Towards Adaptive Technology in Routine Mental Healthcare

This paper summarizes the information technology-related research findings after 5 years with the INTROducing Mental health through Adaptive Technology project. The aim was to improve mental healthcare by introducing new technologies for adaptive interventions in mental healthcare through interdisciplinary research and development. We focus on the challenges related to internet-delivered psychological treatments, emphasising artificial intelligence, human-computer interaction, and software engineering. We present the main research findings, the developed artefacts, and lessons learned from the project before outlining directions for future research. The main findings from this project are encapsulated in a reference architecture that is used for establishing an infrastructure for adaptive internet-delivered psychological treatment systems in clinical contexts. The infrastructure is developed by introducing an interdisciplinary design and development process inspired by domain-driven design, user-centred design, and the person based approach for intervention design. The process aligns the software development with the intervention design and illustrates their mutual dependencies. Finally, we present software artefacts produced within the project and discuss how they are related to the proposed reference architecture. Our results indicate that the proposed development process, the reference architecture and the produced software can be practical means of designing adaptive mental health care treatments in correspondence with the patients’ needs and preferences. In summary, we have created the initial version of an information technology infrastructure to support the development and deployment of Internet-delivered mental health interventions with inherent support for data sharing, data analysis, reusability of treatment content, and adaptation of intervention based on user needs and preferences.publishedVersio

Ecological Momentary Assessment in Internet-Delivered Psychological Treatments using Wearable Technology

The growing prevalence of mental health problems is a global concern. Current psychological treatments are effective for a wide range of mental health problems. Yet, treatments today fall short with regards to scalability and struggle to meet the demand for help. To treat patients in a more cost-effective, accessible, and scalable manner, InternetDelivered Psychological Treatment (IDPT) has posed as a promising solution. Although, IDPT has shown encouraging results, the technology falls short in some regards. One such shortcoming is low user adherence. Adaptive IDPT that allow for personalizing treatment to patient needs may help solve the issue of high drop-out rates in IDPT as they are thought to aid in increasing user adherence. Yet, to adapt and personalize treatment there is a need of meaningful data about patients. In this thesis, we have created an artifact for the use of wearable data in IDPT. More specifically, our artifact can be split in two parts: (1) an extension of an IDPT framework that serves as a general component and allows for the utilization of wearable data to support Ecological Momentary Assessment (EMA) and (2) a demonstrative component that provides an example of how wearable data may be utilized in interventions to support adaptation. We have created an artifact, comprised of these two components, according to the design science research methodology. Through semi-structured interviews with domain experts of electrical engineering and psychology our artifact has been evaluated. As a result of this evaluation, we have learned that our artifact can serve as a basis for future research.Masteroppgave i Programutvikling samarbeid med HVLPROG399MAMN-PRO

The use of extended reality and machine learning to improve healthcare and promote greenhealth

Com a Quarta Revolução Industrial, a propagação da Internet das Coisas, o avanço nas áreas de Inteligência Artificial e de Machine Learning até à migração para a Computação em Nuvem, o termo "Ambientes Inteligentes" cada vez mais deixa de ser uma idealização para se tornar realidade. Da mesma forma as tecnologias de Realidade Extendida também elas têm aumentado a sua presença no mundo tecnológico após um "período de hibernação", desde a popularização do conceito de Metaverse assim como a entrada das grandes empresas informáticas como a Apple e a Google num mercado onde a Realidade Virtual, Realidade Aumentada e Realidade Mista eram dominadas por empresas com menos experiência no desenvolvimento de sistemas (e.g. Meta), reconhecimento a nível mundial (e.g. HTC Vive), ou suporte financeiro e confiança do mercado. Esta tese tem como foco o estudo do potencial uso das tecnologias de Realidade Estendida de forma a promover Saúde Verde assim como seu uso em Hospitais Inteligentes, uma das variantes de Ambientes Inteligentes, incorporando Machine Learning e Computer Vision, como ferramenta de suporte e de melhoria de cuidados de saúde, tanto do ponto de vista do profissional de saúde como do paciente, através duma revisão literarária e análise da atualidade. Resultando na elaboração de um modelo conceptual com a sugestão de tecnologias a poderem ser usadas para alcançar esse cenário selecionadas pelo seu potencial, sendo posteriormente descrito o desenvolvimento de protótipos de partes do modelo conceptual para Óculos de Realidade Extendida como validação de conceito.With the Fourth Industrial Revolution, the spread of the Internet of Things, the advance in the areas of Artificial Intelligence and Machine Learning until the migration to Cloud Computing, the term "Intelligent Environments" increasingly ceases to be an idealization to become reality. Likewise, Extended Reality technologies have also increased their presence in the technological world after a "hibernation period", since the popularization of the Metaverse concept, as well as the entry of large computer companies such as Apple and Google into a market where Virtual Reality, Augmented Reality and Mixed Reality were dominated by companies with less experience in system development (e.g. Meta), worldwide recognition (e.g. HTC Vive) or financial support and trust in the market. This thesis focuses on the study of the potential use of Extended Reality technologies in order to promote GreenHealth as well as their use in Smart Hospitals, one of the variants of Smart Environments, incorporating Machine Learning and Computer Vision, as a tool to support and improve healthcare, both from the point of view of the health professional and the patient, through a literature review and analysis of the current situation. Resulting in the elaboration of a conceptual model with the suggestion of technologies that can be used to achieve this scenario selected for their potential, and then the development of prototypes of parts of the conceptual model for Extended Reality Headsets as concept validation

