A Decentralized Session Management Framework for Heterogeneous Ad-Hoc and Fixed Networks

Wireless technologies are continuously evolving. Second generation cellular networks have gained worldwide acceptance. Wireless LANs are commonly deployed in corporations or university campuses, and their diffusion in public hotspots is growing. Third generation cellular systems are yet to affirm everywhere; still, there is an impressive amount of research ongoing for deploying beyond 3G systems. These new wireless technologies combine the characteristics of WLAN based and cellular networks to provide increased bandwidth. The common direction where all the efforts in wireless technologies are headed is towards an IP-based communication. Telephony services have been the killer application for cellular systems; their evolution to packet-switched networks is a natural path. Effective IP telephony signaling protocols, such as the Session Initiation Protocol (SIP) and the H 323 protocol are needed to establish IP-based telephony sessions. However, IP telephony is just one service example of IP-based communication. IP-based multimedia sessions are expected to become popular and offer a wider range of communication capabilities than pure telephony. In order to conjoin the advances of the future wireless technologies with the potential of IP-based multimedia communication, the next step would be to obtain ubiquitous communication capabilities. According to this vision, people must be able to communicate also when no support from an infrastructured network is available, needed or desired. In order to achieve ubiquitous communication, end devices must integrate all the capabilities necessary for IP-based distributed and decentralized communication. Such capabilities are currently missing. For example, it is not possible to utilize native IP telephony signaling protocols in a totally decentralized way. This dissertation presents a solution for deploying the SIP protocol in a decentralized fashion without support of infrastructure servers. The proposed solution is mainly designed to fit the needs of decentralized mobile environments, and can be applied to small scale ad-hoc networks or also bigger networks with hundreds of nodes. A framework allowing discovery of SIP users in ad-hoc networks and the establishment of SIP sessions among them, in a fully distributed and secure way, is described and evaluated. Security support allows ad-hoc users to authenticate the sender of a message, and to verify the integrity of a received message. The distributed session management framework has been extended in order to achieve interoperability with the Internet, and the native Internet applications. With limited extensions to the SIP protocol, we have designed and experimentally validated a SIP gateway allowing SIP signaling between ad-hoc networks with private addressing space and native SIP applications in the Internet. The design is completed by an application level relay that permits instant messaging sessions to be established in heterogeneous environments. The resulting framework constitutes a flexible and effective approach for the pervasive deployment of real time applications.

The effectiveness of the teach-back method on adherence and self-management in health education for people with chronic disease: A systematic review

- BACKGROUND Chronic diseases are increasing worldwide and have become a significant burden to those affected by those diseases. Disease-specific education programs have demonstrated improved outcomes, although people do forget information quickly or memorize it incorrectly. The teach-back method was introduced in an attempt to reinforce education to patients. To date, the evidence regarding the effectiveness of health education employing the teach-back method in improved care has not yet been reviewed systematically. - OBJECTIVES This systematic review examined the evidence on using the teach-back method in health education programs for improving adherence and self-management of people with chronic disease. - INCLUSION CRITERIA Types of participants: Adults aged 18 years and over with one or more than one chronic disease. Types of intervention: All types of interventions which included the teach-back method in an education program for people with chronic diseases. The comparator was chronic disease education programs that did not involve the teach-back method. Types of studies: Randomized and non-randomized controlled trials, cohort studies, before-after studies and case-control studies. Types of outcomes: The outcomes of interest were adherence, self-management, disease-specific knowledge, readmission, knowledge retention, self-efficacy and quality of life. - SEARCH STRATEGY Searches were conducted in CINAHL, MEDLINE, EMBASE, Cochrane CENTRAL, Web of Science, ProQuest Nursing and Allied Health Source, and Google Scholar databases. Search terms were combined by AND or OR in search strings. Reference lists of included articles were also searched for further potential references. - METHODOLOGICAL QUALITY Two reviewers conducted quality appraisal of papers using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument. - DATA EXTRACTION Data were extracted using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument data extraction instruments. - DATA SYNTHESIS There was significant heterogeneity in selected studies, hence a meta-analysis was not possible and the results were presented in narrative form. - RESULTS Of the 21 articles retrieved in full, 12 on the use of the teach-back method met the inclusion criteria and were selected for analysis. Four studies confirmed improved disease-specific knowledge in intervention participants. One study showed a statistically significant improvement in adherence to medication and diet among type 2 diabetics patients in the intervention group compared to the control group (p < 0.001). Two studies found statistically significant improvements in self-efficacy (p = 0.0026 and p < 0.001) in the intervention groups. One study examined quality of life in heart failure patients but the results did not improve from the intervention (p = 0.59). Five studies found a reduction in readmission rates and hospitalization but these were not always statistically significant. Two studies showed improvement in daily weighing among heart failure participants, and in adherence to diet, exercise and foot care among those with type 2 diabetes. - CONCLUSION Overall, the teach-back method showed positive effects in a wide range of health care outcomes although these were not always statistically significant. Studies in this systematic review revealed improved outcomes in disease-specific knowledge, adherence, self-efficacy and the inhaler technique. There was a positive but inconsistent trend also seen in improved self-care and reduction of hospital readmission rates. There was limited evidence on improvement in quality of life or disease related knowledge retention.

