A taxonomy for emergency service station location problem

The emergency service station (ESS) location problem has been widely studied in the literature since 1970s. There has been a growing interest in the subject especially after 1990s. Various models with different objective functions and constraints have been proposed in the academic literature and efficient solution techniques have been developed to provide good solutions in reasonable times. However, there is not any study that systematically classifies different problem types and methodologies to address them. This paper presents a taxonomic framework for the ESS location problem using an operations research perspective. In this framework, we basically consider the type of the emergency, the objective function, constraints, model assumptions, modeling, and solution techniques. We also analyze a variety of papers related to the literature in order to demonstrate the effectiveness of the taxonomy and to get insights for possible research directions

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

Designing community care systems with AUML

This paper describes an approach to developing an appropriate agent environment appropriate for use in community care applications. Key to its success is that software designers collaborate with environment builders to provide the levels of cooperation and support required within an integrated agent–oriented community system. Agent-oriented Unified Modeling Language (AUML) is a practical approach to the analysis, design, implementation and management of such an agent-based system, whilst providing the power and expressiveness necessary to support the specification, design and organization of a health care service. The background of an agent-based community care application to support the elderly is described. Our approach to building agent–oriented software development solutions emphasizes the importance of AUML as a fundamental initial step in producing more general agent–based architectures. This approach aims to present an effective methodology for an agent software development process using a service oriented approach, by addressing the agent decomposition, abstraction, and organization characteristics, whilst reducing its complexity by exploiting AUML’s productivity potential. </p

Towards a Formal Model of Privacy-Sensitive Dynamic Coalitions

The concept of dynamic coalitions (also virtual organizations) describes the temporary interconnection of autonomous agents, who share information or resources in order to achieve a common goal. Through modern technologies these coalitions may form across company, organization and system borders. Therefor questions of access control and security are of vital significance for the architectures supporting these coalitions. In this paper, we present our first steps to reach a formal framework for modeling and verifying the design of privacy-sensitive dynamic coalition infrastructures and their processes. In order to do so we extend existing dynamic coalition modeling approaches with an access-control-concept, which manages access to information through policies. Furthermore we regard the processes underlying these coalitions and present first works in formalizing these processes. As a result of the present paper we illustrate the usefulness of the Abstract State Machine (ASM) method for this task. We demonstrate a formal treatment of privacy-sensitive dynamic coalitions by two example ASMs which model certain access control situations. A logical consideration of these ASMs can lead to a better understanding and a verification of the ASMs according to the aspired specification.Comment: In Proceedings FAVO 2011, arXiv:1204.579

Knowledge-Intensive Processes: Characteristics, Requirements and Analysis of Contemporary Approaches

Engineering of knowledge-intensive processes (KiPs) is far from being mastered, since they are genuinely knowledge- and data-centric, and require substantial flexibility, at both design- and run-time. In this work, starting from a scientific literature analysis in the area of KiPs and from three real-world domains and application scenarios, we provide a precise characterization of KiPs. Furthermore, we devise some general requirements related to KiPs management and execution. Such requirements contribute to the definition of an evaluation framework to assess current system support for KiPs. To this end, we present a critical analysis on a number of existing process-oriented approaches by discussing their efficacy against the requirements

Design of a case management model for people with chronic disease (Heart Failure and COPD). Phase I: modeling and identification of the main components of the intervention through their actors: patients and professionals (DELTA-ICE-PRO Study

Background Chronic diseases account for nearly 60% of deaths around the world. The extent of this silent epidemic has not met determined responses in governments, policies or professionals in order to transform old Health Care Systems, configured for acute diseases. There is a large list of research about alternative models for people with chronic conditions, many of them with an advanced practice nurse as a key provider, as case management. But some methodological concerns raise, above all, the design of the intervention (intensity, frequency, components, etc). Methods/Design Objectives: General: To develop the first and second phases (theorization and modeling) for designing a multifaceted case-management intervention in people with chronic conditions (COPD and heart failure) and their caregivers. Specific aims: 1) To identify key events in people living with chronic disease and their relation with the Health Care System, from their point of view. 2) To know the coping mechanisms developed by patients and their caregivers along the story with the disease. 3) To know the information processing and its utilization in their interactions with health care providers. 4) To detect potential unmet needs and the ways deployed by patients and their caregivers to resolve them. 5) To obtain a description from patients and caregivers, about their itineraries along the Health Care System, in terms of continuity, accessibility and comprehensiveness of care. 6) To build up a list of promising case-management interventions in patients with Heart Failure and COPD with this information in order to frame it into theoretical models for its reproducibility and conceptualization. 7) To undergo this list to expert judgment to assess its feasibility and pertinence in the Andalusian Health Care. Design: Qualitative research with two phases: For the first five objectives, a qualitative technique with biographic stories will be developed and, for the remaining objectives, an expert consensus through Delphi technique, on the possible interventions yielded from the first phase. The study will be developed in the provinces of Almería, Málaga and Granada in the Southern Spain, from patients included in the Andalusian Health Care Service database with the diagnosis of COPD or Heart Failure, with the collaboration of case manager nurses and general practitioners for the assessment of their suitability to inclusion criteria. Patients and caregivers will be interviewed in their homes or their Health Centers, with their family or their case manager nurse as mediator. Discussion First of a series of studies intended to design a case-management service for people with heart failure and COPD, in the Andalusian Health Care System, where case management has been implemented since 2002. Accordingly with the steps of a theoretical model for complex interventions, in this study, theorization and intervention modeling phases will be developed.This research was carried out with the support of one research grant, awarded by the Regional Health Ministry of Andalusia (Exp. 0222/2008

An Assessment of the Impact of Climate Change on Human Health in New Hampshire

Climate change threatens human health in many ways. The negative impacts of climate change on human health are likely to increase in both magnitude and frequency as the climate continues to change in response to ever increasing global emissions of heat-trapping gases released from a variety of human activities.The Centers for Disease Control and Prevention (CDC) Building Resilience Against Climate Effects (BRACE) framework provides guidance to states and cities to develop strategies and programs to confront the health implications of climate change. This report serves to address Steps 1 and 2 of the BRACE framework via an assessment of past and future climate change across New Hampshire combined with an assessment of the impact of climate change on human health. A key component of the BRACE framework is building resilience. In public health, resilience is a measure of a community’s ability to utilize available resources to respond to, withstand, and recover from adverse situations. More generally, people think of resilience as the ability to recover, persist, or thrive amid change. The New Hampshire Climate and Health Workgroup has tentatively developed the following definition: Resilience is the ability and capacity to anticipate, prepare for, respond to, and recover from significant threats with minimum damage to human health and well-being, the economy, and the environment. The importance of the way we plan our built environment—including land use, transportation, and water management decisions, as well as how we interact with our natural environment and preserve its life-supporting functions—must be emphasized as pivotal points of intersection as we develop climate adaptation strategies. Notably, a resilience-based approach to climate change adaptation should align with New Hampshire’s transformative State Health Improvement Plan. That plan underscores the importance of cross-sector collaboration and coordinated strategies to address the social and environmental determinants of health. These strategies not only support healthy communities for all New Hampshire residents, but they are also critically important for reducing health care costs and reducing the burden of disease