Performance evaluation of cooperation strategies for m-health services and applications

Health telematics are becoming a major improvement for patients’ lives, especially for disabled, elderly, and chronically ill people. Information and communication technologies have rapidly grown along with the mobile Internet concept of anywhere and anytime connection. In this context, Mobile Health (m-Health) proposes healthcare services delivering, overcoming geographical, temporal and even organizational barriers. Pervasive and m-Health services aim to respond several emerging problems in health services, including the increasing number of chronic diseases related to lifestyle, high costs in existing national health services, the need to empower patients and families to self-care and manage their own healthcare, and the need to provide direct access to health services, regardless the time and place. Mobile Health (m- Health) systems include the use of mobile devices and applications that interact with patients and caretakers. However, mobile devices have several constraints (such as, processor, energy, and storage resource limitations), affecting the quality of service and user experience. Architectures based on mobile devices and wireless communications presents several challenged issues and constraints, such as, battery and storage capacity, broadcast constraints, interferences, disconnections, noises, limited bandwidths, and network delays. In this sense, cooperation-based approaches are presented as a solution to solve such limitations, focusing on increasing network connectivity, communication rates, and reliability. Cooperation is an important research topic that has been growing in recent years. With the advent of wireless networks, several recent studies present cooperation mechanisms and algorithms as a solution to improve wireless networks performance. In the absence of a stable network infrastructure, mobile nodes cooperate with each other performing all networking functionalities. For example, it can support intermediate nodes forwarding packets between two distant nodes. This Thesis proposes a novel cooperation strategy for m-Health services and applications. This reputation-based scheme uses a Web-service to handle all the nodes reputation and networking permissions. Its main goal is to provide Internet services to mobile devices without network connectivity through cooperation with neighbor devices. Therefore resolving the above mentioned network problems and resulting in a major improvement for m-Health network architectures performances. A performance evaluation of this proposal through a real network scenario demonstrating and validating this cooperative scheme using a real m-Health application is presented. A cryptography solution for m-Health applications under cooperative environments, called DE4MHA, is also proposed and evaluated using the same real network scenario and the same m-Health application. Finally, this work proposes, a generalized cooperative application framework, called MobiCoop, that extends the incentive-based cooperative scheme for m-Health applications for all mobile applications. Its performance evaluation is also presented through a real network scenario demonstrating and validating MobiCoop using different mobile applications

Telemedicine

Telemedicine is a rapidly evolving field as new technologies are implemented for example for the development of wireless sensors, quality data transmission. Using the Internet applications such as counseling, clinical consultation support and home care monitoring and management are more and more realized, which improves access to high level medical care in underserved areas. The 23 chapters of this book present manifold examples of telemedicine treating both theoretical and practical foundations and application scenarios

Semantic discovery and reuse of business process patterns

Patterns currently play an important role in modern information systems (IS) development and their use has mainly been restricted to the design and implementation phases of the development lifecycle. Given the increasing significance of business modelling in IS development, patterns have the potential of providing a viable solution for promoting reusability of recurrent generalized models in the very early stages of development. As a statement of research-in-progress this paper focuses on business process patterns and proposes an initial methodological framework for the discovery and reuse of business process patterns within the IS development lifecycle. The framework borrows ideas from the domain engineering literature and proposes the use of semantics to drive both the discovery of patterns as well as their reuse

Seeing the wood for the trees. Carer related research and knowledge: A scoping review

This NIHR-SSCR funded scoping review provides a comprehensive mapping of what is known about carers and caring, and aims to help inform policy, practice and research in relation to carers. The review was undertaken by searching 10 electronic bibliographic databases, supplemented by additional web searches to identify academic research, grey literature and wider knowledge. The analysis adopts a selective thematic approach covering: carer variables - the characteristics of different types of carer and different caring situations; types of care - the nature of needs of the cared for person and the features of the care situation; the impact of caring – resilience and coping, employment and health; and carer support and needs assessment. The final section highlights key messages identified from the review. It found that caring involves all sections and age groups of the population, with people are likely to experience one or more periods of caregiving over their lifetime. The uniqueness of each caring relationship is also highlighted. In relation to types of carers, knowledge about ‘hard to reach’ groups, such as BAME and LGBT carers, remains sparse. Older carers are also relatively invisible in policy and research terms. It found that much of the knowledge about carers identified in the review relates to their characteristics, their lived experience and the nature of their caregiving, with relatively less being known about the effectiveness of interventions to support them. The report concludes by offering suggestions for policy and practice. An appendix provides a bibliography of the 3,434 items identified in review, classified into 17 types of reference

Facilitating access to specialist care for patients and carers living with motor neurone disease using telehealth.

Care of patients with motor neurone disease (MND) is best provided by a specialist, multidisciplinary team but access to this care is not universal. Technology-enabled care has the potential to improve access to specialist care in MND. A telehealth system (TiM: Telehealth in Motor neurone disease) was developed to allow patients and carers to share information about their condition using the internet with a specialist MND nurse. An 18-month, mixed methods, randomised, controlled pilot and feasibility study was conducted and a process evaluation explored the use, feasibility, acceptability and potential impact of the TiM system. Clinical outcomes (such as quality of life) were collected and semi-structured interviews with participants and clinicians were conducted. 40 patients and 37 carers were recruited and randomised to receive usual care or usual care plus the TiM system. Participants and clinicians felt that the TiM system was an acceptable and feasible way of improving access to specialist care and thought it could have the potential to improve their care. Formal comparisons of the two treatment groups were not aims of the trial but only modest differences were observed. The study identified further necessary improvements to the TiM, particularly focusing on the way clinicians act upon the information received and interact with patients and carers. The trial methods appeared to be feasible. The main challenge posed by a definitive trial appeared to be how to effectively measure impacts of the TiM on participants and the clinical service. This thesis recommends that the next step of TiM development should include further iterative improvements to TiM system in parallel with research that explores how the system would be used best in different MND services. If these evaluations also suggest the TiM system offers value, a definitive randomised controlled trial may be feasible. However, this thesis identifies better ways to further evaluate this complex intervention