Performance of Ajax Applications on Mobile Devices

The Ajax approach has outgrown its origin as shorthand for "Asynchronous JavaScript + XML". Three years after its naming, Ajax has become widely adopted by web applications. Therefore, there exists a growing interest in using those applications with mobile devices. This thesis evaluates the presentational capability and measures the performance of five mobile browsers on the Apple iPhone and Nokia models N95 and N800. Performance is benchmarked through user-experienced response times as measured with a stopwatch. 12 Ajax toolkit examples and 8 production-quality applications are targeted, all except one in their real environments. In total, over 1750 observations are analyzed and included in the appendix. Communication delays are not considered; the network connection type is WLAN. Results indicate that the initial loading time of an Ajax application can often exceed 20 seconds. Content reordering may be used to partially overcome this limitation. Proper testing is the key for success: the selected browsers are capable of presenting Ajax applications if their differing implementations are overcome, perhaps using a suitable toolkit.

Service Composition on a Mobile Phone

With the recent increase in interest in service-oriented architectures (SOA) and Web services, developing applications with the Web services paradigm has become feasible. Web services are self-describing, platform-independent computational elements. New applications can be assembled from a set of previously created Web services, which are composed together to make a service that uses its components to perform a certain task. This is the idea of service composition. To bring service composition to a mobile phone, I have created Interactive Service Composer for mobile phones. With Interactive Service Composer, the user is able to build service compositions on his mobile phone, consisting of Web services or services that are available from the mobile phone itself. The service compositions are reusable and can be saved in the phone's memory. Previously saved compositions can also be used in new compositions. While developing applications for mobile phones has been possible for some time, the usability of the solutions is not the same as when developing for desktop computers. When developing for mobile phones, the developer has to more carefully consider the decisions he is going to make with the program he is developing. With the lack of processing power and memory, the applications cannot function as well as on desktop PCs. On the other hand, this does not remove the appeal of developing applications for mobile devices.

AndroMedia - Towards a Context-aware Mobile Music Recommender

Portable music players have made it possible to listen to a personal collection of music in almost every situation, and they are often used during some activity to provide a stimulating audio environment. Studies have demonstrated the effects of music on the human body and mind, indicating that selecting music according to situation can, besides making the situation more enjoyable, also make humans perform better. For example, music can boost performance during physical exercises, alleviate stress and positively affect learning. We believe that people intuitively select different types of music for different situations. Based on this hypothesis, we propose a portable music player, AndroMedia, designed to provide personalised music recommendations using the user’s current context and listening habits together with other user’s situational listening patterns. We have developed a prototype that consists of a central server and a PDA client. The client uses Bluetooth sensors to acquire context information and logs user interaction to infer implicit user feedback. The user interface also allows the user to give explicit feedback. Large user interface elements facilitate touch-based usage in busy environments. The prototype provides the necessary framework for using the collected information together with other user’s listening history in a context- enhanced collaborative filtering algorithm to generate context-sensitive recommendations. The current implementation is limited to using traditional collaborative filtering algorithms. We outline the techniques required to create context-aware recommendations and present a survey on mobile context-aware music recommenders found in literature. As opposed to the explored systems, AndroMedia utilises other users’ listening habits when suggesting tunes, and does not require any laborious set up processes.

