundamentan en los campos de la pediatría, neurología, psicología, psiquiatría, pedagogía, fisiatría y lingüística, entre otros, tiene como finalidad ofrecer a los niños con déficit o con riesgo de padecerlos un conjunto de acciones optimizadoras y compensadoras, que faciliten su adecuada maduración en todos los ámbitos y que les permita alcanzar el máximo nivel de desarrollo personal y de integración social. La detección de posibles alteraciones en el desarrollo infantil es un aspecto clave de la atención temprana en la medida en que puede posibilitar la puesta en marcha de diversos mecanismos de actuación disponibles en las entidades implicadas, valiosos para la calidad de vida de la persona. Cuanto antes se realice la detección, existen mayores garantías de prevenir patologías añadidas, lograr mejoras funcionales y posibilitar un ajuste más adaptativo entre el niño y su entorno. El objetivo de la investigación presentada en esta tesis doctoral es analizar, diseñar, verificar y validar un sistema de información abierto, basado en conocimiento, que facilite efectivamente a los profesionales que trabajan con la población infantil entre 0 y 6 años la detección precoz de posibles trastornos del lenguaje. Desde el punto de vista metodológico, la Ingeniería del Conocimiento ofrece un marco conceptual sólido que permite desarrollar y validar Sistemas de Ayuda a la Toma de Decisiones distribuidos y escalables, capaces de ayudar al pediatra de Atención Primaria y al educador infantil en la detección precoz de posibles trastornos del lenguaje en niños. La evaluación del sistema se ha realizado de forma incremental mediante el diseño y validación de pruebas de campo experimentales consistentes en la evaluación de niños en dos escenarios distintos: la escuela infantil y el centro de atención temprana. Los experimentos realizados en poblaciones distintas con alrededor de 344 niños durante 2 años, han permitido contrastar la buena adecuación del sistema propuesto a las necesidades de detección de los profesionales que trabajan con niños entre 0 y 6 años. La tesis resultante ha permitido caracterizar el uso del sistema en entornos reales, conocer la aceptación entre los usuarios y su impacto en la provisión de un servicio de atención temprana como el descrito para el correcto seguimiento del desarrollo del lenguaje en los niños, además de proponer un nuevo modelo de atención y evaluación cooperativa que permita incrementar el conocimiento experimental existente al respecto. ABSTRACT The Information and Communication Technology have led to advances in the context of health both in the effective management of socio‐health information electronically, and in the provision of e‐health and telemedicine. The history of research published in this area confirm this fact by presenting the improvements in the care of the population and the provision of health services. Early attention, whose scientific principles are based on the fields of pediatrics, neurology, psychology, psychiatry, pedagogy, physical medicine and linguistics, among others, aims to provide children with deficits or risk of suffering a set of enhancer actions, which facilitate adequate maturation in all areas and allow them to achieve the highest level of personal development and social integration. The detection of possible changes in child development is a key aspect of early intervention to the extent that it can enable the implementation of different mechanisms of action available to the entities involved, valuable to the quality of life of the person. The earlier the detection is made, there are more guarantees added to prevent diseases, achieving functional improvements and enable a more adaptive fit between the child and his environment. The aim of the research presented is to analyze, design, verify and validate an open information system, based on knowledge, which effectively provide professionals working with the child population between 0 and 6 years, in processes of early detection of language disorders. From the methodological point of view, Knowledge Engineering provides a solid conceptual framework to develop and validate a distributed and scalable decision support systems aim to assist pediatricians and language therapists at early identification and referral of language disorder in childhood. The system evaluation was performed incrementally with the design and validation of consistent experimental field tests in the assessment of children in two different scenarios: the nursery and early intervention center. Experiments in different populations with about 344 children over 2 years, allowed to testing the adequacy of the proposed good detection needs of professionals working with children between 0 and 6 years old system. The resulting thesis has allowed to formalizing the system at real environments and to identifying the acceptance by users as well as its impact on the provision of an early intervention service, such as the one described for the proper monitoring of language development in children. In addition, it proposes a new model of care and cooperative evaluation that lets to increase the existing experimental knowledge about it.