Подход к интеграции разнородных источников медицинских данных на основе микросервисной архитектуры

The task of processing medical information is currently being solved in our country and abroad by means of heterogeneous medical information systems, mainly at the local and regional levels. The ever-increasing volume and complexity of the accumulated information, along with the need to ensure transparency and continuity in the processing of medical data (in particular, for bronchopulmonary diseases) in various organizations, requires the development of a new approach to integrating their heterogeneous sources. At the same time, an important requirement for solving the problem is the possibility of web-oriented implementation, which will make the corresponding applications available to a wide range of users without high requirements for their hardware and software capabilities. The paper considers an approach to the integration of heterogeneous sources of medical information, which is based on the principles of building microservice web architectures. Each data processing module can be used independently of other program modules, providing a universal entry point and the resulting data set in accordance with the accepted data schema. Sequential execution of processing steps implies the transfer of control to the corresponding program modules in the background according to the Cron principle. The schema declares two types of data schemas - local (from medical information systems) and global (for a single storage system), between which the corresponding display parameters are provided according to the principle of constructing XSLT tables. An important distinguishing feature of the proposed approach is the modernization of the medical information storage system, which consists in creating mirror copies of the main server with periodic replication of the relevant information. At the same time, the interaction between clients and data storage servers is carried out according to the type of content delivery systems with the creation of a connection session between end points based on the principle of the nearest distance between them, calculated using the haversine formula. The computational experiments carried out on test data on bronchopulmonary diseases showed the effectiveness of the proposed approach both for loading data and for obtaining them by individual users and software systems. Overall, the reactivity score of the corresponding web-based applications was improved by 40% on a stable connection.Задача обработки медицинской информации в настоящее время в нашей стране и за рубежом решается посредством разнородных медицинских информационных систем, преимущественно локального и регионального уровней. Постоянно возрастающий объем и сложность накапливаемой информации наряду с необходимостью обеспечения прозрачности и преемственности обработки медицинских данных (в частности, к примеру, по бронхолегочным заболеваниям) в различных организациях требует разработки нового подхода к интеграции их разнородных источников. При этом важным требованием к решению поставленной задачи является возможность веб-ориентированной реализации, что позволит сделать соответствующие приложения доступными широкому кругу пользователей без высоких требований к их аппаратно-программным возможностям. В работе рассматривается подход к интеграции разнородных источников медицинской информации, который основан на принципах построения микросервисных веб-архитектур. Каждый модуль обработки данных может быть использован независимо от других программных модулей, предоставляя универсальную точку входа и результирующий набор данных в соответствии с принятой схемой данных. Последовательное выполнение этапов обработки предполагает передачу управления соответствующим программным модулям в фоновом режиме по принципу Cron. В схеме декларируется два вида схем данных – локальная (от медицинских информационных систем) и глобальная (для единой системы хранения), между которыми предусмотрены соответствующие параметры отображения по принципу построения XSLT-таблиц. Важной отличительной особенностью предлагаемого подхода представляется модернизация системы хранения медицинской информации, заключающейся в создании зеркальных копий основного сервера с периодической репликацией соответствующей информации. При этом взаимодействие между клиентами и серверами хранилищ данных осуществляется по типу систем доставки контента с созданием сеанса соединения между конечными точками по принципу ближайшего расстояния между ними, рассчитанного по формуле гаверсинусов. Проведенные вычислительные эксперименты над тестовыми данными по бронхолегочным заболеваниям показали эффективность предложенного подхода как для загрузки данных, так и для их получения отдельными пользователями и программными системами. В целом показатель реактивности соответствующим веб-ориентированных приложений был улучшен на 40% при стабильном соединении

