Telephone interpersonal counseling treatment for frequent attenders to primary care: Development and piloting

Background: Frequent attenders in primary care (FAs) consume a disproportionate amount of healthcare resources and often have depression, anxiety, chronic health issues, and interpersonal problems. Despite extensive medical care, they remain dissatisfied with the care and report no improvement in quality of life. Objective: To pilot a Telephone-based Interpersonal Counseling intervention for Frequent Attenders (TIPC-FA) and assess its feasibility and efficacy in reducing symptoms and healthcare utilization. Method: Top 10% of primary care visitors were randomly assigned to TIPC-FA, Telephone Supportive Contact (Support), or Treatment as Usual (TAU). TIPC-FA and Support groups received six telephone sessions over twelve weeks, while the TAU group was interviewed twice. Multilevel regression tested for changes over time, considering patient and counselor variance. Results: TIPC-FA and Support groups demonstrated reduced depressive symptoms, and the TIPC-FA group showed decreased somatization and anxiety. The TIPC-FA group demonstrated a trend towards less healthcare utilization than the TAU group. Conclusion: This pilot study suggests that IPC via telephone outreach is a feasible approach to treating FAs, achieving a reduction in symptoms not seen in other groups. Promising reduction in healthcare utilization in the TIPC-FA group warrants further exploration in larger-scale trials

Application-infrastructure co-programming: managing the entire complex application lifecycle

With an estimated 20 billion connected devices by 2020 generating enormous amounts of data, more data-centric ways of working are needed to cope with the dynamic load and reconfigurability of on-demand computing. There is a growing range of complex, specialised means by which this flexibility can be achieved, e.g. Software-defined networking (SDN). Specification of Quality of Service (QoS) constraints for time-critical characteristics, such as network availability and bandwidth, will be needed, in the same way that compute requirements can be specified in today's infrastructures. This is the motivation for SWITCH -- an EU-funded H2020 project addressing the entire lifecycle of time-critical, self-adaptive cloud applications by developing new middleware and tools for interactive specification of such applications. This paper presents a user-facing perspective on SWITCH by discussing the SWITCH Interactive Development Environment (SIDE) Workbench. SIDE provides a programmable and dynamic graphical modeling environment for cloud applications that ensures efficient use of compute and network resources while satisfying time-critical QoS requirements. SIDE enables a user to specify the software components, properties and requirements, QoS parameters, machine requirements and their composition into a fully operational, multi-tier cloud application. In order to enable SIDE to represent the software and infrastructure constraints and to communicate them to other SWITCH components, we have defined a co-programming model using TOSCA that is capable of representing the application's state during the entire lifecycle of the application. We show how the SIDE Web GUI, along with TOSCA and the other subsystems, can support three use cases and provide a walk-through of one of these use cases to illustrate the power of such an approach

Application-infrastructure co-programming: managing the entire complex application lifecycle

With an estimated 20 billion connected devices by 2020 generating enormous amounts of data, more data-centric ways of working are needed to cope with the dynamic load and reconfigurability of on-demand computing. There is a growing range of complex, specialised means by which this flexibility can be achieved, e.g. Software-defined networking (SDN). Specification of Quality of Service (QoS) constraints for time-critical characteristics, such as network availability and bandwidth, will be needed, in the same way that compute requirements can be specified in today's infrastructures. This is the motivation for SWITCH -- an EU-funded H2020 project addressing the entire lifecycle of time-critical, self-adaptive cloud applications by developing new middleware and tools for interactive specification of such applications. This paper presents a user-facing perspective on SWITCH by discussing the SWITCH Interactive Development Environment (SIDE) Workbench. SIDE provides a programmable and dynamic graphical modeling environment for cloud applications that ensures efficient use of compute and network resources while satisfying time-critical QoS requirements. SIDE enables a user to specify the software components, properties and requirements, QoS parameters, machine requirements and their composition into a fully operational, multi-tier cloud application. In order to enable SIDE to represent the software and infrastructure constraints and to communicate them to other SWITCH components, we have defined a co-programming model using TOSCA that is capable of representing the application's state during the entire lifecycle of the application. We show how the SIDE Web GUI, along with TOSCA and the other subsystems, can support three use cases and provide a walk-through of one of these use cases to illustrate the power of such an approach