An Efficient Patch Dissemination Strategy for Mobile Networks

Mobile phones and personal digital assistants are becoming increasingly important in our daily life since they enable us to access a large variety of ubiquitous services. Mobile networks, formed by the connection of mobile devices following some relationships among mobile users, provide good platforms for mobile virus spread. Quick and efficient security patch dissemination strategy is necessary for the update of antivirus software so that it can detect mobile virus, especially the new virus under the wireless mobile network environment with limited bandwidth which is also large scale, decentralized, dynamically evolving, and of unknown network topology. In this paper, we propose an efficient semi autonomy-oriented computing (SAOC) based patch dissemination strategy to restrain the mobile virus. In this strategy, some entities are deployed in a mobile network to search for mobile devices according to some specific rules and with the assistance of a center. Through experiments involving both real-world networks and dynamically evolving networks, we demonstrate that the proposed strategy can effectively send security patches to as many mobile devices as possible at a considerable speed and lower cost in the mobile network. It is a reasonable, effective, and secure method to reduce the damages mobile viruses may cause

Computerization of workflows, guidelines and care pathways: a review of implementation challenges for process-oriented health information systems

There is a need to integrate the various theoretical frameworks and formalisms for modeling clinical guidelines, workflows, and pathways, in order to move beyond providing support for individual clinical decisions and toward the provision of process-oriented, patient-centered, health information systems (HIS). In this review, we analyze the challenges in developing process-oriented HIS that formally model guidelines, workflows, and care pathways. A qualitative meta-synthesis was performed on studies published in English between 1995 and 2010 that addressed the modeling process and reported the exposition of a new methodology, model, system implementation, or system architecture. Thematic analysis, principal component analysis (PCA) and data visualisation techniques were used to identify and cluster the underlying implementation ‘challenge’ themes. One hundred and eight relevant studies were selected for review. Twenty-five underlying ‘challenge’ themes were identified. These were clustered into 10 distinct groups, from which a conceptual model of the implementation process was developed. We found that the development of systems supporting individual clinical decisions is evolving toward the implementation of adaptable care pathways on the semantic web, incorporating formal, clinical, and organizational ontologies, and the use of workflow management systems. These architectures now need to be implemented and evaluated on a wider scale within clinical settings

Inequalities in Rotavirus Vaccine Uptake in Ethiopia:A Decomposition Analysis

A previous study in Ethiopia reported significant variation in rotavirus vaccine uptake across socioeconomic strata. This study aims to quantify socioeconomic inequality of rotavirus vaccine uptake in Ethiopia and to identify the contributing factors for the inequality. The concentration curve (CC) and the Erreygers Normalized Concentration Index (ECI) were used to assess the socioeconomic related inequality in rotavirus vaccine uptake using data from the 2016 Ethiopian Demographic and Health Survey. Decomposition analysis was conducted to identify the drivers of inequalities. The CC for rotavirus vaccine uptake lay below the line of equality and the ECI was 0.270 (p <0.001) indicating that uptake of rotavirus vaccine in Ethiopia was significantly concentrated among children from families with better socioeconomic status. The decomposition analysis showed that underlining inequalities in maternal health care services utilization, including antenatal care use (18.4%) and institutional delivery (8.1%), exposure to media (12.8%), and maternal educational level (9.7%) were responsible for the majority of observed inequalities in the uptake of rotavirus vaccine. The findings suggested that there is significant socioeconomic inequality in rotavirus vaccine uptake in Ethiopia. Multi-sectoral actions are required to reduce the inequalities, inclusive increasing maternal health care services, and educational attainments among economically disadvantaged mothers

Exploiting non-dominance in multi agent systems: An artificial immune algorithm for distributed and complex Problem solving environments

An ideal Multi Agent System is flat and has no dominant hierarchy. Multi agent computational and problem solving environments have been advocated for their ability to deliver overall solutions that are innovative and creative. There is however a significant threat to the coherence of Multi Agent Systems; chaos. This paper poses a new vision to the control and immunisation of the Multi Agent Systems against chaos. Employing a complexity measure of the problem and its lower and upper bounds, and monitoring the complexity of the problem solving agents’ interactions, we propose the holistic control of the Multi Agent Systems that leads to immunisation of the system against chaos. The control however is not central and appears in the form of the agents’ common knowledge and determines their tendency to proactively communicate