Modelo Híbrido para la Ayuda al Capitán

En esta Tesis se plantea una nueva forma de entender la evacuación apoyándonos en tecnologías existentes y accesibles que nos permitirán ver este proceso como un ente dinámico. Se trata de una metodología que implica no solo el uso de herramientas de análisis que permitan la definición de planes de evacuación en tiempo real, sino que también se apunta hacia la creación de una infraestructura física que permita alimentar con información actualizada al sistema de forma que, según la situación y la evolución de la emergencia, sea posible realizar planes alternativos que se adapten a las nuevas circunstancias. En base a esto, el sistema asimilará toda esa información y aportará soluciones que faciliten la toma de decisiones durante toda la evolución del incidente. Las aportaciones originales de esta Tesis son múltiples y muy variadas, pudiéndolas resumir en los siguientes puntos: 1. Estudio completo del estado del arte: a. Detección y análisis de diferentes proyectos a nivel internacional que de forma parcial tratan algunos aspectos desarrollados en la Tesis. b. Completo estudio a nivel mundial del software desarrollado total o parcialmente para la simulación del comportamiento humano y análisis de procesos de evacuación. Se ha generado una base de datos que cataloga de forma exhaustiva estas aplicaciones, permitiendo realizar un completo análisis y posibilitando la evolución futura de los contenidos de la misma. En la tesis se han analizado casi un centenar de desarrollos, pero el objetivo es seguir completando esta base de datos debido a la gran utilidad y a las importantes posibilidades que ofrece. 2. Desarrollo de un importante capítulo que trata sobre la posibilidad de utilizar entornos virtuales como alternativa intermedia al uso de simuladores y simulacros. En esta sección se divide en dos bloques: a. Ensayos en entornos reales y virtuales. b. Ensayos en entornos virtuales (pruebas realizadas con varios entornos virtuales). 3. Desarrollo de e-Flow net design: paquete de herramientas desarrolladas sobre Rhinoceros para el diseño de la red de evacuación basada en los elementos definidos en la tesis: Nodes, paths, Relations y Areas. 4. Desarrollo de e-Flow Simulator: Conjunto de herramientas que transforman Rhinoceros en un simulador 3D de comportamiento humano. Este simulador, de desarrollo propio, incorpora un novedoso algoritmo de comportamiento a nivel de individuo que incluye aspectos que no se han encontrado en otros simuladores. Esta herramienta permite realizar simulaciones programadas de grupos de individuos cuyo comportamiento se basa en el análisis del entorno y en la presencia de referencias dinámicas. Incluye otras importantes novedades como por ejemplo: herramientas para análisis de la señalización, elementos de señalización dinámica, incorporación sencilla de obstáculos, etc. También se ha creado una herramienta que posibilita la implementación del movimiento del propio escenario simulando la oscilación del mismo, con objeto de reflejar la influencia del movimiento del buque en el desplazamiento de los individuos. 5. En una fase avanzada del desarrollo, se incorporó la posibilidad de generar un vídeo de toda la simulación, momento a partir del cual, se han documentado todas las pruebas (y se continúan documentando) en una base de datos que recoge todas las características de las simulaciones, los problemas detectados, etc. Estas pruebas constituyen, en el momento en que se ha cerrado la redacción de la Tesis, un total de 81 GB de datos. Generación y análisis de rutas en base a la red de evacuación creada con e-Flow Net design y las simulaciones realizadas con e-Flow Net simulator. a. Análisis para la optimización de la configuración de la red en base a los nodos por área existentes. b. Definición de procesos previos al cálculo de rutas posibles. c. Cálculo de rutas: i. Análisis de los diferentes algoritmos que existen en la actualidad para la optimización de rutas. ii. Desarrollo de una nueva familia de algoritmos que he denominado “Minimum Decision Algorithm (MDA)”, siendo los algoritmos que componen esta familia: 1. MDA básico. 2. MDA mínimo. 3. MDA de no interferencia espacial. 4. MDA de expansión. 5. MDA de expansión ordenada para un único origen. 6. MDA de expansión ordenada. iii. Todos estos algoritmos se han implementado en la aplicación e-Flow creada en la Tesis para el análisis de rutas y que constituye el núcleo del Sistema de Ayuda al Capitán. d. Determinación de las alternativas para el plan de evacuación. Tras la definición de las rutas posibles, se describen diferentes procesos existentes de análisis por ponderación en base a criterios, para pasar finalmente a definir el método de desarrollo propio propuesto en esta Tesis y cuyo objetivo es responder en base a la población de rutas posibles obtenidas mediante los algoritmos MDA, qué combinación de rutas constituyen el Plan o Planes más adecuados para cada situación. La metodología creada para la selección de combinaciones de rutas que determinan un Plan completo, se basa en cuatro criterios básicos que tras su aplicación ofrecen las mejores alternativas. En esta fase también se incluye un complejo análisis de evolución temporal que incorpora novedosas definiciones y formulaciones. e. Derivado de la definición de la metodología creada en esta Tesis para la realización de los análisis de evolución temporal, se ha podido definir un nuevo teorema matemático que se ha bautizado como “Familia de cuadriláteros de área constante”. 