Guidance to 2018 good practice : ARIA digitally-enabled, integrated, person-centred care for rhinitis and asthma

AimsMobile Airways Sentinel NetworK (MASK) belongs to the Fondation Partenariale MACVIA-LR of Montpellier, France and aims to provide an active and healthy life to rhinitis sufferers and to those with asthma multimorbidity across the life cycle, whatever their gender or socio-economic status, in order to reduce health and social inequities incurred by the disease and to improve the digital transformation of health and care. The ultimate goal is to change the management strategy in chronic diseases.MethodsMASK implements ICT technologies for individualized and predictive medicine to develop novel care pathways by a multi-disciplinary group centred around the patients.StakeholdersInclude patients, health care professionals (pharmacists and physicians), authorities, patient's associations, private and public sectors.ResultsMASK is deployed in 23 countries and 17 languages. 26,000 users have registered.EU grants (2018)MASK is participating in EU projects (POLLAR: impact of air POLLution in Asthma and Rhinitis, EIT Health, DigitalHealthEurope, Euriphi and Vigour).Lessons learnt(i) Adherence to treatment is the major problem of allergic disease, (ii) Self-management strategies should be considerably expanded (behavioural), (iii) Change management is essential in allergic diseases, (iv) Education strategies should be reconsidered using a patient-centred approach and (v) Lessons learnt for allergic diseases can be expanded to chronic diseases.Peer reviewe

Allergic Rhinitis and its Impact on Asthma (ARIA) Phase 4 (2018): Change management in allergic rhinitis and asthma multimorbidity using mobile technology

Allergic Rhinitis and its Impact on Asthma (ARIA) has evolved from a guideline by using the best approach to integrated care pathways using mobile technology in patients with allergic rhinitis (AR) and asthma multimorbidity. The proposed next phase of ARIA is change management, with the aim of providing an active and healthy life to patients with rhinitis and to those with asthma multimorbidity across the lifecycle irrespective of their sex or socioeconomic status to reduce health and social inequities incurred by the disease. ARIA has followed the 8-step model of Kotter to assess and implement the effect of rhinitis on asthma multimorbidity and to propose multimorbid guidelines. A second change management strategy is proposed by ARIA Phase 4 to increase self-medication and shared decision making in rhinitis and asthma multimorbidity. An innovation of ARIA has been the development and validation of information technology evidence-based tools (Mobile Airways Sentinel Network [MASK]) that can inform patient decisions on the basis of a self-care plan proposed by the health care professional

Optimal control of a head-of-line processor sharing model with regular and opportunity customers

Motivated by a workload control setting, we study a model where two types of customers are served by a single server according to the head-of-line processor sharing discipline. Regular customers and opportunity customers are arriving to the system according to two independent Poisson processes, each requiring an exponentially distributed service time. The regular customers will queue, incurring some holding costs. On contrary, an opportunity customer has to be taken into service directly, or is lost otherwise. There can be at most one opportunity customer in the system. The server can work on both one regular and one opportunity customer at the same time, where one can decide on how the server speed is split out. Moreover, one can decide whether to accept or reject an opportunity customer, incurring penalty costs for the latter. In this way, one has partial control about the workload in the system. We formulate the model as a Markov decision problem. We prove that the optimal policy, minimizing the expected discounted long-run cost, has a monotone structure in the number of regular customers. That is, the optimal policy for accepting an opportunity customer is described be a threshold, and the fraction of the server's attention devoted to the opportunity customer is a monotone decreasing function. Further, we generalize our model to the case where opportunity customers will queue as well, and to the case where also regular customers can be rejected

Optimal lateral transshipment policies for a two location inventory problem with multiple demand classes

\u3cp\u3eWe consider an inventory model for spare parts with two stockpoints, providing repairable parts for a critical component of advanced technical systems. As downtime costs for these systems are expensive, ready–for–use spare parts are kept in stock to be able to quickly respond to a breakdown of a system. We allow for lateral transshipments of parts between the stockpoints upon a demand arrival. Each stockpoint faces demands from multiple demand classes. We are interested in the optimal lateral transshipment policy. There are three ways in which a demand can by satisfied: from own stock, via a lateral transshipment, or via an emergency procedure. Using stochastic dynamic programming, we characterize and prove the structure of the optimal policy, that is, the policy for satisfying the demands which minimizes the average operating costs of the system. This optimal policy is a threshold type policy, with state-dependent thresholds at each stockpoint for every demand class. We show a partial ordering in these thresholds in the demand classes. In addition, we derive conditions under which the so-called hold back and complete pooling policies are optimal, two policies that are often assumed in the literature. Furthermore, we study several model extensions which fit in the same modeling framework.\u3c/p\u3

Optimal policy for a multi-location inventory system with a quick response warehouse

We study a multi-location inventory problem with a so-called quick response warehouse. In case of a stock-out at a local warehouse, the demand might be satis??ed by a stock transfer from the quick response warehouse. We derive the optimal policy for when to accept and when to reject such a demand at the quick response warehouse. We also derive conditions under which it is always optimal to accept these demands. Furthermore, we conduct a numerical study and consider model variations

Approximate evaluation of multi-location inventory models with lateral transshipments and hold back levels

We consider a continuous-time, single-echelon, multi-location inventory model with Poisson demand processes. In case of a stock-out at a local warehouse, a demand can be fulfilled via a lateral transshipment (LT). Each warehouse is assigned a pre-determined sequence of other warehouses where it will request for an LT. However, a warehouse can hold its last part(s) back from such a request. This is called a hold back pooling policy, where each warehouse has hold back levels determining whether a request for an LT by another warehouse is satisfied. We are interested in the fractions of demand satisfied from stock (fill rate), via an LT, and via an emergency procedure from an external source. From these, the average costs of a policy can be determined. We present a new approximation algorithm for the evaluation of a given policy, approximating the above mentioned fractions. Whereas algorithms currently known in the literature approximate the stream of LT requests from a warehouse by a Poisson process, we use an interrupted Poisson process. This is a process that is turned alternatingly On and Off for exponentially distributed durations. This leads to the On/Off overflow algorithm. In a numerical study we show that this algorithm is significantly more accurate than the algorithm based on Poisson processes, although it requires a longer computation time. Furthermore, we show the benefits of hold back levels, and we illustrate how our algorithm can be used in a heuristic search for the setting of the hold back levels

Optimal lateral transshipment policy for a two location inventory problem

We consider an inventory model for spare parts with two stockpoints, providing repairable parts for a critical component of advanced technical systems. As downtime costs for these systems are huge, ready-for-use spare parts are kept on stock, to be able to quickly respond to a breakdown of a system. We allow for lateral transshipments of parts between the stockpoints upon a demand arrival for a spare part. We are interested in the optimal lateral transshipment policy. We consider a continuous review setting, where the initial number of spare parts at each location is given. We assume Poisson demand processes, and allow for asymmetric demand rates and asymmetric costs structures at the two locations. Defective parts are replaced, and returned to the stockpoint for repair. Each location has ample repair capacity, and repair times are exponentially distributed, with the same mean repair time for both locations. Demands are satisfied from own stock, via a lateral transshipment, or via an emergency procedure. Using dynamic programming, we completely characterize and prove the structure of the optimal lateral transshipment policy, that is, the policy for satisfying demands, minimizing the long-run average costs of the system. This optimal policy is a threshold type policy. In addition, we derive conditions under which the so-called hold back and complete pooling policies are optimal, which are both policies that are often assumed in the literature

Indoor positioning in peer to peer networks

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