Подход к интеграции разнородных источников медицинских данных на основе микросервисной архитектуры

Задача обработки медицинской информации в настоящее время в нашей стране и за рубежом решается посредством разнородных медицинских информационных систем, преимущественно локального и регионального уровней. Постоянно возрастающий объем и сложность накапливаемой информации наряду с необходимостью обеспечения прозрачности и преемственности обработки медицинских данных (в частности, к примеру, по бронхолегочным заболеваниям) в различных организациях требует разработки нового подхода к интеграции их разнородных источников. При этом важным требованием к решению поставленной задачи является возможность веб-ориентированной реализации, что позволит сделать соответствующие приложения доступными широкому кругу пользователей без высоких требований к их аппаратно-программным возможностям. В работе рассматривается подход к интеграции разнородных источников медицинской информации, который основан на принципах построения микросервисных веб-архитектур. Каждый модуль обработки данных может быть использован независимо от других программных модулей, предоставляя универсальную точку входа и результирующий набор данных в соответствии с принятой схемой данных. Последовательное выполнение этапов обработки предполагает передачу управления соответствующим программным модулям в фоновом режиме по принципу Cron. В схеме декларируется два вида схем данных – локальная (от медицинских информационных систем) и глобальная (для единой системы хранения), между которыми предусмотрены соответствующие параметры отображения по принципу построения XSLT-таблиц. Важной отличительной особенностью предлагаемого подхода представляется модернизация системы хранения медицинской информации, заключающейся в создании зеркальных копий основного сервера с периодической репликацией соответствующей информации. При этом взаимодействие между клиентами и серверами хранилищ данных осуществляется по типу систем доставки контента с созданием сеанса соединения между конечными точками по принципу ближайшего расстояния между ними, рассчитанного по формуле гаверсинусов. Проведенные вычислительные эксперименты над тестовыми данными по бронхолегочным заболеваниям показали эффективность предложенного подхода как для загрузки данных, так и для их получения отдельными пользователями и программными системами. В целом показатель реактивности соответствующим веб-ориентированных приложений был улучшен на 40% при стабильном соединении

Systematic Literature Review: Current Products, Topic, and Implementation of Graph Database

Planning, developing, and updating software cannot be separated from the role of the database. From various types of databases, graph databases are considered to have various advantages over their predecessor, relational databases. Graph databases then become the latest trend in the software and data science industry, apart from the development of graph theory itself. The proliferation of research on GDB in the last decade raises questions about what topics are associated with GDB, what industries use GDB in its data processing, what the GDB models are, and what types of GDB have been used most frequently by users in the last few years. This article aims to answer these questions through a Literature Review, which is carried out by determining objectives, determining the limits of review coverage, determining inclusion and exclusion criteria for data retrieval, data extraction, and quality assessment. Based on a review of 60 studies, several research topics related to GDB are Semantic Web, Big Data, and Parallel computing. A total of 19 (30%) studies used Neo4j as their database. Apart from Social Networks, the industries that implement GDB the most are the Transportation sector, Scientific Article Networks, and general sectors such as Enterprise Data, Biological data, and History data. This Literature Review concludes that research on the topic of the Graph Database is still developing in the future. This is shown by the breadth of application and the variety of new derivatives of GDB products offered by researchers to address existing problems

Servicios web con GraphQL: una revisión sistemática de la literatura

El objetivo de este estudio fue el de hacer una revisión sistemática de la literatura sobre los servicios web con GraphQL indistintamente del lenguaje de programación y la lógica usada. Para realizar el objetivo, se ha buscado en las bases de datos en línea ProQuest y ScienceDirect usando una cadena de búsqueda (“Web services” AND “GraphQL” AND “REST”) para luego encontrar artículos científicos de acceso libre publicados en inglés o español durante los últimos 5 años (entre enero de 2015 y junio de 2020). De los 5 artículos seleccionados, se identificaron 4 artículos que se enfocaron en el desarrollo de repositorios públicos y centralizados relacionados con la medicina usando a GraphQL como tecnología de gestión de datos y 1 artículo en el que se desarrollan dispositivos de Internet Of Things (IoT) aumentando el rendimiento cuando se desea consultar y publicar datos a un servicio web usando GraphQL. Finalmente, es este artículo se exploran conceptos de GraphQL comparándolos con los de REST, y las tendencias próximas a esta tecnología. Espero que la información contenida en esta revisión sea de utilidad para la investigación en los servicios web con GraphQL

