6 research outputs found

    Digital innovation in Multiple Sclerosis Management

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    Due to innovation in technology, a new type of patient has been created, the e-patient, characterized by the use of electronic communication tools and commitment to participate in their own care. The extent to which the world of digital health has changed during the COVID-19 pandemic has been widely recognized. Remote medicine has become part of the new normal for patients and clinicians, introducing innovative care delivery models that are likely to endure even if the pendulum swings back to some degree in a post-COVID age. The development of digital applications and remote communication technologies for patients with multiple sclerosis has increased rapidly in recent years. For patients, eHealth apps have been shown to improve outcomes and increase access to care, disease information, and support. For HCPs, eHealth technology may facilitate the assessment of clinical disability, analysis of lab and imaging data, and remote monitoring of patient symptoms, adverse events, and outcomes. It may allow time optimization and more timely intervention than is possible with scheduled face-to-face visits. The way we measure the impact of MS on daily life has remained relatively unchanged for decades, and is heavily reliant on clinic visits that may only occur once or twice each year.These benefits are important because multiple sclerosis requires ongoing monitoring, assessment, and management.The aim of this Special Issue is to cover the state of knowledge and expertise in the field of eHealth technology applied to multiple sclerosis, from clinical evaluation to patient education

    A socio-technical framework to guide implementation and value realisation of distributed ledger technologies (dlt) in the construction sector

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    Construction is highly resistant to change. Its many challenges have persisted for decades rooted in a lack of trust, reluctance to collaborate and share information. New technologies offer increased transparency, efficiency, and collaboration. Building Information Modelling (BIM), while being the most successful to advance construction to date, has not done enough to combat the challenges. The aim of this research was to investigate the potential of distributed ledger technologies (DLT) and smart contracts (SCs) to provide solutions for the sector. Through empirical investigations (systematic literature review, interviews, focus groups, survey), a framework to guide implementation and value realisation of DLT and SCs in the construction sector was proposed. A socio-technical approach was taken resulting in a framework encompassing four dimensions of technology, process, policy and society. This approach recognises DLT and SCs are not a panacea in and of themselves and should be used in conjunction with advancements across the four dimensions to de-risk any potential failure of these systems. The framework is made up of several conceptual constructs for use at meso and macro scales to support evaluation of the as-is to achieve a desired state and offers progressive roadmaps to reach the point of implementation. The findings demonstrate the requirement for DLT and SCs to integrate with other systems (e.g., BIM, IoT, AI) to add value. Furthermore, technology alone is insufficient to solve the sector’s problems also requiring reform of outdated practices (e.g., procurement, payments, contract management). Contributions to knowledge include: the first known socio-technical framework for systematic and progressive implementation of DLT and SCs in construction. This places equal importance on society and technology for the implementation of these new technological systems and will facilitate their success to unlock benefits for the sector amid the myriad challenges it faces; through this socio-technical approach, the framework encourages active involvement of stakeholders placing importance on the realisation that engaging with users of the system is central to its success; the position of an organisation (or group) looking to develop DLT- or SC-based applications at the meso scale or the position of the sector with regard to how it wants to incorporate these technologies into its existing systems and processes at the macro scale can be evaluated using the framework’s progressive approach that considers every stage of developing and implementing an application; the constructs considering both meso and macro scales minimise any potential decoupling between policy and practice in terms of implementation; and the framework aims to provide a flexible set of tools to encourage the sector to create an ecosystem ready to support these applications as well as provide guidance in the development of applications

    The survival and nutritional status of children in relation to aspects of maternal health : follow-up studies in rural Uganda

