Exploring Health Care Access for Gay, Bisexual, and Other Men Who Have Sex with Men Living in Middlesex County, Ontario

Published research suggests gay, bisexual, and other men who have sex with men (GB-MSM) present in health care with additional, distinct psychosocial and sexual health concerns compared to heterosexual men, emphasizing the importance of access to health care for these groups. This exploratory thesis used data from the online survey (n=202) of the Health in Middlesex Men Matters (HiMMM) Project – a community-based study examining health care access for GB-MSM living in Middlesex County, Ontario. For each manuscript, blockwise modified Poisson regression models were fit sequentially with predisposing, enabling, and need variables, as theorized by the Behavioral Model of Health Services Use. The first manuscript identified factors associated with access to a primary care provider (PCP), identifying subgroups with which to direct health care promotion efforts centred upon access. Older age, student status, marital and relationship status, social support (from a significant other and from GLBT - gay, lesbian, bisexual and transgender - communities), and self-perceived general health were crudely associated with having a PCP and were variably significantly associated with the outcome during the modelling process with additional variables. The second examined factors associated with sexual orientation disclosure and communication with providers about GB-MSM health issues. Marital/relationship status, experiences of homophobia, and assessment of provider’s communication were associated with having a PCP know respondents’ sexual orientation, crudely and in the modelling process with other variables. Internalized homonegativity, experiences of homophobia, provider communication, and prior negative experiences with a PCP were associated with talking to a PCP about GB-MSM health issues. The third examined demographic, socio-behavioural, and community-relevant factors associated with mental health service utilization in the past 12 months for local GB-MSM. Access to a PCP, childhood versus current religiosity or spirituality, self-perceived mental health, and internalized homonegativity were associated with the outcome, crudely, and in the blockwise modelling process with other variables. The fourth manuscript investigated demographic and socio-behavioural factors associated with not accessing HIV testing services, and explored descriptive reasons for this, discussing implications for HIV testing promotion. Factors significantly associated with being untested included social connection to GLBT communities, current versus childhood religiosity/spirituality levels, education, and employment

Multi-Factor Authentication: A Survey

Today, digitalization decisively penetrates all the sides of the modern society. One of the key enablers to maintain this process secure is authentication. It covers many different areas of a hyper-connected world, including online payments, communications, access right management, etc. This work sheds light on the evolution of authentication systems towards Multi-Factor Authentication (MFA) starting from Single-Factor Authentication (SFA) and through Two-Factor Authentication (2FA). Particularly, MFA is expected to be utilized for human-to-everything interactions by enabling fast, user-friendly, and reliable authentication when accessing a service. This paper surveys the already available and emerging sensors (factor providers) that allow for authenticating a user with the system directly or by involving the cloud. The corresponding challenges from the user as well as the service provider perspective are also reviewed. The MFA system based on reversed Lagrange polynomial within Shamir’s Secret Sharing (SSS) scheme is further proposed to enable more flexible authentication. This solution covers the cases of authenticating the user even if some of the factors are mismatched or absent. Our framework allows for qualifying the missing factors by authenticating the user without disclosing sensitive biometric data to the verification entity. Finally, a vision of the future trends in MFA is discussed.Peer reviewe

Improving sustainability through intelligent cargo and adaptive decision making

In the current society, logistics is faced with the challenge to meet more stringent sustainability goals. Shippers and transport service providers both aim to reduce the carbon footprint of their logistic operations. To do so, optimal use of logistics resources and physical infrastructure should be aimed for. An adaptive decision making process for the selection of a specific transport modality, transport provider and timeslot (aimed at minimisation of the carbon footprint) enables shippers to achieve this. This requires shippers to have access to up-to-date capacity information from transport providers (e.g. current and scheduled loading status of the various transport means and information on carbon footprint) and traffic information (e.g. city logistics and current traffic information). A prerequisite is an adequate infrastructure for collaboration and open exchange of information between the various stakeholders in the logistics value chain to obtain the up-to-date information. This paper gives a view on how such an advanced information infrastructure can be realised, currently being developed within the EU iCargo project. The paper describes a reference logistics value chain, including business benefits for each of the roles in the logistics value chain of aiming for sustainability. A case analysis is presented that reflects a practical situation in which the various roles collaborate and exchange information for realizing sustainability goals, using adaptive decision making for selecting a transport modality, transport provider, and timeslot. A high-level overview is provided of the requirements on and technical implementation of the supporting advanced infrastructure for collaboration and open information exchange.In the current society, logistics is faced with the challenge to meet more stringent sustainability goals. Shippers and transport service providers both aim to reduce the carbon footprint of their logistic operations. To do so, optimal use of logistics resources and physical infrastructure should be aimed for. An adaptive decision making process for the selection of a specific transport modality, transport provider and timeslot (aimed at minimisation of the carbon footprint) enables shippers to achieve this. This requires shippers to have access to up-to-date capacity information from transport providers (e.g. current and scheduled loading status of the various transport means and information on carbon footprint) and traffic information (e.g. city logistics and current traffic information). A prerequisite is an adequate infrastructure for collaboration and open exchange of information between the various stakeholders in the logistics value chain to obtain the up-to-date information. This paper gives a view on how such an advanced information infrastructure can be realised, currently being developed within the EU iCargo project. The paper describes a reference logistics value chain, including business benefits for each of the roles in the logistics value chain of aiming for sustainability. A case analysis is presented that reflects a practical situation in which the various roles collaborate and exchange information for realizing sustainability goals, using adaptive decision making for selecting a transport modality, transport provider, and timeslot. A high-level overview is provided of the requirements on and technical implementation of the supporting advanced infrastructure for collaboration and open information exchange.In the current society, logistics is faced with the challenge to meet more stringent sustainability goals. Shippers and transport service providers both aim to reduce the carbon footprint of their logistic operations. To do so, optimal use of logistics resources and physical infrastructure should be aimed for. An adaptive decision making process for the selection of a specific transport modality, transport provider and timeslot (aimed at minimisation of the carbon footprint) enables shippers to achieve this. This requires shippers to have access to up-to-date capacity information from transport providers (e.g. current and scheduled loading status of the various transport means and information on carbon footprint) and traffic information (e.g. city logistics and current traffic information). A prerequisite is an adequate infrastructure for collaboration and open exchange of information between the various stakeholders in the logistics value chain to obtain the up-to-date information. This paper gives a view on how such an advanced information infrastructure can be realised, currently being developed within the EU iCargo project. The paper describes a reference logistics value chain, including business benefits for each of the roles in the logistics value chain of aiming for sustainability. A case analysis is presented that reflects a practical situation in which the various roles collaborate and exchange information for realizing sustainability goals, using adaptive decision making for selecting a transport modality, transport provider, and timeslot. A high-level overview is provided of the requirements on and technical implementation of the supporting advanced infrastructure for collaboration and open information exchange