Systematic Literature Review: Current Products, Topic, and Implementation of Graph Database

Planning, developing, and updating software cannot be separated from the role of the database. From various types of databases, graph databases are considered to have various advantages over their predecessor, relational databases. Graph databases then become the latest trend in the software and data science industry, apart from the development of graph theory itself. The proliferation of research on GDB in the last decade raises questions about what topics are associated with GDB, what industries use GDB in its data processing, what the GDB models are, and what types of GDB have been used most frequently by users in the last few years. This article aims to answer these questions through a Literature Review, which is carried out by determining objectives, determining the limits of review coverage, determining inclusion and exclusion criteria for data retrieval, data extraction, and quality assessment. Based on a review of 60 studies, several research topics related to GDB are Semantic Web, Big Data, and Parallel computing. A total of 19 (30%) studies used Neo4j as their database. Apart from Social Networks, the industries that implement GDB the most are the Transportation sector, Scientific Article Networks, and general sectors such as Enterprise Data, Biological data, and History data. This Literature Review concludes that research on the topic of the Graph Database is still developing in the future. This is shown by the breadth of application and the variety of new derivatives of GDB products offered by researchers to address existing problems

Development of a mobile artifact to support adaptive iCBT using multi modality support and usage data

For det økende antallet kvinner som overlever brystkreft, er det mange som sliter med kroniske symptomer som fatigue, stress, depresjon, angst og en rekke andre fysiske og psykiske symptomer. Selv om CBT og iCBT er vanlige og effektive behandlinger for å håndtere slike symptomer, eksisterer det utfordringer relatert til tilgjengelighet, kostnader og skaleringsevne i sammenheng med de tradisjonelle tilnærmingene til å levere CBT. Selvstyrt iCBT potensialet til å tilby mer skalerbare og tilgjengelige alternativer til tradisjonell iCBT , men møter betydelige utfordringer relatert til etterlevelse. Ved å tilby en med individualisert opplevelse, kan selstyrt iCBT tilby en billig, effektiv og tilgjengelig måte å håndtere symptomer på. Gjennom prosjektet presentert i denne avhandlingen har vi brukt design science metodologien til å utvikle en artefakt for å demonstrere potensielt nyttig funksjonalitet for å tilrettelegge for adaptiv iCBT ved hjelp av en mobilapplikasjon. Vår fokus har vært å utvikle funskjonalitet for å tilby multimodal levering av CBT innhold, og funksjonalitet for å legge til rette for innsamling av bruksdata. Som en del av arbeidet vårt har vi introdusert bruken av talesynteseteknologi for å tilby multimodal levering av innhold gjennom on-demand levering av lydinnhold i applikasjonen. Vi har også evaluert den implementerte artifakten i henhold til både brukeropplevelsen og innholdsfunkjsonaliteten ved hjelp av eksperter innen UX og CBT. Resultatet fra UX evalueringen var brukt for å forbedre artefaktets design.For the increasing number of women who survive breast cancer, many find themselves struggling with chronic symptoms like fatigue, stress, depression, anxiety and a wide range of physical and psychological symptoms. While CBT and iCBT are common and effective treatments for managing these symptoms, there are challenges related to the availability, cost and ability to scale when considering traditional approaches to delivering CBT. Self-guided iCBT has the potential to provide more scalable and affordable alternatives to traditional CBT, but faces significant challenges related to user adherence. By providing a more personalized experience, self-guided iCBT may provide a cheap, effective and available means of managing symptoms. Throughout the master thesis project presented in this thesis, we have used design science methodology to develop an artifact for demonstrating potential useful functionality for facilitating adaptive iCBT using a mobile application. Our focus has been on developing functionality for providing multimodal delivery of CBT content, and functionality for facilitating the collection of usage data in order to enable the possibility for more personalized iCBT. As a part of this work, we have introduced the use of speech synthesis technology for providing multi-modality delivery of content through in-app audio on-demand. Also, we have evaluated the implemented artifact with respect to both user experience and content features with the help of experts within UX and CBT. The results from the UX evaluation was used to improve the design of the artifact.Masteroppgave i Programutvikling samarbeid med HVLPROG399MAMN-PRO

