Co-payment Strategies for Chronic Medications: A Qualitative and Comparative Analysis at European Level

The management of pharmacotherapy and the process of dispensing medicines is becoming critical in clinical pharmacy due to the increase of incidence and prevalence of chronic diseases, the complexity and customization of therapeutic regimens, the introduction of innovative and more expensive medicines, the unbalanced relation between expenditure and revenue as well as due to the lack of rationalization associated with medication use. For these reasons, co-payments emerged in Europe in the 70s and have been applied over the past few years in healthcare. Co-payments lead to a rationing and rationalization of user’s access under healthcare services and products, and simultaneously, to a qualification and improvement of the services and products for the end-user. This analysis, under hospital practices particularly and co-payment strategies in general, was carried out on all the European regions and identified four reference countries, that apply repeatedly this tool and with different approaches. The structure, content and adaptation of European co-payments were analyzed through 7 qualitative attributes and 19 performance indicators, and the results expressed in a scorecard, allowing to conclude that the German models (total score of 68,2% and 63,6% in both elected co-payments) can collect more compliance and effectiveness, the English models (total score of 50%) can be more accessible, and the French models (total score of 50%) can be more adequate to the socio-economic and legal framework. Other European models did not show the same quality and/or performance, so were not taken as a standard in the future design of co-payments strategies. In this sense, we can see in the co-payments a strategy not only to moderate the consumption of healthcare products and services, but especially to improve them, as well as a strategy to increment the value that the end-user assigns to these services and products, such as medicines.

Orchestra Course Outcomes in Terms of Values Education

Music education aims to bring up individuals most appropriately and to advanced levels as a balanced whole physically, cognitively, affectively, and kinesthetically while making a major contribution to the physical and spiritual development of the individual. The most crucial aim of music education, an influential education medium per se, is to make music be loved; yet, among its educational aims are concepts such as affinity, friendship, goodness, philanthropy, responsibility, and respect all extremely crucial bringing up individuals as a balanced whole. One of the most essential assets of the music education is the training of making music together, solidifying musical knowledge and enabling the acquisition of cooperation. This habit requires internalization of values like responsibility, patience, cooperativeness, respect, self-control, friendship, and fairness. If musicians lack these values, the ensemble will become after some certain time a cacophony. In this qualitative research, the attitudes of music teacher candidates in orchestra/chamber music classes will be examined in terms of values.

Sky Farming: The Alternative Concept of Green Building Using Vertical Landscape Model in Urban Area as an Effort to Achieve Sustainable Development

This paper is a literature review presented descriptively to review the concept of green building to face the challenge of sustainable development and food in urban areas. In this paper, researchers initiated the concept of green building with sky farming method. Sky farming use vertical landscape system in order to realizing food self-sufficient green city. Sky farming relying on plantings and irrigation system efficiency in the building which is adopted the principles of green building. Planting system is done by applying hydroponic plants with Nutrient Film Technique (NFT) using energy source of solar cell and grey water from the processing of waste treatment plant. The application of sky farming in urban areas can be a recommendation for the design of environmental-friendly construction. In order to keep the land and distance efficiency, this system is a futuristic idea that would be the connector of human civilization in the future.

Extracting the Coupled Dynamics in Thin-Walled Beams from Numerical Data Bases

In this work we use the Discrete Proper Orthogonal Decomposition transform to characterize the properties of coupled dynamics in thin-walled beams by exploiting numerical simulations obtained from finite element simulations. The outcomes of the will improve our understanding of the linear and nonlinear coupled behavior of thin-walled beams structures. Thin-walled beams have widespread usage in modern engineering application in both large scale structures (aeronautical structures), as well as in nano-structures (nano-tubes). Therefore, detailed knowledge in regard to the properties of coupled vibrations and buckling in these structures are of great interest in the research community. Due to the geometric complexity in the overall structure and in particular in the cross-sections it is necessary to involve computational mechanics to numerically simulate the dynamics. In using numerical computational techniques, it is not necessary to over simplify a model in order to solve the equations of motions. Computational dynamics methods produce databases of controlled resolution in time and space. These numerical databases contain information on the properties of the coupled dynamics. In order to extract the system dynamic properties and strength of coupling among the various fields of the motion, processing techniques are required. Time- Proper Orthogonal Decomposition transform is a powerful tool for processing databases for the dynamics. It will be used to study the coupled dynamics of thin-walled basic structures. These structures are ideal to form a basis for a systematic study of coupled dynamics in structures of complex geometry.

