Identifying models of HIV care and treatment service delivery in Tanzania, Uganda, and Zambia using cluster analysis and Delphi survey.

BACKGROUND: Organization of HIV care and treatment services, including clinic staffing and services, may shape clinical and financial outcomes, yet there has been little attempt to describe different models of HIV care in sub-Saharan Africa (SSA). Information about the relative benefits and drawbacks of different models could inform the scale-up of antiretroviral therapy (ART) and associated services in resource-limited settings (RLS), especially in light of expanded client populations with country adoption of WHO's test and treat recommendation. METHODS: We characterized task-shifting/task-sharing practices in 19 diverse ART clinics in Tanzania, Uganda, and Zambia and used cluster analysis to identify unique models of service provision. We ran descriptive statistics to explore how the clusters varied by environmental factors and programmatic characteristics. Finally, we employed the Delphi Method to make systematic use of expert opinions to ensure that the cluster variables were meaningful in the context of actual task-shifting of ART services in SSA. RESULTS: The cluster analysis identified three task-shifting/task-sharing models. The main differences across models were the availability of medical doctors, the scope of clinical responsibility assigned to nurses, and the use of lay health care workers. Patterns of healthcare staffing in HIV service delivery were associated with different environmental factors (e.g., health facility levels, urban vs. rural settings) and programme characteristics (e.g., community ART distribution or integrated tuberculosis treatment on-site). CONCLUSIONS: Understanding the relative advantages and disadvantages of different models of care can help national programmes adapt to increased client load, select optimal adherence strategies within decentralized models of care, and identify differentiated models of care for clients to meet the growing needs of long-term ART patients who require more complicated treatment management

Scalable RAN Virtualization in Multi-Tenant LTE-A Heterogeneous Networks (Extended version)

Cellular communications are evolving to facilitate the current and expected increasing needs of Quality of Service (QoS), high data rates and diversity of offered services. Towards this direction, Radio Access Network (RAN) virtualization aims at providing solutions of mapping virtual network elements onto radio resources of the existing physical network. This paper proposes the Resources nEgotiation for NEtwork Virtualization (RENEV) algorithm, suitable for application in Heterogeneous Networks (HetNets) in Long Term Evolution-Advanced (LTE-A) environments, consisting of a macro evolved NodeB (eNB) overlaid with small cells. By exploiting Radio Resource Management (RRM) principles, RENEV achieves slicing and on demand delivery of resources. Leveraging the multi-tenancy approach, radio resources are transferred in terms of physical radio Resource Blocks (RBs) among multiple heterogeneous base stations, interconnected via the X2 interface. The main target is to deal with traffic variations in geographical dimension. All signaling design considerations under the current Third Generation Partnership Project (3GPP) LTE-A architecture are also investigated. Analytical studies and simulation experiments are conducted to evaluate RENEV in terms of network's throughput as well as its additional signaling overhead. Moreover we show that RENEV can be applied independently on top of already proposed schemes for RAN virtualization to improve their performance. The results indicate that significant merits are achieved both from network's and users' perspective as well as that it is a scalable solution for different number of small cells.Comment: 40 pages (including Appendices), Accepted for publication in the IEEE Transactions on Vehicular Technolog

Towards Autonomic Service Provisioning Systems

This paper discusses our experience in building SPIRE, an autonomic system for service provision. The architecture consists of a set of hosted Web Services subject to QoS constraints, and a certain number of servers used to run session-based traffic. Customers pay for having their jobs run, but require in turn certain quality guarantees: there are different SLAs specifying charges for running jobs and penalties for failing to meet promised performance metrics. The system is driven by an utility function, aiming at optimizing the average earned revenue per unit time. Demand and performance statistics are collected, while traffic parameters are estimated in order to make dynamic decisions concerning server allocation and admission control. Different utility functions are introduced and a number of experiments aiming at testing their performance are discussed. Results show that revenues can be dramatically improved by imposing suitable conditions for accepting incoming traffic; the proposed system performs well under different traffic settings, and it successfully adapts to changes in the operating environment.Comment: 11 pages, 9 Figures, http://www.wipo.int/pctdb/en/wo.jsp?WO=201002636

Internal report cluster 1: Urban freight innovations and solutions for sustainable deliveries (1/4)

Technical report about sustainable urban freight solutions, part 1 of

Multimedia delivery in the future internet

The term “Networked Media” implies that all kinds of media including text, image, 3D graphics, audio and video are produced, distributed, shared, managed and consumed on-line through various networks, like the Internet, Fiber, WiFi, WiMAX, GPRS, 3G and so on, in a convergent manner [1]. This white paper is the contribution of the Media Delivery Platform (MDP) cluster and aims to cover the Networked challenges of the Networked Media in the transition to the Future of the Internet. Internet has evolved and changed the way we work and live. End users of the Internet have been confronted with a bewildering range of media, services and applications and of technological innovations concerning media formats, wireless networks, terminal types and capabilities. And there is little evidence that the pace of this innovation is slowing. Today, over one billion of users access the Internet on regular basis, more than 100 million users have downloaded at least one (multi)media file and over 47 millions of them do so regularly, searching in more than 160 Exabytes1 of content. In the near future these numbers are expected to exponentially rise. It is expected that the Internet content will be increased by at least a factor of 6, rising to more than 990 Exabytes before 2012, fuelled mainly by the users themselves. Moreover, it is envisaged that in a near- to mid-term future, the Internet will provide the means to share and distribute (new) multimedia content and services with superior quality and striking flexibility, in a trusted and personalized way, improving citizens’ quality of life, working conditions, edutainment and safety. In this evolving environment, new transport protocols, new multimedia encoding schemes, cross-layer inthe network adaptation, machine-to-machine communication (including RFIDs), rich 3D content as well as community networks and the use of peer-to-peer (P2P) overlays are expected to generate new models of interaction and cooperation, and be able to support enhanced perceived quality-of-experience (PQoE) and innovative applications “on the move”, like virtual collaboration environments, personalised services/ media, virtual sport groups, on-line gaming, edutainment. In this context, the interaction with content combined with interactive/multimedia search capabilities across distributed repositories, opportunistic P2P networks and the dynamic adaptation to the characteristics of diverse mobile terminals are expected to contribute towards such a vision. Based on work that has taken place in a number of EC co-funded projects, in Framework Program 6 (FP6) and Framework Program 7 (FP7), a group of experts and technology visionaries have voluntarily contributed in this white paper aiming to describe the status, the state-of-the art, the challenges and the way ahead in the area of Content Aware media delivery platforms