Divided care and the Third Way:user involvement in statutory and voluntary sector cancer services

In health care, as in much of the public sphere, the voluntary sector is playing an increasingly large role in the funding, provision and delivery of services and nowhere is this more apparent than in cancer care. Simultaneously the growth of privatisation, marketisation and consumerism has engendered a rise in the promotion of 'user involvement' in health care. These changes in the organisation and delivery of health care, in part inspired by the 'Third Way' and the promotion of public and citizen participation, are particularly apparent in the British National Health Service. This paper presents initial findings from a three-year study of user involvement in cancer services. Using both case study and survey data, we explore the variation in the definition, aims, usefulness and mechanisms for involving users in the evaluation and development of cancer services across three Health Authorities in South West England. The findings have important implications for understanding shifts in power, autonomy and responsibility between patients, carers, clinicians and health service managers. The absence of any common definition of user involvement or its purpose underlines the limited trust between the different actors in the system and highlights the potentially negative impact of a Third Way health service.

A domain specific modeling approach for coordinating user-centric communication services

Rapid advances in electronic communication devices and technologies have resulted in a shift in the way communication applications are being developed. These new development strategies provide abstract views of the underlying communication technologies and lead to the so-called user-centric communication applications. One user-centric communication (UCC) initiative is the Communication Virtual Machine (CVM) technology, which uses the Communication Modeling Language (CML) for modeling communication services and the CVM for realizing these services. In communication-intensive domains such as telemedicine and disaster management, there is an increasing need for user-centric communication applications that are domain-specific and that support the dynamic coordination of communication services commonly found in collaborative communication scenarios. However, UCC approaches like the CVM offer little support for the dynamic coordination of communication services resulting from inherent dependencies between individual steps of a collaboration task. Users either have to manually coordinate communication services, or reply on a process modeling technique to build customized solutions for services in a specific domain that are usually costly, rigidly defined and technology specific. ^ This dissertation proposes a domain-specific modeling approach to address this problem by extending the CVM technology with communication-specific abstractions of workflow concepts commonly found in business processes. The extension involves (1) the definition of the Workflow Communication Modeling Language (WF-CML), a superset of CML, and (2) the extension of the functionality of CVM to process communication-specific workflows. The definition of WF-CML includes the meta-model and the dynamic semantics for control constructs and concurrency. We also extended the CVM prototype to handle the modeling and realization of WF-CML models. A comparative study of the proposed approach with other workflow environments validates the claimed benefits of WF-CML and CVM.^

MIUS News: Maps and Imagery User Services @ FIU Green Library: Vol. 1, Issue 1 2007

Fall 2007 Newsletter for FIU's Maps and Imagery User Services department.

A middleware to support services delivery in a domain-specific virtual machine

The increasing use of model-driven software development has renewed emphasis on using domain-specific models during application development. More specifically, there has been emphasis on using domain-specific modeling languages (DSMLs) to capture user-specified requirements when creating applications. The current approach to realizing these applications is to translate DSML models into source code using several model-to-model and model-to-code transformations. This approach is still dependent on the underlying source code representation and only raises the level of abstraction during development. Experience has shown that developers will many times be required to manually modify the generated source code, which can be error-prone and time consuming. ^ An alternative to the aforementioned approach involves using an interpreted domain-specific modeling language (i-DSML) whose models can be directly executed using a Domain Specific Virtual Machine (DSVM). Direct execution of i-DSML models require a semantically rich platform that reduces the gap between the application models and the underlying services required to realize the application. One layer in this platform is the domain-specific middleware that is responsible for the management and delivery of services in the specific domain. ^ In this dissertation, we investigated the problem of designing the domain-specific middleware of the DSVM to facilitate the bifurcation of the semantics of the domain and the model of execution (MoE) while supporting runtime adaptation and validation. We approached our investigation by seeking solutions to the following sub-problems: (1) How can the domain-specific knowledge (DSK) semantics be separated from the MoE for a given domain? (2) How do we define a generic model of execution (GMoE) of the middleware so that it is adaptable and realizes DSK operations to support delivery of services? (3) How do we validate the realization of DSK operations at runtime? ^ Our research into the domain-specific middleware was done using an i-DSML for the user-centric communication domain, Communication Modeling Language (CML), and for microgrid energy management domain, Microgrid Modeling Language (MGridML). We have successfully developed a methodology to separate the DSK and GMoE of the middleware of a DSVM that supports specialization for a given domain, and is able to perform adaptation and validation at runtime. ^

Understanding the Diversity of User Requirements for Interactive Online Health Services