Service-Oriented Framework for Developing Interoperable e-Health Systems in a Low-Income Country

e-Health solutions in low-income countries are fragmented, address institution-specific needs, and do little to address the strategic need for inter-institutional exchange of health data. Although various e-health interoperability frameworks exist, contextual factors often hinder their effective adoption in low-income countries. This underlines the need to investigate such factors and to use findings to adapt existing e-health interoperability models. Following a design science approach, this research involved conducting an exploratory survey among 90 medical and Information Technology personnel from 67 health facilities in Uganda. Findings were used to derive requirements for e-health interoperability, and to orchestrate elements of a service oriented framework for developing interoperable e-health systems in a low-income country (SOFIEH). A service-oriented approach yields reusable, flexible, robust, and interoperable services that support communication through well-defined interfaces. SOFIEH was evaluated using structured walkthroughs, and findings indicate that it scored well regarding applicability, usability, and understandability

Machina ex deos. Successes and challenges of implementing mobile computing technologies for development. The experience of nine Indian village health projects using a project-issued mobile application

As mobile computing technologies become increasingly functional and affordable, global donor and local development organizations find ways to justify and fund their use in grassroots development work. This dissertation asks two questions: (1) In resource-constrained social sector settings, what project features govern and structure use of work-issued mobile devices? And: (2) How do decision-makers adjust to maximize the benefit of newly-introduced devices while minimizing new burdens to the project and project staff? More simply, what variables under social sector projects’ control might promote successful use of information and communication technologies in development (ICTD) projects? This research represents systematic, qualitative comparison of nine extended deployments of a popular mobile health application, CommCare. Each studied project deployed devices loaded with CommCare to health workers in India as a supportive job aid and/or a data collection tool to help monitor beneficiary populations’ health status and frontline workers’ work. This dissertation examines the conditions under which these health workers were able and willing to use CommCare devices in their jobs, and whether and how they deviated from the use of those devices prescribed by their supervisors. Primary data for this study come from 62 in-depth, semi-structured interviews, extensive review of project documents, and personal observations from field study in India over six months in 2013. Employing a sociotechnical lens and a principal agent model, my data support expectations that use of CommCare devices would help align community health workers’ behavior with their supervisors’ organization and mission-related priorities. Use of the devices improved health workers’ professional competence and improved communications, data quality, and data access. These improvements facilitated project supervisors’ monitoring of health workers and beneficiaries, and funders’ monitoring of projects. Contradicting expectations, use of CommCare devices also weakened organizational oversight and control through new data challenges and increased health worker autonomy in their personal and professional lives. These dual benefits and challenges ultimately served the overall projects’ missions.Public Affair

Beyond the knowledge gap paradigm: the role of psychological empowerment in parents’ vaccination decision

Even though the efficacy and safety of immunization have been widely proven (Plotkin, 2014), an increasing number of parents have refused to vaccinate their children against serious infectious diseases in the past twenty years (Dubé, Gagnon, Nickels, Jeram, & Schuster, 2014). A recent shift in the study of vaccination decision- making has seen scholars moving beyond the idea that mere lack of knowledge could explain why parents decide to opt out of the recommended schedule, showing that making a vaccination decision is a complex cognitive and emotional process where several factors play a role. Variables such as risk perception, anticipated regret or prosocial attitude can potentially contribute to choosing or not choosing a given vaccination (Yaqub, Castle-Clarke, Sevdalis, & Chataway, 2014). The aim of this dissertation, which is based on the Health Empowerment Model (Schulz & Nakamoto, 2013), is to explore and assess the role of vaccination knowledge (as a dimension of vaccination literacy) in parental vaccination decision-making, while studying, at the same time, the implications of parents’ psychological empowerment on the decision about immunizing their child, with a special focus on the measles-mumps-rubella (MMR) vaccination. Six unique studies that employed both qualitative (individual interviews and focus groups) and quantitative (content analysis, survey and experiment) methods are presented, which aim to assess the influence of vaccination literacy and psychological empowerment on vaccination-related outcomes such as intention, while providing a valid and reliable measurement tool for the empowerment construct as well as a context-specific conceptualization. A content analysis (Chapter II) focusing on the arguments cited by users posting online about vaccination shows that a distinction can be made between an anti-vaccination group, a general pro- vaccination group (using diverse arguments supporting vaccination) and a safety- focused pro-vaccination group. The anti-vaccination group appears to be more active than the others and to also use multiple sources (mainly its own experience and media). The findings of an interview study (Chapter III) reveal that parents tend to misinterpret current vaccination recommendations and experience negative outcomes of their low self-perceived competence. The study also shows that parents think that their MMR vaccination decision can have an impact on different levels and that they have a preference for shared-decision making in relation to their child’s healthcare provider. A second qualitative study employing focus group interviews (Chapter IV) shows that parents are concerned with their legal responsibility and issues of freedom with regards to the MMR vaccination decision. A key finding is that parents’ relationship with the pediatrician in terms of trust is crucial to their self-perceived competence, suggesting their preference for a model of autonomy that does not exclude a shared decision-making approach with the child’s healthcare provider. Finally, a distinction emerges between information seekers, avoiders, and passive recipients. A scale is developed and its psychometric properties are evaluated (Chapter V) to provide a valid and reliable tool to measure psychological empowerment in the vaccination decision. The final tool captures parents’ perceived influence of one’s personal and family experience regarding vaccination, their desire not to ask other parents about their experience with vaccinations and their lack of interest in the vaccination opinion of other parents. These elements can be seen as context-specific extensions of the empowerment dimension of self-determination. The findings of an experimental study (Chapter VI) demonstrate that providing accurate information on the vaccination through a smartphone app employing gamification can positively and significantly increase parents’ knowledge and empowerment. Furthermore, providing information in a gamified way also led to a higher intention to vaccinate and higher parental confidence in the decision. Finally, a mixed method study to evaluate the experiment described above (Chapter VII), suggests that parents have a preference for information and opinions, compared to solely being empowered and pushed to look for information. The results recommend that empowering efforts be always accompanied by proper and exhaustive information. On the basis of these findings, this dissertation contributes to understanding parents’ empowerment needs in the vaccination decision, providing new insights to current research that seeks to study the vaccination decision as a complex process. The results of the studies can significantly inform ways to improve not only communication between health professionals and parents on the vaccination topic, but also future public health strategies and policies ultimately aimed at increasing vaccination coverage