An XML Messaging Service for Mobile Devices

In recent years, XML has been accepted as the format of messages for several applications. Prominent examples include SOAP for Web services, XMPP for instant messaging, and RSS and Atom for content syndication. This XML usage is understandable, as the format itself is a well-accepted standard for structured data, and it has excellent support for many popular programming languages, so inventing an application-specific format no longer seems worth the effort. Simultaneously with this XML's rise to prominence there has been an upsurge in the number and capabilities of various mobile devices. These devices are connected through various wireless technologies to larger networks, and a goal of current research is to integrate them seamlessly into these networks. These two developments seem to be at odds with each other. XML as a fully text-based format takes up more processing power and network bandwidth than binary formats would, whereas the battery-powered nature of mobile devices dictates that energy, both in processing and transmitting, be utilized efficiently. This thesis presents the work we have performed to reconcile these two worlds. We present a message transfer service that we have developed to address what we have identified as the three key issues: XML processing at the application level, a more efficient XML serialization format, and the protocol used to transfer messages. Our presentation includes both a high-level architectural view of the whole message transfer service, as well as detailed descriptions of the three new components. These components consist of an API, and an associated data model, for XML processing designed for messaging applications, a binary serialization format for the data model of the API, and a message transfer protocol providing two-way messaging capability with support for client mobility. We also present relevant performance measurements for the service and its components. As a result of this work, we do not consider XML to be inherently incompatible with mobile devices. As the fixed networking world moves toward XML for interoperable data representation, so should the wireless world also do to provide a better-integrated networking infrastructure. However, the problems that XML adoption has touch all of the higher layers of application programming, so instead of concentrating simply on the serialization format we conclude that improvements need to be made in an integrated fashion in all of these layers.

TCP Performance with Vertical Handoff

With the proliferation of wireless and mobile devices equipped with multiple radio interfaces to connect to the Internet, vertical handoff involving different wireless access technologies will enable users to get the best of connectivity and service quality during the lifetime of a TCP connection. A vertical handoff may introduce an abrupt, significant change in the access link characteristics and as a result the end-to-end path characteristics such as the bandwidth and the round-trip time (RTT) of a TCP connection may change considerably. TCP may take several RTTs to adapt to these changes in path characteristics and during this interval there may be packet losses and / or inefficient utilization of the available bandwidth. In this thesis we study the behaviour and performance of TCP in the presence of a vertical handoff. We identify the different handoff scenarios that adversely affect TCP performance. We propose several enhancements to the TCP sender algorithm that are specific to the different handoff scenarios to adapt TCP better to a vertical handoff. Our algorithms are conservative in nature and make use of cross-layer information obtained from the lower layers regarding the characteristics of the access links involved in a handoff. We evaluate the proposed algorithms by extensive simulation of the various handoff scenarios involving access links with a wide range of bandwidth and delay. We show that the proposed algorithms are effective in improving the TCP behaviour in various handoff scenarios and do not adversely affect the performance of TCP in the absence of cross-layer information.

The effect of flexor tenotomy on healing and prevention of neuropathic diabetic foot ulcers on the distal end of the toe

Background Flexor tenotomy is a minimally invasive surgical alternative for the treatment of neuropathic diabetic foot ulcers on the distal end of the toe. The influence of infection on healing and time to heal after flexor tenotomy is unknown. Flexor tenotomy can also be used as a prophylactic treatment. The effectiveness as a prophylactic treatment has not been described before. Methods A retrospective study was performed with the inclusion of all consecutive flexor tenotomies from one hospital between January 2005 and December 2011. Results From 38 ulcers, 35 healed (92%), with a mean time to heal of 22 ± 26 days. The longest duration for healing was found for infected ulcers that were penetrating to bone (35 days; p = .042). Cases of prophylactic flexor tenotomies (n=9) did not result in any ulcer or other complications during follow-up. Conclusions The results of this study suggest that flexor tenotomy may be beneficial for neuropathic diabetic foot ulcers on the distal end of the toe, with a high healing percentage and a short mean time to heal. Infected ulcers that penetrated to bone took a significantly longer time to heal. Prospective research, to confirm the results of this retrospective study, should be performed.