7. Especificación de la infraestructura física del Sistema de Ayuda al Capitán: parte fundamental de sistema es la infraestructura física sobre la que se sustentaría. Esta infraestructura estaría compuesta por sensores, actuadores, aplicaciones para dispositivos móviles, etc. En este capítulo se analizan los diferentes elementos que la constituirían y las tecnologías implicadas. 8. Especificación de la infraestructura de servicios. 9. Creación del Blog Virtual Environments (http://epcinnova-virtualenvironments.blogspot.com.es/) en el que se han publicado todas las pruebas realizadas en el capítulo que analiza los entornos virtuales como alternativa a los simuladores y a los ensayos en laboratorio o los simulacros, incluyendo en muchos casos la posibilidad de que el visitante del blog pueda realizar la simulación en el entorno virtual. Este blog también incluye otras secciones que se han trabajado durante la Tesis: • Recopilación de diferentes entornos virtuales existentes. • Diagrama que recopila información sobre accidentes tanto en el ámbito marítimo como en el terrestre (en desarrollo). • Esquema propuesto para el acopio de información obtenida a partir de un simulacro. 10. Esta Tesis es la base para el proyecto e-Flow (nombre de una de las aplicaciones que desarrolladas en esta obra), un proyecto en el que el autor de esta Tesis ha trabajado como Project Manager. En el proyecto participa un consorcio de empresas y la UPM, y tiene como objetivo trasladar a la realidad gran parte de los planteamientos e ideas presentadas en esta Tesis. Este proyecto incluye el desarrollo de la infraestructura física y de servicios que permitirán, entre otras cosas, implementar en infraestructuras complejas una plataforma que posibilita la evacuación dinámica y un control ubicuo de los sistemas de monitorización y actuación implementados. En estos momentos se está finalizando el proyecto, cuyo objetivo final es la implementación de un piloto en un Hospital. También destacamos los siguientes avances a nivel de difusión científico-tecnológico: • Ponencia en el “52 congreso de la Ingeniería Naval en España” presentando un artículo “e-Flow- Sistema integral inteligente de soporte a la evacuación”. En este artículo se trata tanto el proyecto e-Flow del que soy Project Manager, como esta Tesis Doctoral, al ser temas estrechamente vinculados. En 2014 se publicó en dos números de la Revista Ingeniería Naval el artículo presentado a estas jornadas. • Co-autor en el artículo “E-Flow: A communication system for user notification in dynamic evacuation scenarios” presentado en el 7th International Conference on Ubicuous Computing & Ambient Intelligence (UCAMI) celebrado en Costa Rica. Por último, una de las aportaciones más interesantes, es la definición de un gran número de líneas de investigación futuras en base a todos los avances realizados en esta Tesis. ABSTRACT With this Thesis a new approach for understanding evacuation process is considered, taking advantage of the existing and open technologies that will allow this process to be interpreted as a dynamic entity. The methodology involves not only tools that allows on.-time evacuation plans, but also creates a physical insfrastructure that makes possible to feed the system with information on real time so, considering in each moment the real situation as well as the specific emergency development it will be feasible to generate alternative plans that responds to the current emergency situation. In this respect, the system will store all this information and will feedback with solutions that will help the decision making along the evacuation process. The innovative and singular contributions of this Thesis are numerous and rich, summarised as follows: 1.- Complete state-of-art study: a. Detection and analysis of different projects on an international level that, although partially, deal with some aspects developed in this Thesis. b. Thorough study at a international level of the developed software - total or partially done - for the simulation of the human behaviour and evacuation processes analysis. A database has been generated that classifies in detail these applications allowing to perform a full analysis and leading to future evolution of its contents. Within the Thesis work, almost a hundred of developments have been analysed but the purpose is to keep up updating this database due to the broad applications and possibilities that it involves. 