An architecture for secure data management in medical research and aided diagnosis

Programa Oficial de Doutoramento en Tecnoloxías da Información e as Comunicacións. 5032V01[Resumo] O Regulamento Xeral de Proteccion de Datos (GDPR) implantouse o 25 de maio de 2018 e considerase o desenvolvemento mais importante na regulacion da privacidade de datos dos ultimos 20 anos. As multas fortes definense por violar esas regras e non e algo que os centros sanitarios poidan permitirse ignorar. O obxectivo principal desta tese e estudar e proponer unha capa segura/integracion para os curadores de datos sanitarios, onde: a conectividade entre sistemas illados (localizacions), a unificacion de rexistros nunha vision centrada no paciente e a comparticion de datos coa aprobacion do consentimento sexan as pedras angulares de a arquitectura controlar a sua identidade, os perfis de privacidade e as subvencions de acceso. Ten como obxectivo minimizar o medo a responsabilidade legal ao compartir os rexistros medicos mediante o uso da anonimizacion e facendo que os pacientes sexan responsables de protexer os seus propios rexistros medicos, pero preservando a calidade do tratamento do paciente. A nosa hipotese principal e: os conceptos Distributed Ledger e Self-Sovereign Identity son unha simbiose natural para resolver os retos do GDPR no contexto da saude? Requirense solucions para que os medicos e investigadores poidan manter os seus fluxos de traballo de colaboracion sen comprometer as regulacions. A arquitectura proposta logra eses obxectivos nun ambiente descentralizado adoptando perfis de privacidade de datos illados.[Resumen] El Reglamento General de Proteccion de Datos (GDPR) se implemento el 25 de mayo de 2018 y se considera el desarrollo mas importante en la regulacion de privacidad de datos en los ultimos 20 anos. Las fuertes multas estan definidas por violar esas reglas y no es algo que los centros de salud puedan darse el lujo de ignorar. El objetivo principal de esta tesis es estudiar y proponer una capa segura/de integración para curadores de datos de atencion medica, donde: la conectividad entre sistemas aislados (ubicaciones), la unificacion de registros en una vista centrada en el paciente y el intercambio de datos con la aprobacion del consentimiento son los pilares de la arquitectura propuesta. Esta propuesta otorga al titular de los datos un rol central, que le permite controlar su identidad, perfiles de privacidad y permisos de acceso. Su objetivo es minimizar el temor a la responsabilidad legal al compartir registros medicos utilizando el anonimato y haciendo que los pacientes sean responsables de proteger sus propios registros medicos, preservando al mismo tiempo la calidad del tratamiento del paciente. Nuestra hipotesis principal es: .son los conceptos de libro mayor distribuido e identidad autosuficiente una simbiosis natural para resolver los desafios del RGPD en el contexto de la atencion medica? Se requieren soluciones para que los medicos y los investigadores puedan mantener sus flujos de trabajo de colaboracion sin comprometer las regulaciones. La arquitectura propuesta logra esos objetivos en un entorno descentralizado mediante la adopcion de perfiles de privacidad de datos aislados.[Abstract] The General Data Protection Regulation (GDPR) was implemented on 25 May 2018 and is considered the most important development in data privacy regulation in the last 20 years. Heavy fines are defined for violating those rules and is not something that healthcare centers can afford to ignore. The main goal of this thesis is to study and propose a secure/integration layer for healthcare data curators, where: connectivity between isolated systems (locations), unification of records in a patientcentric view and data sharing with consent approval are the cornerstones of the proposed architecture. This proposal empowers the data subject with a central role, which allows to control their identity, privacy profiles and access grants. It aims to minimize the fear of legal liability when sharing medical records by using anonymisation and making patients responsible for securing their own medical records, yet preserving the patient’s quality of treatment. Our main hypothesis is: are the Distributed Ledger and Self-Sovereign Identity concepts a natural symbiosis to solve the GDPR challenges in the context of healthcare? Solutions are required so that clinicians and researchers can maintain their collaboration workflows without compromising regulations. The proposed architecture accomplishes those objectives in a decentralized environment by adopting isolated data privacy profiles