Breaking the Barriers to Specialty Care: Practical Ideas to Improve Health Equity and Reduce Cost - Call to Action for a System-wide Focus on Equity

Tremendous health outcome inequities remain in the U.S. across race and ethnicity, gender and sexual orientation, socio-economic status, and geography—particularly for those with serious conditions such as lung or skin cancer, HIV/AIDS, or cardiovascular disease.These inequities are driven by a complex set of factors—including distance to a specialist, insurance coverage, provider bias, and a patient's housing and healthy food access. These inequities not only harm patients, resulting in avoidable illness and death, they also drive unnecessary health systems costs.This 5-part series highlights the urgent need to address these issues, providing resources such as case studies, data, and recommendations to help the health care sector make meaningful strides toward achieving equity in specialty care.Top TakeawaysThere are vast inequalities in access to and outcomes from specialty health care in the U.S. These inequalities are worst for minority patients, low-income patients, patients with limited English language proficiency, and patients in rural areas.A number of solutions have emerged to improve health outcomes for minority and medically underserved patients. These solutions fall into three main categories: increasing specialty care availability, ensuring high-quality care, and helping patients engage in care.As these inequities are also significant drivers of health costs, payers, health care provider organizations, and policy makers have a strong incentive to invest in solutions that will both improve outcomes and reduce unnecessary costs. These actors play a critical role in ensuring that equity is embedded into core care delivery at scale.Part 5: "Call to Action for a System-wide Focus on Equity"These solutions create value not only for patients, but also for health care providers and public and private payers.  Each of these actors have a role to play in scaling and sustaining the health equity solutions.

A Semantic-Agent Framework for PaaS Interoperability

Suchismita Hoare, Na Helian, and Nathan Baddoo, 'A Semantic-Agent Framework for PaaS Interoperability', in Proceedings of the The IEEE International Conference on Cloud and Big Data Computing, Toulouse, France, 18-21, July 2016. DOI: 10.1109/UIC-ATC-ScalCom-CBDCom-IoP-SmartWorld.2016.0126 © 2017 IEEE. Personal use of this material is permitted. Permission from IEEE must be obtained for all other uses, in any current or future media, including reprinting/republishing this material for advertising or promotional purposes, creating new collective works, for resale or redistribution to servers or lists, or reuse of any copyrighted component of this work in other works.Cloud Platform as a Service (PaaS) is poised for a wider adoption by its relevant stakeholders, especially Cloud application developers. Despite this, the service model is still plagued with several adoption inhibitors, one of which is lack of interoperability between proprietary application infrastructure services of public PaaS solutions. Although there is some progress in addressing the general PaaS interoperability issue through various devised solutions focused primarily on API compatibility and platform-agnostic application design models, interoperability specific to differentiated services provided by the existing public PaaS providers and the resultant disparity owing to the offered services’ semantics has not been addressed effectively, yet. The literature indicates that this dimension of PaaS interoperability is awaiting evolution in the state-of-the-art. This paper proposes the initial system design of a PaaS interoperability (IntPaaS) framework to be developed through the integration of semantic and agent technologies to enable transparent interoperability between incompatible PaaS services. This will involve uniform description through semantic annotation of PaaS provider services utilizing the OWL-S ontology, creating a knowledgebase that enables software agents to automatically search for suitable services to support Cloud-based Greenfield application development. The rest of the paper discusses the identified research problem along with the proposed solution to address the issue.Submitted Versio