Pimeä hehku : Satanismi ja saatananpalvonta 1990-luvun suomalaisessa nuorisokulttuurissa

Satanism in the Finnish Youth Culture of the 1990s The aim of this study was to investigate Satanism among Finnish youth in the 1990s. Thematic interviews of young Finnish Satanists are the basic material of this study. The research employs a theoretical framework derived from narrative psychology and the role-theoretical thinking of Dan P. McAdams. The young Satanists in Finland have been divided into two different groups: the criminal and drug using "devil-worshipping gangs"; and the more educated and philosophically oriented "Satanists" (Heino 1993). What can we say about this division? In the 1990s around Finland, there were young people calling themselves as devil- worshippers (either singular or in groups). They were strongly committed to a mythical devilish and cosmic battle, which they believed was going on in this world. They had problems with their mental health, also in their family socialization and peer groups. In their personal attitudes they were either active fighters or passive tramps. There were also rationally oriented young Satanists, that were ritually active and mainly atheistic. They strongly expressed their personal experiences of being individual and of being different than others. In their personal attitudes they were critical fighters and active survivors. They saw their lives through the satanistic 'finding-oneself experience'. They understood themselves as a "postmodern tribe" (Michel Maffesoli's sosiocultural concept): their sense of themselves was that of a dynamic collectivity which is social, dynamic, nonlocal and mythically historical. Death and black metal culture in the 1990s formed a common space for youth culture, where young individuals could work out their feelings and express their attitudes to life using dark satanic themes and symbols. The sense of "otherness" (also other than satanic) and collective demands for authenticity were essential tools that were used for identity work here. Personal disengagement from satanic/satanistic groups were observed to be gradual or quite rapid. Religious conversions back-and-forth also accured. At the end of the 1990s all off satanism in Finland bore a negative devil-worshipping stigma. Ritual homicide in South-Finland (Kerava/Hyvinkää) was connected to Satanism, which then became unpopular both in the personal life stories and alternative youth cultural circles at the beginning of the 2000s.

Gap acceptance behavior of mobile phone distracted drivers at roundabouts

While mobile phones have become ubiquitous in modern society, the use of mobile phones while driving is increasing at an alarming rate despite the associated crash risks. A significant safety concern is that driving while distracted by a mobile phone is more prevalent among young drivers, a less experienced driving cohort with elevated crash risk. The objective of this study was to examine the gap acceptance behavior of distracted young drivers at roundabouts. The CARRS-Q Advanced Driving Simulator was used to test participants on a simulated gap acceptance scenario at roundabouts. Conflicting traffic from the right approach of a four-legged roundabout were programmed to have a series of vehicles having the gaps between them proportionately increased from two to six seconds. Thirty-two licensed young drivers drove the simulator under three phone conditions: baseline (no phone conversation), hands-free and handheld phone conversations. Results show that distracted drivers started responding to the gap acceptance scenario at a distance closer to the roundabout and approached the roundabout at slower speeds. They also decelerated at faster rates to reduce their speeds prior to gap acceptance compared to non-distracted drivers. Although accepted gap sizes were not significantly different across phone conditions, differences in the safety margins at various gap sizes—measured by Post Encroachment Time (PET) between the driven vehicle and the conflicting vehicle—were statistically significant across phone conditions. PETs for distracted drivers were smaller across different gap sizes, suggesting a lower safety margin taken by distracted drivers compared to non-distracted drivers. The results aid in understanding how cognitive distraction resulting from mobile phone conversations while driving influences driving behavior during gap acceptance at roundabouts.

Vallankumous kotona! : Arkielämän visuaalinen murros 1960-luvun lopussa ja 1970-luvun alussa

Revolution at home! Visual Changes in Everyday Life in Finland in the Late 1960s and Early 1970s The purpose of my research was to investigate the visual changes in private homes in Finland during the 1960s and 1970s. The 1960s is often described as a turning point in Finnish life, a time when the society's previous agricultural orientation began to give way first to an industrial orientation and then, by the end of the 1970s, to a service orientation. My title refers to three elements in the transition period: the question of daily life; the timeframe; and the visual changes observable in private homes, which in retrospect signalled a kind of revolution in the social orientation. Those changes appeared not only in colours and designs but also in the forms and materials of household objects. My premise is that analysing interiors from a historical perspective can reveal valuable information about Finnish society and social attitudes, information that might easily escape attention otherwise. I have used the time-honoured method of collecting narratives. As far back as Aristotle, formulating narratives has been a means of gaining knowledge. By collecting and classifying narratives about the 1960s and 1970s, it is possible to gain new insight into these important decades. The archetypal 1960s narrative, involving student demonstrations and young people's efforts to improve society, is well known. Less well known is the narrative that relates the changes going on in daily life. Substantially the study focuses mainly on fabrics, porcelain ware and the use of plastics. Marimekko's style is especially important when following innovations in the 1950s, 1960s and 1970s. Porcelain production at the Arabia factory was another element that had a great influence on the look of Finnish homes and kitchens; and a further widespread phenomenon of the late 1960s and early 1970s was the use of plastics in many different forms. Further evidence was sought in Anttila department store mail catalogues, which displayed products that were marketed on a large scale, as well as in magazines such as Avotakka. The terminal point of the visual evolution is the real homes, as seen in the questionnaire "Homemade". I have used the 800 pages of the oral history text that respondents of the Finnish Literature Society have written about their first home in the 1960s. I also used archival material on actual homes in Helsinki from the archives of the Helsinki City Museum. The basic story is the elite narrative, which was produced by students in the 1960s. My main narrative from the same time is visual change in everyday life in the late 1960s and early 1970s. I have classified the main narrative of visual change into four subcategories: the narrative of national ideas, the narrative of a better standard of living, the narrative of objects in the culture of everyday life and the narrative of changing colour and form.