Modelling the Behavior of Commercial and Test Textiles against Laundering Process by Statistical Assessment of Their Performance

Various exterior factors have perpetual effects on textile materials during wear, use and laundering in everyday life. In accordance with their frequency of use, textile materials are required to be laundered at certain intervals. The medium in which the laundering process takes place have inevitable detrimental physical and chemical effects on textile materials caused by the unique parameters of the process inherently existing. Connatural structures of various textile materials result in many different physical, chemical and mechanical characteristics. Because of their specific structures, these materials have different behaviors against several exterior factors. By modeling the behavior of commercial and test textiles as group-wise against laundering process, it is possible to disclose the relation in between these two groups of materials, which will lead to better understanding of their behaviors in terms of similarities and differences against the washing parameters of the laundering. Thus, the goal of the current research is to examine the behavior of two groups of textile materials as commercial textiles and as test textiles towards the main washing machine parameters during laundering process such as temperature, load quantity, mechanical action and level of water amount by concentrating on shrinkage, pilling, sewing defects, collar abrasion, the other defects other than sewing, whitening and overall properties of textiles. In this study, cotton fabrics were preferred as commercial textiles due to the fact that garments made of cotton are the most demanded products in the market by the textile consumers in daily life. Full factorial experimental set-up was used to design the experimental procedure. All profiles always including all of the commercial and the test textiles were laundered for 20 cycles by commercial home laundering machine to investigate the effects of the chosen parameters. For the laundering process, a modified version of ‘‘IEC 60456 Test Method’’ was utilized. The amount of detergent was altered as 0.5% gram per liter depending on varying load quantity levels. Datacolor 650®, EMPA Photographic Standards for Pilling Test and visual examination were utilized to test and characterize the textiles. Furthermore, in the current study the relation in between commercial and test textiles in terms of their performance was deeply investigated by the help of statistical analysis performed by MINITAB® package program modeling their behavior against the parameters of the laundering process. In the experimental work, the behaviors of both groups of textiles towards washing machine parameters were visually and quantitatively assessed in dry state.

Reduction of False Positives in Head-Shoulder Detection Based on Multi-Part Color Segmentation

The paper presents a method that utilizes figure-ground color segmentation to extract effective global feature in terms of false positive reduction in the head-shoulder detection. Conventional detectors that rely on local features such as HOG due to real-time operation suffer from false positives. Color cue in an input image provides salient information on a global characteristic which is necessary to alleviate the false positives of the local feature based detectors. An effective approach that uses figure-ground color segmentation has been presented in an effort to reduce the false positives in object detection. In this paper, an extended version of the approach is presented that adopts separate multipart foregrounds instead of a single prior foreground and performs the figure-ground color segmentation with each of the foregrounds. The multipart foregrounds include the parts of the head-shoulder shape and additional auxiliary foregrounds being optimized by a search algorithm. A classifier is constructed with the feature that consists of a set of the multiple resulting segmentations. Experimental results show that the presented method can discriminate more false positive than the single prior shape-based classifier as well as detectors with the local features. The improvement is possible because the presented approach can reduce the false positives that have the same colors in the head and shoulder foregrounds.

Importance of Risk Assessment in Managers´ Decision-Making Process

Making decisions is the core of management and a result of conscious activities which is under way in a particular environment and concrete conditions. The managers decide about the goals, procedures and about the methods how to respond to the changes and to the problems which developed. Their decisions affect the effectiveness, quality, economy and the overall successfulness in every organisation. In spite of this fact, they do not pay sufficient attention to the individual steps of the decision-making process. They emphasise more how to cope with the individual methods and techniques of making decisions and forget about the way how to cope with analysing the problem or assessing the individual solution variants. In many cases, the underestimating of the analytical phase can lead to an incorrect assessment of the problem and this can then negatively influence its further solution. Based on our analysis of the theoretical solutions by individual authors who are dealing with this area and the realised research in Slovakia and also abroad we can recognise an insufficient interest of the managers to assess the risks in the decision-making process. The goal of this paper is to assess the risks in the managers´ decision-making process relating to the conditions of the environment, to the subject’s activity (the manager’s personality), to the insufficient assessment of individual variants for solving the problems but also to situations when the arisen problem is not solved. The benefit of this paper is the effort to increase the need of the managers to deal with the risks during the decision-making process. It is important for every manager to assess the risks in his/her decision-making process and to make efforts to take such decisions which reflect the basic conditions, states and development of the environment in the best way and especially for the managers´ decisions to contribute to achieving the determined goals of the organisation as effectively as possible.