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    Background: Low income countries continue to experience high under-five mortality and a high prevalence of protein energy malnutrition (PEM) among surviving children. There is lack of empirical data for accurate tracking of child survival and for determining the consequences of early childhood PEM on future health and education. Main aim: To assess under –five mortality trends and associated factors to inform the design of child survival interventions, and also examine the impact of childhood PEM on future adolescent health and schooling among survivors in a rural population in Uganda. Methods: Four studies were nested in the Kyamulibwa Health and Demographic Surveillance Site in southwestern Uganda. In study 1, prospective data collected between 2002 and 2012 were extracted for 10,118 children under the age of five years and used to estimate age-specific mortality rates using the synthetic cohort life-table method. Calendar year-specific hazard rates and risk factors were explored by Cox regression. In study II, women of reproductive age were enrolled and stillbirth rates were compared using i) 12 months recall of pregnancy outcome (n= 1800) (method 1) and ii) lifetime recall (method 2) and associated risk factors were explored. In study III, 1054 children followed to adolescence were categorised as stunted/wasted, recovered, deteriorated and normal after three nutritional assessments between 1999 and 2011. Mean blood pressures and schooling years achieved measured in 2011 were compared in the 4 groups. In study IV, a pragmatic trial, involving registration of pregnancies and delivering stage-of-pregnancy-specific text message (SMS) via community health workers to pregnant women in 13 intervention villages (n=262) compared with pregnant women in control villages (n=263) with no intervention. Place of birth (home or health facility) was the main outcome. Results: Under-five mortality was 92 per 1000 live births. Overall mortality declined by 33% between 2002 and 2012 with the highest decline observed in the post-neonatal period. Early neonatal mortality did not change. Stillbirth rates differed by method of estimation; 26.2/1000 births versus 13.8/1000 births respectively by methods 1 and 2. No decline in stillbirth rates was observed. Under-five mortality increased with decreasing child age, HIV infection of the child, a birth interval 4 and a home delivery. Stillbirth risk increased with maternal age and reduced with increasing parity. In study III, wasting was negatively associated with systolic blood pressure (-7.90 95%CI [- 14.52,-1.28], p= 0.02) and diastolic blood pressure (-3.92, 95%CI [-7.42, -0.38], p= 0.03) among surviving children. Recovery from wasting was positively associated with diastolic blood pressure (1.93, 95%CI (0.11, 3.74] p=0.04). Both stunting and wasting regardless of recovery were negatively associated with school achievement. In study IV, the SMS intervention was associated with lower odds of homebirths [AOR=0.38, 95%CI (0.15-0.97)]. Home births were associated with muslim religion [AOR= 4.0, 95%CI (1.72-9.34)], primary or no maternal education [AOR= 2.51, 95%CI (1.00-6.35)] and health facility distance ≥ 2 km [AOR= 2.26, 95%CI (0.95-5.40)]. Conclusions: Survival of children in rural Uganda is improving, and could improve further with increased uptake of family planning and facility births. Promoting community health workers‘ role in improving child survival through use of mobile phones for delivering tailored messages to mothers is a potential strategy that could be scaled up in rural communities

    Information filtering in high velocity text streams using limited memory - An event-driven approach to text stream analysis

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    This dissertation is concerned with the processing of high velocity text streams using event processing means. It comprises a scientific approach for combining the area of information filtering and event processing. In order to be able to process text streams within event driven means, an event reference model was developed that allows for the conversion of unstructured or semi-structured text streams into discrete event types on which event processing engines can operate. Additionally, a set of essential reference processes in the domain of information filtering and text stream analysis were described using event-driven concepts. In a second step, a reference architecture was designed that described essential architectural components required for the design of information ltering and text stream analysis systems in an event-driven manner. Further to this, a set of architectural patterns for building event driven text analysis systems was derived that support the design and implementation of such systems. Subsequently, a prototype was built using the theoretic foundations. This system was initially used to study the effect of sliding window sizes on the properties of dynamic sub-corpora. It could be shown that small sliding window based corpora are similar to larger sliding windows and thus can be used as a resource-saving alternative. Next, a study of several linguistic aspects of text streams was undertaken that showed that event stream summary statistics can provide interesting insights into the characteristics of high velocity text streams. Finally, four essential information filtering and text stream analysis components were studied, viz. filter policies, term weighting, thresholds and query expansion. These were studied using three temporal search profile types and were evaluated using standard information retrieval performance measures. The goal was to study the efficiency of traditional as well as new algorithms within the given context of high velocity text stream data, in order to provide advise which methods work best. The results of this dissertation are intended to provide software architects and developers with valuable information for the design and implementation of event-driven text stream analysis systems

    An ICF Decision Supporting System Based on Sensoring Technologies

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