A standards-based ICT framework to enable a service-oriented approach to clinical decision support

This research provides evidence that standards based Clinical Decision Support (CDS) at the point of care is an essential ingredient of electronic healthcare service delivery. A Service Oriented Architecture (SOA) based solution is explored, that serves as a task management system to coordinate complex distributed and disparate IT systems, processes and resources (human and computer) to provide standards based CDS. This research offers a solution to the challenges in implementing computerised CDS such as integration with heterogeneous legacy systems. Reuse of components and services to reduce costs and save time. The benefits of a sharable CDS service that can be reused by different healthcare practitioners to provide collaborative patient care is demonstrated. This solution provides orchestration among different services by extracting data from sources like patient databases, clinical knowledge bases and evidence-based clinical guidelines (CGs) in order to facilitate multiple CDS requests coming from different healthcare settings. This architecture aims to aid users at different levels of Healthcare Delivery Organizations (HCOs) to maintain a CDS repository, along with monitoring and managing services, thus enabling transparency. The research employs the Design Science research methodology (DSRM) combined with The Open Group Architecture Framework (TOGAF), an open source group initiative for Enterprise Architecture Framework (EAF). DSRM’s iterative capability addresses the rapidly evolving nature of workflows in healthcare. This SOA based solution uses standards-based open source technologies and platforms, the latest healthcare standards by HL7 and OMG, Decision Support Service (DSS) and Retrieve, Update Locate Service (RLUS) standard. Combining business process management (BPM) technologies, business rules with SOA ensures the HCO’s capability to manage its processes. This architectural solution is evaluated by successfully implementing evidence based CGs at the point of care in areas such as; a) Diagnostics (Chronic Obstructive Disease), b) Urgent Referral (Lung Cancer), c) Genome testing and integration with CDS in screening (Lynch’s syndrome). In addition to medical care, the CDS solution can benefit organizational processes for collaborative care delivery by connecting patients, physicians and other associated members. This framework facilitates integration of different types of CDS ideal for the different healthcare processes, enabling sharable CDS capabilities within and across organizations

The Measurement of Local Government Spending Quality with Indicators of Sustainable Local Development in Indonesia

Spending Quality becomes an important element in achieving sustainable development in Indonesia today. Through spending quality instruments, can be government control in evaluating the planning and budgeting process does. This study aims to formulate the measurement spending quality of local government and its relation to sustainable development indicators. In this study, the empirical analyses were performed using the Partial Least Squares Structural Equation Models (PLS-SEM), and also supported by Smart-PLS in handling computational work. The findings of this study suggest that the quality of expenditure is formed by five constructs (priority, allocation, time, accountability, and effectiveness), and reflected on fourteen indicators. Indicators of sustainable development is reflected by the construct Effectiveness areas related to basic services (especially education and health), infrastructure, human development and poverty eradication. Effectiveness found indicators that affected quality of spending in the current year (t), the year after (t + 1) and two years after the spending has done (t + 2). Indicators index constituent quality of spending reflects the holistic dimension of planning and budgeting system of regional development, from the planning, implementation and evaluation of performance. Completely indicator of the quality of spending, making the quality index of regional expenditures could potentially be as one of the important indicators in the management of regional development in achieving the goals of sustainable development Keywords: spending quality, local development, decentralization fiscal, PLS-SE