Six-Phase Tooth-Coil Winding Starter-Generator Embedded in Aerospace Engine

This paper is devoted to solve the problem of increasing the electrification of aircraft engines by installing a synchronous generator at high pressure shaft. Technical solution of this problem by various research centers is discussed. A design solution of the problem was proposed. To evaluate the effectiveness of the proposed cooling system, thermal analysis was carried out in ANSYS software.

CFD-Parametric Study in Stator Heat Transfer of an Axial Flux Permanent Magnet Machine

This paper copes with the numerical simulation for convective heat transfer in the stator disk of an axial flux permanent magnet (AFPM) electrical machine. Overheating is one of the main issues in the design of AFMPs, which mainly occurs in the stator disk, so that it needs to be prevented. A rotor-stator configuration with 16 magnets at the periphery of the rotor is considered. Air is allowed to flow through openings in the rotor disk and channels being formed between the magnets and in the gap region between the magnets and the stator surface. The rotating channels between the magnets act as a driving force for the air flow. The significant non-dimensional parameters are the rotational Reynolds number, the gap size ratio, the magnet thickness ratio, and the magnet angle ratio. The goal is to find correlations for the Nusselt number on the stator disk according to these non-dimensional numbers. Therefore, CFD simulations have been performed with the multiple reference frame (MRF) technique to model the rotary motion of the rotor and the flow around and inside the machine. A minimization method is introduced by a pattern-search algorithm to find the appropriate values of the reference temperature. It is found that the correlations are fast, robust and is capable of predicting the stator heat transfer with a good accuracy. The results reveal that the magnet angle ratio diminishes the stator heat transfer, whereas the rotational Reynolds number and the magnet thickness ratio improve the convective heat transfer. On the other hand, there a certain gap size ratio at which the stator heat transfer reaches a maximum.

A Survey of Semantic Integration Approaches in Bioinformatics

Technological advances of computer science and data analysis are helping to provide continuously huge volumes of biological data, which are available on the web. Such advances involve and require powerful techniques for data integration to extract pertinent knowledge and information for a specific question. Biomedical exploration of these big data often requires the use of complex queries across multiple autonomous, heterogeneous and distributed data sources. Semantic integration is an active area of research in several disciplines, such as databases, information-integration, and ontology. We provide a survey of some approaches and techniques for integrating biological data, we focus on those developed in the ontology community.

Numerical Study of Flapping-Wing Flight of Hummingbird Hawkmoth during Hovering: Longitudinal Dynamics

In recent decades, flapping wing aerodynamics has attracted great interest. Understanding the physics of biological flyers such as birds and insects can help improve the performance of micro air vehicles. The present research focuses on the aerodynamics of insect-like flapping wing flight with the approach of numerical computation. Insect model of hawkmoth is adopted in the numerical study with rigid wing assumption currently. The numerical model integrates the computational fluid dynamics of the flow and active control of wing kinematics to achieve stable flight. The computation grid is a hybrid consisting of background Cartesian nodes and clouds of mesh-free grids around immersed boundaries. The generalized finite difference method is used in conjunction with single value decomposition (SVD-GFD) in computational fluid dynamics solver to study the dynamics of a free hovering hummingbird hawkmoth. The longitudinal dynamics of the hovering flight is governed by three control parameters, i.e., wing plane angle, mean positional angle and wing beating frequency. In present work, a PID controller works out the appropriate control parameters with the insect motion as input. The controller is adjusted to acquire desired maneuvering of the insect flight. The numerical scheme in present study is proven to be accurate and stable to simulate the flight of the hummingbird hawkmoth, which has relatively high Reynolds number. The PID controller is responsive to provide feedback to the wing kinematics during the hovering flight. The simulated hovering flight agrees well with the real insect flight. The present numerical study offers a promising route to investigate the free flight aerodynamics of insects, which could overcome some of the limitations of experiments.

The Morphology of Sri Lankan Text Messages

Communicating via a text or an SMS (Short Message Service) has become an integral part of our daily lives. With the increase in the use of mobile phones, text messaging has become a genre by itself worth researching and studying. It is undoubtedly a major phenomenon revealing language change. This paper attempts to describe the morphological processes of text language of urban bilinguals in Sri Lanka. It will be a typological study based on 500 English text messages collected from urban bilinguals residing in Colombo. The messages are selected by categorizing the deviant forms of language use apparent in text messages. These stylistic deviations are a deliberate skilled performance by the users of the language possessing an in-depth knowledge of linguistic systems to create new words and thereby convey their linguistic identity and individual and group solidarity via the message. The findings of the study solidifies arguments that the manipulation of language in text messages is both creative and appropriate. In addition, code mixing theories will be used to identify how existing morphological processes are adapted by bilingual users in Sri Lanka when texting. The study will reveal processes such as omission, initialism, insertion and alternation in addition to other identified linguistic features in text language. The corpus reveals the most common morphological processes used by Sri Lankan urban bilinguals when sending texts.