2. Development of an important chapter that studies the possibility of using virtual scenarios as mid-term alternative for the use of simulations. This section is divided in two blocks: a. Trials in virtual and real scenarios b. Trials in virutal scenarios (trials performed with several ones). 3. E-Flow net design development: Set of tools developed under Rhinoceros for the evacuation net design based on the elements defined in the Thesis: Nodes, Paths, Relations, Areas 4. E-Flow simulator development: Set of tools that uses Rhinoceros as a 3D simulator of human behaviour. This simulator, of my own design, includes a new and original algorithm of human behaviour that involves aspects that are not found in other simulators. This tool allows to perform groups programmed simulations which behaviour is based on their enviroment analysis and presence of dynamic references. It includes other important innovations as for example: tools for signals analysis, dynamic signal elements, easy obstacle adding etc... More over, a tool that allows the own scenario movement implementation has been created by simulating the own oscillation movement, with the purpose of playing the vessel movement's influences in the individuals' displacements. 5. In an advanced stage of the development, the possibility of generating a video recording of all the simulation was also integrated, then from that moment all tests have been filed (and keep on doing so) in a database that collects all simulation characteristics, failures detected, etc. These stored tests amounts to a total of 81 GB at the moment of finishing the Thesis work. Generation and analysis of paths regarding the evacuation net created with E-Flow design and the simulations performed with E-Flow net Simulator. a. Analysis for the optimisation of the network configuration based in the existing nodes per area. b. Definition of the processes previous to the calculation of the feasible paths c. Paths calculation: i. Analysis of the different algorithms on existance nowadays for the routes optimisation. ii. Development of a new family of algorithms that I have called “Minimum Decision Algorithm (MDA)”, being composed of: 1. MDA basic 2. MDA minimum 3. MDA of not spacial interference 4. MDA of expansion (es de extenderse) o enlargement ( es de crecimiento) 5. MDA of organised expansion for a single origin (of organised enlargement for a single origin) 6. MDA of organised expansion (of organised enlargement) iii. All these algorithms have been implemented in the E-Flow application created in the Thesis dfor the routes analysis and it is the core of the Captain's support system. d. Determination of the alternatives for the evacuation plan. After defining all possible paths, different processes of analysis existing for weighing-based criteria are described, thus to end defining the own development method proposed in this Thesis and that aims to respond in an agreggation of possible routes basis obtained by means of the MDA algorithms what is the routes' combination more suitable for the Plan or Plans in every situation. The methodology created fot the selection of the combinations of routes that determine a complete Plan is baesd in four basic criteria that after applying, offer the best alternatives. In this stage a complex analysis of the progress along time is also included, that adds original and innovative defintions and formulations. e. Originated from the methodology created in this Thesis for the perfoming of the analysy of the progress along time, a new mathematic theorem has been defined, that has been called as "Family of quadrilateral of constant area". 7. Specification of the physiscal infrastructure of the Captain's help system: essential part is this physical infrastructure that will support it. This system will be made of sensors, actuators, apps for mobile devices etc... Within this chapter the different elements and technologies that make up this infrastructure will be studied. 8. Specification for the services infrastructure. 9. Start up of the Blog. " Virtual Environments (http://epcinnova-virtualenvironments.blogspot.com.es/)" in which all tests performed have been published in terms of analysis of the virtual enviroments as alternative to the simulators as well as to the laboratory experiments or simulations, including in most of the cases the possibility that the visitor can perform the simulation within the virtual enviroment. This blog also includes other sections that have been worked along and within this Thesis: - Collection of different virtual scenarios existent. - Schema that gathers information concerning accidents for maritime and terrestrial areas (under development) - Schema proposed for the collecting of information obtained from a simulation. 