Peer reviewed

The impact of user charges on patient choice of healthcare services in Ireland

This research assesses the impact of user charges in the context of consumer choice to ascertain how user charges in healthcare impact on patient behaviour in Ireland. Quantitative data is collected from a subset of the population in walk-in Urgent Care Clinics and General Practitioner surgeries to assess their responses to user charges and whether user charges are a viable source of part-funding healthcare in Ireland. Examining the economic theories of Becker (1965) and Grossman (1972), the research has assessed the impact of user charges on patient choice in terms of affordability and accessibility in healthcare. The research examined a number of private, public and part-publicly funded healthcare services in Ireland for which varying levels of user charges exist depending on patients’ healthcare cover. Firstly, the study identifies the factors affecting patient choice of privately funded walk-in Urgent Care Clinics in Ireland given user charges. Secondly, the study assesses patient response to user charges for a mainly public or part-publicly provided service; prescription drugs. Finally, the study examines patients’ attitudes towards the potential application of user charges for both public and private healthcare services when patient choice is part of a time-money trade-off, convenience choice or preference choice. These services are valued in the context of user charges becoming more prevalent in healthcare systems over time. The results indicate that the impact of user charges on healthcare services vary according to socio-economic status. The study shows that user charges can disproportionately affect lower income groups and consequently lead to affordability and accessibility issues. However, when valuing the potential application of user charges for three healthcare services (MRI scans, blood tests and a branded over a generic prescription drug), this research indicates that lower income individuals are willing to pay for healthcare services, albeit at a lower user charge than higher income earners. Consequently, this study suggests that user charges may be a feasible source of part-financing Irish healthcare, once the user charge is determined from the patients’ perspective, taking into account their ability to pay.

A probabilistic approach to user mobility prediction for wireless services.

Mobile and wireless networks have long exploited mobility predictions, focused on predicting the future location of given users, to perform more efficient network resource management. In this paper, we present a new approach in which we provide predictions as a probability distribution of the likelihood of moving to a set of future locations. This approach provides wireless services a greater amount of knowledge and enables them to perform more effectively. We present a framework for the evaluation of this new type of predictor, and develop 2 new predictors, HEM and G-Stat. We evaluate our predictors accuracy in predicting future cells for mobile users, using two large geolocation data sets, from MDC [11], [12] and Crawdad [13]. We show that our predictors can successfully predict with as low as an average 2.2% inaccuracy in certain scenarios.

Sim-xl: A Powerful And User-friendly Tool For Peptide Cross-linking Analysis.

Chemical cross-linking has emerged as a powerful approach for the structural characterization of proteins and protein complexes. However, the correct identification of covalently linked (cross-linked or XL) peptides analyzed by tandem mass spectrometry is still an open challenge. Here we present SIM-XL, a software tool that can analyze data generated through commonly used cross-linkers (e.g., BS3/DSS). Our software introduces a new paradigm for search-space reduction, which ultimately accounts for its increase in speed and sensitivity. Moreover, our search engine is the first to capitalize on reporter ions for selecting tandem mass spectra derived from cross-linked peptides. It also makes available a 2D interaction map and a spectrum-annotation tool unmatched by any of its kind. We show SIM-XL to be more sensitive and faster than a competing tool when analyzing a data set obtained from the human HSP90. The software is freely available for academic use at http://patternlabforproteomics.org/sim-xl. A video demonstrating the tool is available at http://patternlabforproteomics.org/sim-xl/video. SIM-XL is the first tool to support XL data in the mzIdentML format; all data are thus available from the ProteomeXchange consortium (identifier PXD001677).

A New Approach for Video Adaptation through Overlay Services Networks

Video adaptation is an extensively explored content providing technique aimed at appropriately suiting several usage scenarios featured by different network requirements and constraints, user`s terminal and preferences. However, its usage in high-demand video distribution systems, such as CNDs, has been badly approached, ignoring several aspects of optimization of network use. To address such deficiencies, this paper presents an approach for implementing the adaptation service by exploring the concept of overlay services networks. As a result of demonstrate the benefits of this proposal, it is made a comparison of this proposed adaptation service with other strategies of video adaptation.

The interaction between technologies and society: Lessons learnt from 160 evolutionary years of online news services

In mapping the evolutionary process of online news and the socio-cultural factors determining this development, this paper has a dual purpose. First, in reworking the definition of “online communication”, it argues that despite its seemingly sudden emergence in the 1990s, the history of online news started right in the early days of the telegraphs and spread throughout the development of the telephone and the fax machine before becoming computer-based in the 1980s and Web-based in the 1990s. Second, merging macro-perspectives on the dynamic of media evolution by DeFleur and Ball-Rokeach (1989) and Winston (1998), the paper consolidates a critical point for thinking about new media development: that something technically feasible does not always mean that it will be socially accepted and/or demanded. From a producer-centric perspective, the birth and development of pre-Web online news forms have been more or less generated by the traditional media’s sometimes excessive hype about the power of new technologies. However, placing such an emphasis on technological potentials at the expense of their social conditions not only can be misleading but also can be detrimental to the development of new media, including the potential of today’s online news.

User's Views of an Outreaching Social Work Team in Hong Kong

This article reports the survey findings of a recent study on users’ views of the service provided by an outreaching social work team in Hong Kong. It attempts to explore how youth at risk can be jointly involved in evaluating the quality of the social service. Users appear to have favourable opinions towards the service received and would like to have greater involvement in programme planning, implementation and evaluation. Finally, recommendations on improving the understanding of the needs of users and encouraging greater user participation in future service delivery are suggested.