Patient innovation : its prevalence, antecedents and impact

In order to maintain the level of healthcare that we now associate with developed countries, innovation is imperative. Previous literature has shown that patients of chronic diseases are often involved in the development of new treatments and medical devices to help them cope with their health-condition. However the innovation developed by patients is often ignored or even rejected. A possible approach to address this issue is to open up healthcare innovation, by allowing patients and their caregivers to become themselves active contributors to the innovation process. In this context, the aim of this dissertation is to (1) quantify the extent to which patients and caregivers of rare diseases innovate, (2) find demographic and non-demographic antecedents of patient innovation, and (3) assess how the innovations impact the lives of patients. A telephone survey was conducted with the main objective of measuring the extent to which respondents had innovated, or not. 496 patients and caregivers of 250 rare diseases responded to the survey. Following the data collection we performed a descriptive analysis of the data and a multiple logistic regression to identify statistically relevant predictor variables of patient innovators. We found that 13% of respondents had innovated, and the variables that emerged as predictors of being an innovator are: higher level of education, being unemployed or looking after at home, being aware of the expenses with the disease, and Information and Communication Technology readiness. On the other side, being single has a negative impact on the propensity to innovate when compared with being married. Moreover, in a 7-point Likert scale measuring the quality of life of the patient, the innovations led to an average improvement of 2.4 points. Not only are patients developing completely new-to-the-market innovations, that are improving the patients’ quality of life, but they also assume the risks of trying solutions that had not yet been tested. This study suggests that the current producer-based and paternalistic healthcare model should be revised, so patients are given the chance of playing a more proactive role.De forma a mantermos a saúde nos níveis que hoje associamos com países desenvolvidos, a inovação é imperativa. Estudos anteriores revelaram que em vários casos pacientes de doenças crónicas estão envolvidos no desenvolvimento de novos tratamentos e equipamentos médicos que os ajudam a lidar com a sua condição. Contudo, as inovações desenvolvidas por pacientes são frequentemente ignoradas ou até rejeitadas. Uma possível solução para superar esta crise de inovação seria deixar que pacientes e cuidadores se tornassem eles próprios contribuidores ativos no processo de inovação. Deste modo o objectivo desta dissertação é (1) quantificar até que ponto pacientes e cuidadores de doenças raras inovam, (2) identificar antecedentes demográficos e não-demográficos de inovação por pacientes, e (3) avaliar o modo como as inovações por pacientes afetam a vida dos pacientes. Conduziu-se um questionário telefónico com o fim de determinar até que ponto os entrevistados teriam inovado ou não. 496 pacientes e cuidadores de 250 doenças raras responderam ao questionário. Após a recolha de dados, efetuámos uma análise descritiva dos dados bem como uma regressão logística múltipla de forma a identificar variáveis estatisticamente relevantes preditoras do fenómeno de inovação por pacientes. Constatámos que 13% dos respondentes inovaram. As variáveis que emergiram como preditoras foram: educação superior, estar desempregado ou ser doméstico, estar ciente das despesas com a doença, utilização de tecnologias de informação. Por outro lado, ser solteiro, quando comparado com ser casado, tem um impacto negativo na propensão para inovar. Adicionalmente, numa escala de Likert de sete pontos que mediu a qualidade de vida do paciente, denotou-se uma melhoria média de 2.4 pontos após a inovação. Estes indivíduos não apenas desenvolvem inovações que melhoram a qualidade de vida dos pacientes, mas assumem também o risco de experimentar soluções que não foram ainda testadas. Este estudo sugere que o atual modelo de saúde paternalista, cujo epicentro são os produtores, deverá ser revisto tendo em vista a possibilidade de pacientes assumirem um papel mais proactivo

Virtualization-Based Cognitive Radio Networks

Abstract The emerging network virtualization technique is considered as a promising technology that enables the deployment of multiple virtual networks over a single physical network. These virtual networks are allowed to share the set of available resources in order to provide different services to their intended users. While several previous studies have focused on wired network virtualization, the field of wireless network virtualization is not well investigated. One of the promising wireless technologies is the Cognitive Radio (CR) technology that aims to handle the spectrum scarcity problem through efficient Dynamic Spectrum Access (DSA). In this paper, we propose to incorporate virtualization concepts into CR Networks (CRNs) to improve their performance. We start by explaining how the concept of multilayer hypervisors can be used within a CRN cell to manage its resources more efficiently by allowing the CR Base Station (BS) to delegate some of its management responsibilities to the CR users. By reducing the CRN users' reliance on the CRN BS, the amount of control messages can be decreased leading to reduced delay and improved throughput. Moreover, the proposed framework allows CRNs to better utilize its resources and support higher traffic loads which is in accordance with the recent technological advances that enable the Customer-Premises Equipments (CPEs) of potential CR users (such as smart phone users) to concurrently run multiple applications each generating its own traffic. We then show how our framework can be extended to handle multi-cell CRNs. Such an extension requires addressing the self-coexistence problem. To this end, we use a traffic load aware channel distribution algorithm. Through simulations, we show that our proposed framework can significantly enhance the CRN performance in terms of blocking probability and network throughput with different primary user level of activities

A Namibian digital health innovation ecosystem framework

Digital Health relates to “health information systems which enable the merging of social-care and healthcare systems. This would impact on the organisation, service delivery as well as the technological infrastructure” (Herselman & Botha, 2016, p.10). However, with relatively sparse research publications emanating from within the Namibian Health domain, and the concept of Namibian Digital Health as an emergent phenomenon, a Namibian Digital Health Innovation Ecosystem Framework would provide a start to conceptualising, developing and implementing such an ecosystem for Namibia and thus unlocking the potential of Digital Health in this country. The purpose of this study is to develop a Namibian Digital Health Innovation Ecosystem Framework based on literature reviews and the feedback from knowledgeable professionals (KPs) in Namibia, as well as global experts. The methodology which was applied in this study to address the purpose, and to answer the research questions, was Design Science Research Methodology and the Design Science Research Methodology (DSRM) process of Peffers, Tuunanen, Rothenberger and Chatterjee (2008), was adopted. Pragmatism is the overall philosophy guiding the study, as proposed by Ackoff’s theory regarding the hierarchy of human understanding (1989) and Shneiderman’s visual information seeking mantra (1996). During Phases 2 and 3 of the study interpretivism and positivism were applied as philosophies, guided by hermeneutics and triangulation, towards understanding the feedback of Knowledgeable Professionals (KPs) in Namibia, as well as the global experts. The study was divided into three phases. The first phase entailed a literature study which identified the components of Digital Health, Innovation and Digital Ecosystems as well as related research of Digital health, Innovation and Digital Ecosystems in developed and developing countries. This process led to the compilation of the initial Namibian Digital Health Innovation Ecosystem Framework using a conceptual approach. In the second phase of the study, the initial Namibian Digital Health Innovation Ecosystem was evaluated by KPs in Namibia using the Delphi method and interviews. Phase 2 adopted both quantitative and qualitative approaches. The findings from Phase 2 resulted in the development of the intermediate Namibian Digital Health Innovation Ecosystem Framework. In Phase 3 of the study, the intermediate framework was validated by global experts. Feedback was collected from global experts through questionnaires which were analysed through qualitative content analysis. The findings, from Phase 3 led to the development of the final Namibian Digital Health Innovation Ecosystems Framework. The guidelines, which can be used by the Namibian government to implement the suggested digital health innovation ecosystem framework, were also provided.Information ScienceD. Litt. et Phil. (Information Systems