10. This Thesis is the basis of the E-Flow project (name of one of the applications developed in this work), a project in which the Thesis' author has worked in as Project Manager. In the project takes part a consortium of firms as well as the UPM and the aim is to bring to real life most part of the approaches and ideas contained in this Thesis. This project includes the development of the physical infrastructure as well as the services that will allow, among others, implement in complex infrastrucutres a platform that will make possible a dynamic evacuation and a continuous control of the monitoring and acting systems implemented. At the moment the project is getting to an end which goal is the implementation of a pilot project in a Hospital. We also would like to highlight the following advances concerning the scientific-technology divulgation: • Talk in the " 52th Congress of the Naval Engineering in Spain" with the article "E-Flow . Intelligent system integrated for supporting evacuation". This paper is about project E-Flow which I am Project Manager of, as well as this Thesis for the Doctorate, being both closely related. Two papers published In 2014 in the Naval Engineering Magazine. • Co-author in the article “E-Flow: A communication system for user notification in dynamic evacuation scenarios” [17] introduced in the 7th International Conference on Ubicuous Computing & Ambient Intelligence (UCAMI) held in Costa Rica. Last, but not least, one of the more interesting contributions is the defintion of several lines of research in the future, based on the advances made in this Thesis.

Discrete Multi-Criteria Methods for lands use and conservation planning on La Colacha in Arroyos Menores (Río Cuarto, Province of Córdoba, Argentina)

The study area is La Colacha sub-basins from Arroyos Menores basins, natural areas at West and South of Río Cuarto in Province of Córdoba of Argentina, fertile with loess soils and monsoon temperate climate, but with soil erosions including regressive gullies that degrade them progressively. Cultivated gently since some hundred sixty years, coordinated action planning became necessary to conserve lands while keeping good agro-production. The authors had improved data on soils and on hydrology for the study area, evaluated systems of soil uses and actions to be recommended and applied Decision Support Systems (DSS) tools for that, and were conducted to use discrete multi-criteria models (MCDM) for the more global views about soil conservation and hydraulic management actions and about main types of use of soils. For that they used weighted PROMETHEE, ELECTRE, and AHP methods with a system of criteria grouped as environmental, economic and social, and criteria from their data on effects of criteria. The alternatives resulting offer indication for planning depending somehow on sub basins and on selections of weights, but actions for conservation of soils and water management measures are recommended to conserve the basins conditions, actually sensibly degrading, mainly keeping actual uses of the lands.

A model of air transport passenger incidents and rights

This paper describes a representation of the legal framework in the air transport passenger's rights domain and the foremost incidents that trigger the top of consumer complaints ranking in the EU. It comprises the development of a small network of three ontologies, formalisation of scenarios, specification of properties and identification of relations. The approach is illustrated by means of a case study based in the context of a real life cancelled flight incident. This is part of an intended support-system that aims to provide both consumers and companies with relevant legal information to enhance the decision-making process.

Análise do aproveitamento múltiplo do reservatório de Barra Bonita - SP, através da aplicação de técnica de programação linear associada a modelo de rede de fluxo

O objeto deste trabalho é a análise do aproveitamento múltiplo do reservatório de Barra Bonita, localizado na confluência entre os rios Piracicaba e Tietê, no estado de São Paulo e pertencente ao chamado sistema Tietê-Paraná. Será realizada a otimização da operação do reservatório, através de programação linear, com o objetivo de aumentar a geração de energia elétrica, através da maximização da vazão turbinada. Em seguida, a partir dos resultados da otimização da geração de energia, serão utilizadas técnicas de simulação computacional, para se obter índices de desempenho conhecidos como confiabilidade, resiliência e vulnerabilidade, além de outros fornecidos pelo próprio modelo de simulação a ser utilizado. Estes índices auxiliam a avaliação da freqüência, magnitude e duração dos possíveis conflitos existentes. Serão analisados os possíveis conflitos entre a navegação, o armazenamento no reservatório, a geração de energia e a ocorrência de enchentes na cidade de Barra Bonita, localizada a jusante da barragem.