Integrating Geographic Information into Diabetes Disease Management

Background: Traditional chronic disease management did not pay attention to effects of geographic factors on the compliance of treatment regime, which resulted in geographic inequality in outcomes of chronic disease management. This study aims to examine the geographic distribution and clustering of quality indicators of diabetes care. Method: We first extracted address, demographic information and quality of care indicators (number of visits, complications, prescription and laboratory records) of patients with diabetes for 2014 from medical information system in a medical center in Tainan City, Taiwan, and the patients’ addresses were transformed into district- and village-level data. We then compared the differences of geographic distribution and clustering of quality of care indicators between districts and villages. Despite the descriptive results, rate ratios and 95% confidence intervals (CI) were estimated for indices of care in order to compare the quality of diabetes care among different areas. Results: A total of 23,588 patients with diabetes were extracted from the hospital data system; whereas 12,716 patients’ information and medical records were included to the following analysis. More than half of the subjects in this study were male and between 60-79 years old. Furthermore, the quality of diabetes care did indeed vary by geographical levels. Thru the smaller level, we could point out clustered areas more specifically. Fuguo Village (of Yongkang District) and Zhiyi Village (of Sinhua District) were found to be “hotspots” for nephropathy and cerebrovascular disease; while Wangliau Village and Erwang Village (of Yongkang District) would be “coldspots” for lowest proportion of ≥80% compliance to blood lipids examination. On the other hand, Yuping Village (in Anping District) was the area with the lowest proportion of ≥80% compliance to all laboratory examination. Conclusion: In spite of examining the geographic distribution, calculating rate ratios and their 95% CI could also be a useful and consistent method to test the association. This information is useful for health planners, diabetes case managers and other affiliate practitioners to organize care resources to the areas most needed.

Research of the Load Bearing Capacity of Inserts Embedded in CFRP under Different Loading Conditions

Continuous carbon fiber reinforced plastics (CFRP) exhibit a high application potential for lightweight structures due to their outstanding specific mechanical properties. Embedded metal elements, so-called inserts, can be used to join structural CFRP parts. Drilling of the components to be joined can be avoided using inserts. In consequence, no bearing stress is anticipated. This is a distinctive benefit of embedded inserts, since continuous CFRP have low shear and bearing strength. This paper aims at the investigation of the load bearing capacity after preinduced damages from impact tests and thermal-cycling. In addition, characterization of mechanical properties during dynamic high speed pull-out testing under different loading velocities was conducted. It has been shown that the load bearing capacity increases up to 100% for very high velocities (15 m/s) in comparison with quasi-static loading conditions (1.5 mm/min). Residual strength measurements identified the influence of thermal loading and preinduced mechanical damage. For both, the residual strength was evaluated afterwards by quasi-static pull-out tests. Taking into account the DIN EN 6038 a high decrease of force occurs at impact energy of 16 J with significant damage of the laminate. Lower impact energies of 6 J, 9 J, and 12 J do not decrease the measured residual strength, although the laminate is visibly damaged - distinguished by cracks on the rear side. To evaluate the influence of thermal loading, the specimens were placed in a climate chamber and were exposed to various numbers of temperature cycles. One cycle took 1.5 hours from -40 °C to +80 °C. It could be shown that already 10 temperature cycles decrease the load bearing capacity up to 20%. Further reduction of the residual strength with increasing number of thermal cycles was not observed. Thus, it implies that the maximum damage of the composite is already induced after 10 temperature cycles.

An Ontology Model for Systems Engineering Derived from ISO/IEC/IEEE 15288: 2015: Systems and Software Engineering - System Life Cycle Processes

ISO/IEC/IEEE 15288: 2015, Systems and Software Engineering - System Life Cycle Processes is an international standard that provides generic top-level process descriptions to support systems engineering (SE). However, the processes defined in the standard needs improvement to lift integrity and consistency. The goal of this research is to explore the way by building an ontology model for the SE standard to manage the knowledge of SE. The ontology model gives a whole picture of the SE knowledge domain by building connections between SE concepts. Moreover, it creates a hierarchical classification of the concepts to fulfil different requirements of displaying and analysing SE knowledge.

