Impact of the economic crisis in the approval of new oncological drugs:the Portuguese paradigm

Background: The European crisis lead to funding restrains in healthcare, already under pressure due to the ageing of the population and the increase of demands from innovation. Portugal is the paradigm of the European crisis since has both an economic and demographic crisis. The researchers aimed to evaluate the impact of economic restrains in Portugal for access and reimbursement of new oncological drugs. Methodology: A qualitative approach was used, supported by 27 formal, tape recorded, semi-structured interviews to representatives of the different healthcare stakeholders and policymakers. The content analysis with semantic associations through co-occurrence analysis were done with the support of Tropes® software. Results: The results of the content analysis showed that economic restrains are leading to a policy of cost control with lower prices and reduced access to innovation; an excessive delay in the approval of new drugs; lack of transparency; serious limitations and inequity between hospitals. Contractual boundaries to national prescription was established and agreements with pharmaceuticals were made. Changes in the reimbursement process are being implemented with an increase of risk sharing mechanisms and implementation of a new system of health technological evaluation (SINATS). Treatment protocols are also being revised and public hospitals are trying to increase the number of clinical trials but there is still much bureaucracy. In this qualitative approach, the following factors with impact on survival were identified: Innovation and technological development, government funding, the price of drugs and type of oncological diseases. Conclusions: The economic crisis is leading to a very serious problem of inequity. However, it is also an opportunity for a structural reform. In Portugal, an attempt of reform is being made with the implementation of SINATS since it is important to distinguish molecules that effectively bring added value. In order to consider the strategic vision in which the patient is the center of all efforts, the process of reimbursement approval for new medicines should be faster, more transparent and interdisciplinary. Moreover, the decisions must be done triangulating evidence based medicine, economics, health policy and ethical and legal issues. For National Health Service sustainability, efficiency and efficacy, clinical and economic reassessments must be done after market introduction of new medicines, with subsequent renegotiations.info:eu-repo/semantics/publishedVersio

Prototyping Formal System Models with Active Objects

We propose active object languages as a development tool for formal system models of distributed systems. Additionally to a formalization based on a term rewriting system, we use established Software Engineering concepts, including software product lines and object orientation that come with extensive tool support. We illustrate our modeling approach by prototyping a weak memory model. The resulting executable model is modular and has clear interfaces between communicating participants through object-oriented modeling. Relaxations of the basic memory model are expressed as self-contained variants of a software product line. As a modeling language we use the formal active object language ABS which comes with an extensive tool set. This permits rapid formalization of core ideas, early validity checks in terms of formal invariant proofs, and debugging support by executing test runs. Hence, our approach supports the prototyping of formal system models with early feedback.Comment: In Proceedings ICE 2018, arXiv:1810.0205

Developing a distributed electronic health-record store for India

The DIGHT project is addressing the problem of building a scalable and highly available information store for the Electronic Health Records (EHRs) of the over one billion citizens of India

Proceedings of International Workshop "Global Computing: Programming Environments, Languages, Security and Analysis of Systems"

According to the IST/ FET proactive initiative on GLOBAL COMPUTING, the goal is to obtain techniques (models, frameworks, methods, algorithms) for constructing systems that are flexible, dependable, secure, robust and efficient. The dominant concerns are not those of representing and manipulating data efficiently but rather those of handling the co-ordination and interaction, security, reliability, robustness, failure modes, and control of risk of the entities in the system and the overall design, description and performance of the system itself. Completely different paradigms of computer science may have to be developed to tackle these issues effectively. The research should concentrate on systems having the following characteristics: • The systems are composed of autonomous computational entities where activity is not centrally controlled, either because global control is impossible or impractical, or because the entities are created or controlled by different owners. • The computational entities are mobile, due to the movement of the physical platforms or by movement of the entity from one platform to another. • The configuration varies over time. For instance, the system is open to the introduction of new computational entities and likewise their deletion. The behaviour of the entities may vary over time. • The systems operate with incomplete information about the environment. For instance, information becomes rapidly out of date and mobility requires information about the environment to be discovered. The ultimate goal of the research action is to provide a solid scientific foundation for the design of such systems, and to lay the groundwork for achieving effective principles for building and analysing such systems. This workshop covers the aspects related to languages and programming environments as well as analysis of systems and resources involving 9 projects (AGILE , DART, DEGAS , MIKADO, MRG, MYTHS, PEPITO, PROFUNDIS, SECURE) out of the 13 founded under the initiative. After an year from the start of the projects, the goal of the workshop is to fix the state of the art on the topics covered by the two clusters related to programming environments and analysis of systems as well as to devise strategies and new ideas to profitably continue the research effort towards the overall objective of the initiative. We acknowledge the Dipartimento di Informatica and Tlc of the University of Trento, the Comune di Rovereto, the project DEGAS for partially funding the event and the Events and Meetings Office of the University of Trento for the valuable collaboration

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

The Dag-Brucken ASRS Case Study

In 1996 an agreement was made between a well-known beverage manufacturer, Super-Cola Taiwan, (SCT) and a small Australian electrical engineering company, Dag-Brücken ASRS Pty Ltd, (DB), to provide an automated storage and retrieval system (ASRS) facility as part of SCT’s production facilities in Asia. Recognising the potential of their innovative and technically advanced design, DB was awarded a State Premiers Export Award and was a finalist in that year’s National Export Awards. The case tracks the development and subsequent implementation of the SCT ASRS project, setting out to highlight how the lack of appropriate IT development processes contributed to the ultimate failure of the project and the subsequent winding up of DB only one year after being honoured with these prestigious awards. The case provides compelling evidence of the types of project management incompetency that, from the literature, appears to contribute to the high failure rate in IT projects. For confidentiality reasons, the names of the principal parties are changed, but the case covers actual events documented by one of the project team members as part of his postgraduate studies, providing an example of the special mode of evidence collection that Yin (1994) calls ‘participant-observation’