Waste-to-energy as a tool of circular economy: Prediction of higher heating value of biomass by artificial neural network (ANN) and multivariate linear regression (MLR).

Circular economy is a global trend as a promising strategy for the sustainable use of natural resources. In this context, waste-to-energy presents an effective solution to respond to the ever-increasing waste generation and energy demand duality. However, waste diversity makes their management a serious challenge. Among their categories, biomass waste valorization is an attractive solution energy regarding its low cost and raw materials availability. Nevertheless, the knowledge of biomass waste characteristics, such as composition and energy content, is a necessity. In this research, new models are developed to estimate biomass wastes higher heating value (HHV) based on the ultimate analysis using linear regression and artificial neural network (ANN). The quality-measure of the two models for new dataset was evaluated with statistical metrics such as coefficient of correlation (R), root mean squared error (RMSE), mean absolute error (MAE) and mean absolute percentage error (MAPE). The methods developed in this work provided attractive accuracies comparing to other literature models. Additionally, it is found that the ANN, as machine learning method, is the best model for biomass HHV prediction (R = 0.75377, RMSE = 1.17527, MAE = 0.93315 and MAPE = 5.73%). Therefore, obtained results can be widely employed to design and optimize the reactors of combustion. In fact, the developed ANN software is a simple and accurate tool for HHV estimation based on ultimate analysis. Indeed, ANN is one of the most applicable and widely used software in the field of waste-to-energy.

[Patient-Centered Care model and New Public Management : Confluence and paradox.] / Approche centrée sur le patient et nouvelle gestion publique : confluence et paradoxe.

The search for efficiency and concentration on patient needs and satisfaction are at the topic of current conceptions in terms of the quality and organization of health services. There is indeed a relative consolidation of organizational approaches called Patient-Centered Care (e.g. CCM, DM, case management, population management) for the structured management of patients with chronic diseases and a real desire to implement them in the domain of health. This evolution continues in the management of health systems through New Public Management - NPM. There is a strong pressure on professionals (care professionals and managers) to ensure greater efficiency in terms of activities and greater efficiency in terms of the use of resources. Both developments point to a greater emphasis on personalizing care, differentiating benefits, and taking into account the satisfaction of beneficiaries of public services. However, without being antinomic, the two evolutions underlie divergent and even paradoxical issues and mechanisms.

Impacts of a navigation program based on health information technology for patients receiving oral anticancer therapy: the CAPRI randomized controlled trial.

BACKGROUND: The emergence of oral delivery in cancer therapeutics is expected to result in an increased need for better coordination between all treatment stakeholders, mainly to ensure adequate treatment delivery to the patient. There is significant interest in the nurse navigation program's potential to improve transitions of care by improving communication between treatment stakeholders and by providing personalized organizational assistance to patients. The use of health information technology is another strategy aimed at improving cancer care coordination that can be combined with the NN program to improve remote patient follow-up. However, the potential of these two strategies combined to improve oral treatment delivery is limited by a lack of rigorous evidence of actual impact. METHODS/DESIGN: We are conducting a large scale randomized controlled trial designed to assess the impact of a navigation program denoted CAPRI that is based on two Nurse Navigators and a web portal ensuring coordination between community and hospital as well as between patients and navigators, versus routine delivery of oral anticancer therapy. The primary research aim is to assess the impact of the program on treatment delivery for patients with metastatic cancer, as measured by Relative Dose Intensity. The trial involves a number of other outcomes, including tumor response, survival, toxic side effects, patient quality of life and patient experience An economic evaluation adopting a societal perspective will be conducted, in order to estimate those health. care resources' used. A parallel process evaluation will be conducted to describe implementation of the intervention. DISCUSSION: If the CAPRI program does improve treatment delivery, the evidence on its economic impact will offer important knowledge for health decision-makers, helping develop new follow-up services for patients receiving oral chemotherapy and/or targeted therapy. The process evaluation will determine the best conditions in which such a program might be implemented. TRIAL REGISTRATION: NCT 02828462 . Registered 29 June 2016.

Analysis of nurse navigators' activities for hospital discharge coordination: a mixed method study for the case of cancer patients.

BACKGROUND: Modern cancer care requires the development of clinical pathways to enhance coordination, but there are few descriptive studies about the content of coordination activities. More specifically, little is known about hospital discharge coordination, although this is seen as a sensitive phase of clinical pathway. PURPOSE: The purpose of this study was to identify and quantify the categories of activities performed by nurse navigators for hospital discharge coordination. METHODS: Patients supported within the Coordinating Outpatient Care department (COC) at Gustave Roussy (Villejuif, France). Study conducted over two consecutive phases (Feb-September 2014): (1) a qualitative phase to identify the categories of coordination activities (interviews with patients plus, focus groups with nurse navigators-NNs); (2) a quantitative phase to quantify the relative share of each category. The calls received through the telephone platform of COC (made by both patients and primary care providers) were systematically reported (caller; reason for the call; procedure performed) and then analyzed. RESULTS: Qualitative phase: 17 interviews with patients, plus 2 focus groups with NNs. Quantitative phase: 543 calls analyzed. The callers were patients or their relatives (38 %), private nurses (35 %), medical device providers (20 %), and other primary care providers (e.g., pharmacists, family physicians) (7 %). Five categories of coordination activities identified: (F1) Patient monitoring (29 %); (F2) Helping to navigate (24 %); (F3) Managing technical problems (17 %); (F4) Explaining care protocols (16 %); (F5) Collecting and transmitting the patient medical record information (14 %). CONCLUSIONS: The majority of requirements are related to organizational issues (e.g., navigation, lack of information, appointments). Nurse navigators' training and qualification must therefore combine both clinical and managerial skills.

Internet-based technologies to improve cancer care coordination: current use and attitudes among cancer patients.

BACKGROUND: The uses of internet-based technologies (e.g. patient portals, websites and applications) by cancer patients could be strong drive for change in cancer care coordination practices. The goal of this study was to assess the current utilisation of internet-based technologies (IBT) among cancer patients, and their willingness to use them for their health, as well as analyse the influence of socio-demographics on both aspects. METHODS: A questionnaire-based survey was conducted in June 2013, over seven non-consecutive days within seven outpatient departments of Gustave Roussy, a comprehensive cancer centre (≈160,000 consultations yearly), located just outside Paris. We computed descriptive statistics and performed correlation analysis to investigate patients' usage and attitudes in correspondence with age, gender, socioeconomic status, social isolation, and place of living. We then conducted multinomial logistic regressions using R. RESULTS: The participation level was 85% (n=1371). The median age was 53.4. 71% used a mobile phone everyday and 93% had access to Internet from home. Age and socioeconomic status were negatively associated with the use of IBT (p<0.001). Regarding patients' expected benefits, a wide majority valued its use in health care, and especially, the possibility to enhance communication with providers. 84% of patients reported feeling comfortable with the use of such technologies but age and socioeconomic status had a significant influence. CONCLUSION: Most patients used IBTs every day. Overall, patients advocated for an extended use of IBT in oncology. Differences in perceived ease of use corresponding to age and socioeconomic status have to be addressed.