Promoting Innovation Pedagogy in a Capacity Building Project in Indonesia

This study presents a project that tests and adjusts active European learning and teaching methods in Indonesian universities to increase their external impact on enterprises and other organizations; it also assesses the implementation of the Erasmus+ projects funded by the European Union. The project is based on the approach of innovation pedagogy that responds to regional development needs and integrates applied research and development projects into education to create capabilities for students to participate in development work after graduation. The assessment of the Erasmus+ project resulted in many improvements that can be made to achieve higher quality and innovativeness. The results of this study are useful for those who want to improve the applied research and development projects of higher education institutions.

Sulfur Removal of Hydrocarbon Fuels Using Oxidative Desulfurization Enhanced by Fenton Process

A comprehensive development towards the production of ultra-clean fuels as a feed stoke is getting to raise due to the increasing use of diesel fuels and global air pollution. Production of environmental-friendly fuels can be achievable by some limited single methods and most integrated ones. Oxidative desulfurization (ODS) presents vast ranges of technologies possessing suitable characteristics with regard to the Fenton process. Using toluene as a model fuel feed with dibenzothiophene (DBT) as a sulfur compound under various operating conditions is the attempt of this study. The results showed that this oxidative process followed a pseudo-first order kinetics. Removal efficiency of 77.43% is attained under reaction time of 40 minutes with (Fe+2/H2O2) molar ratio of 0.05 in acidic pH environment. In this research, temperature of 50 °C represented the most influential role in proceeding the reaction.

Effects of Introducing Similarity Measures into Artificial Bee Colony Approach for Optimization of Vehicle Routing Problem

Vehicle Routing Problem (VRP) is a complex combinatorial optimization problem and it is quite difficult to find an optimal solution consisting of a set of routes for vehicles whose total cost is minimum. Evolutionary and swarm intelligent (SI) algorithms play a vital role in solving optimization problems. While the SI algorithms perform search, the diversity between the solutions they exploit is very important. This is because of the need to avoid early convergence and to get an appropriate balance between the exploration and exploitation. Therefore, it is important to check how far the solutions are diverse. In this paper, we measure the similarity between solutions, which ABC exploits while optimizing VRP. The similar solutions found are discarded at the end of the iteration and only unique solutions are passed on to the next iteration. The bees of discarded solutions become scouts and they start searching for new solutions. This process is continued and results show that the solution is optimized at lesser number of iterations but with the overhead of computing similarity in all the iterations. The problem instance from Solomon benchmarked dataset has been used for evaluating the presented methodology.

Gravitational Frequency Shifts for Photons and Particles

The research, in this case, considers the integration of the Quantum Field Theory and the General Relativity Theory. As two successful models in explaining behaviors of particles, they are incompatible since they work at different masses and scales of energy, with the evidence that regards the description of black holes and universe formation. It is so considering previous efforts in merging the two theories, including the likes of the String Theory, Quantum Gravity models, and others. In a bid to prove an actionable experiment, the paper’s approach starts with the derivations of the existing theories at present. It goes on to test the derivations by applying the same initial assumptions, coupled with several deviations. The resulting equations get similar results to those of classical Newton model, quantum mechanics, and general relativity as long as conditions are normal. However, outcomes are different when conditions are extreme, specifically with no breakdowns even for less than Schwarzschild radius, or at Planck length cases. Even so, it proves the possibilities of integrating the two theories.

Spatial and Temporal Variability of Fog Over the Indo-Gangetic Plains, India

The aim of the paper is to analyze the characteristics of winter fog in terms of its trend and spatial-temporal variability over Indo-Gangetic plains. The study reveals that during last four and half decades (1971-2015), an alarming increasing trend in fog frequency has been observed during the winter months of December and January over the study area. The frequency of fog has increased by 118.4% during the peak winter months of December and January. It has also been observed that on an average central part of IGP has 66.29% fog days followed by west IGP with 41.94% fog days. Further, Empirical Orthogonal Function (EOF) decomposition and Mann-Kendall variation analysis are used to analyze the spatial and temporal patterns of winter fog. The findings have significant implications for the further research of fog over IGP and formulate robust strategies to adapt the fog variability and mitigate its effects. The decision by Delhi Government to implement odd-even scheme to restrict the use of private vehicles in order to reduce pollution and improve quality of air may result in increasing the alarming increasing trend of fog over Delhi and its surrounding areas regions of IGP.