How terrorist campaigns end : The Rode Jeugd in the Netherlands and the Symbionese Liberation Army in the United States

This study explores the decline of terrorism by conducting source-based case studies on two left-wing terrorist campaigns in the 1970s, those of the Rode Jeugd in the Netherlands and the Symbionese Liberation Army in the United States. The purpose of the case studies is to bring more light into the interplay of different external and internal factors in the development of terrorist campaigns. This is done by presenting the history of the two chosen campaigns as narratives from the participants’ points of view, based on interviews with participants and extensive archival material. Organizational resources and dynamics clearly influenced the course of the two campaigns, but in different ways. This divergence derives at least partly from dissimilarities in organizational design and the incentive structure. Comparison of even these two cases shows that organizations using terrorism as a strategy can differ significantly, even when they share ideological orientation, are of the same size and operate in the same time period. Theories on the dynamics of terrorist campaigns would benefit from being more sensitive to this. The study also highlights that the demise of a terrorist organization does not necessarily lead to the decline of the terrorist campaign. Therefore, research should look at the development of terrorist activity beyond the lifespan of a single organization. The collective ideological beliefs and goals functioned primarily as a sustaining force, a lens through which the participants interpreted all developments. On the other hand, it appears that the role of ideology should not be overstated. Namely, not all participants in the campaigns under study fully internalized the radical ideology. Rather, their participation was mainly based on their friendship with other participants. Instead of ideology per se, it is more instructive to look at how those involved described their organization, themselves and their role in the revolutionary struggle. In both cases under study, the choice of the terrorist strategy was not merely a result of a cost-benefit calculation, but an important part of the participants’ self-image. Indeed, the way the groups portrayed themselves corresponded closely with the forms of action that they got involved in. Countermeasures and the lack of support were major reasons for the decline of the campaigns. However, what is noteworthy is that the countermeasures would not have had the same kind of impact had it not been for certain weaknesses of the groups themselves. Moreover, besides the direct impact the countermeasures had on the campaign, equally important was how they affected the attitudes of the larger left-wing community and the public in general. In this context, both the attitudes towards the terrorist campaign and the authorities were relevant to the outcome of the campaigns.

A mobile app offering distractions and tips to cope with cigarette craving: A qualitative study

Background Despite considerable effort, most smokers relapse within a few months after quitting due to cigarette craving. The widespread adoption of mobile phones presents new opportunities to provide support during attempts to quit. Objective To design and pilot a mobile app "DistractMe" to enable quitters to access and share distractions and tips to cope with cigarette cravings. Methods A qualitative study with 14 smokers who used DistractMe on their mobiles during the first weeks of their quit attempt. Based on interviews, diaries, and log data, we examined how the app supported quitting strategies. Results Three distinct techniques of coping when using DistractMe were identified: diversion, avoidance, and displacement. We further identified three forms of engagement with tips for coping: preparation, fortification, and confrontation. Overall, strategies to prevent cravings and their effects (avoidance, displacement, preparation, and fortification) were more common than immediate coping strategies (diversion and confrontation). Tips for coping were more commonly used than distractions to cope with cravings, because they helped to fortify the quit attempt and provided opportunities to connect with other users of the application. However, distractions were important to attract new users and to facilitate content sharing. Conclusions Based on the qualitative results, we recommend that mobile phone-based interventions focus on tips shared by peers and frequent content updates. Apps also require testing with larger groups of users to assess whether they can be self-sustaining.