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.

The Evaluation of Event Sport Tourism on Regional Economic Development

Event sport tourism (EST) has become an especially important economic sector around the world. As the magnitude continues to grow, attracting more tourists, media, and investment for the host community, and many local areas/regions and states have identified the expenditures by visitors as a potential source of economic or employment growth. The main purposes of this study are to investigate stakeholders’ insights into the feature of hosting EST and using them as a regional development strategy. Continuing the focus of previous literature on the regional development and economic benefits by hosting EST, a total of fıve semi-structured interview questions are designed and a thematic analysis is employed to conduct with eight key sport and tourism decision makers in Atlanta during July to August 2016. Through the depth interviews, the study will contribute to a better understanding of stakeholders’ decision-making, identifying benefits and constraints as well as leveraging the impacts of hosting EST. These findings have provided stakeholders’ perspectives of hosting EST and using them as a reference of regional development in emerging sport tourism markets in the US. Additionally, this study examines key considerations and issues that affect and are critical to reliable understanding of the economic impacts of hosting EST on the regional development, and it will be able to benefit future management authorities (i.e. governments and communities) in their sport tourism development endeavors in defining and hosting successful EST. Furthermore, the insights gained from the qualitative analysis could help other cities/regions analyzing the economic impacts of hosting EST and using it as an instrument of city development strategy.

Quantification of GHGs Emissions from Electricity and Diesel Fuel Consumption in Basalt Mining Industry in Thailand

The mineral and mining industry is necessary for countries to have an adequate and reliable supply of materials to meet their socio-economic development. Despite its importance, the environmental impacts from mineral exploration are hugely significant. This study aimed to investigate and quantify the amount of GHGs emissions emitted from both electricity and diesel vehicle fuel consumption in basalt mining in Thailand. Plant A, located in the northeastern region of Thailand, was selected as a case study. Results indicated that total GHGs emissions from basalt mining and operation (Plant A) were approximately 2,501,086 kgCO2e and 1,997,412 kgCO2e in 2014 and 2015, respectively. The estimated carbon intensity ranged between 1.824 kgCO2e to 2.284 kgCO2e per ton of rock product. Scope 1 (direct emissions) was the dominant driver of its total GHGs compared to scope 2 (indirect emissions). As such, transport related combustion of diesel fuels generated the highest GHGs emission (65%) compared to emissions from purchased electricity (35%). Some of the potential implications for mining entities were also presented.

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.

Intersectional Bullying, LGBT Youth and the Construction of Power

This paper explores the impact of intersectional bullying of lesbian, gay, bisexual, transgender (LGBT) youth from a multi-layered experience perspective within bullying incidents at school. Present inclusionary measures at school may not be designed as a continuous process of finding better methods for responding to diversity, rather remain ‘fixed’ as singular solutions applied universally. This paper argues recognizing education through a lens of inclusion begins to realize most educational systems are poorly equipped to handle diversity.

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.

An Algorithm for Determining the Arrival Behavior of a Secondary User to a Base Station in Cognitive Radio Networks

This paper presents the development of an algorithm that predicts the arrival of a secondary user (SU) to a base station (BS) in a cognitive network based on infrastructure, requesting a Best Effort (BE) or Real Time (RT) type of service with a determined bandwidth (BW) implementing neural networks. The algorithm dynamically uses a neural network construction technique using the geometric pyramid topology and trains a Multilayer Perceptron Neural Networks (MLPNN) based on the historical arrival of an SU to estimate future applications. This will allow efficiently managing the information in the BS, since it precedes the arrival of the SUs in the stage of selection of the best channel in CRN. As a result, the software application determines the probability of arrival at a future time point and calculates the performance metrics to measure the effectiveness of the predictions made.

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.

Effect of Hooked-End Steel Fibres Geometry on Pull-Out Behaviour of Ultra-High Performance Concrete

In this study, a comprehensive approach has been adopted to examine in detail the effect of various hook geometries on bond-slip characteristics. Extensive single fibre pull-out tests on ultra-high performance matrix with three different W/B ratios and embedded lengths have been carried out. Test results showed that the mechanical deformation of fibre hook is the main mechanism governing the pull-out behaviour. Furthermore, the quantitative analyses have been completed to compare the hook design contribution of 3D, 4D and 5D fibres to assess overall pull-out behaviour. It was also revealed that there is a strong relationship between the magnitude of hook contribution and W/B ratio (i.e. matrix strength). Reducing the W/B ratio from 0.20 to 0.11 greatly optimizes the interfacial transition zone (ITZ) and enables better mobilization, straightening of the hook and results in bond-slip-hardening behaviour.

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.

Simulation of Surge Protection for a Direct Current Circuit

In this paper, the performance of a simple surge protection for a direct current circuit was simulated. The protection circuit was developed from modified electric macro models of a gas discharge tube and a transient voltage suppressor diode. Moreover, a combination wave generator circuit was used as source of energy surges. The simulations showed that the circuit presented ensures immunity corresponding with test level IV of the IEC 61000-4-5:2014 international standard. The developed circuit can be modified to meet the requirements of any other equipment to be protected. Similarly, the parameters of the combination wave generator can be changed to provide different surge amplitudes.

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.

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.

Hybrid Rocket Motor Performance Parameters: Theoretical and Experimental Evaluation

A mathematical model to predict the performance parameters (thrusts, chamber pressures, fuel mass flow rates, mixture ratios, and regression rates during firing time) of hybrid rocket motor (HRM) is evaluated. The internal ballistic (IB) hybrid combustion model assumes that the solid fuel surface regression rate is controlled only by heat transfer (convective and radiative) from flame zone to solid fuel burning surface. A laboratory HRM is designed, manufactured, and tested for low thrust profile space missions (10-15 N) and for validating the mathematical model (computer program). The polymer material and gaseous oxidizer which are selected for this experimental work are polymethyle-methacrylate (PMMA) and polyethylene (PE) as solid fuel grain and gaseous oxygen (GO2) as oxidizer. The variation of various operational parameters with time is determined systematically and experimentally in firing of up to 20 seconds, and an average combustion efficiency of 95% of theory is achieved, which was the goal of these experiments. The comparison between recording fire data and predicting analytical parameters shows good agreement with the error that does not exceed 4.5% during all firing time. The current mathematical (computer) code can be used as a powerful tool for HRM analytical design parameters.

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.

Time Temperature Dependence of Long Fiber Reinforced Polypropylene Manufactured by Direct Long Fiber Thermoplastic Process

In order to reduce fuel consumption, the weight of automobiles has to be reduced. Fiber reinforced polymers offer the potential to reach this aim because of their high stiffness to weight ratio. Additionally, the use of fiber reinforced polymers in automotive applications has to allow for an economic large-scale production. In this regard, long fiber reinforced thermoplastics made by direct processing offer both mechanical performance and processability in injection moulding and compression moulding. The work presented in this contribution deals with long glass fiber reinforced polypropylene directly processed in compression moulding (D-LFT). For the use in automotive applications both the temperature and the time dependency of the materials properties have to be investigated to fulfill performance requirements during crash or the demands of service temperatures ranging from -40 °C to 80 °C. To consider both the influence of temperature and time, quasistatic tensile tests have been carried out at different temperatures. These tests have been complemented by high speed tensile tests at different strain rates. As expected, the increase in strain rate results in an increase of the elastic modulus which correlates to an increase of the stiffness with decreasing service temperature. The results are in good accordance with results determined by dynamic mechanical analysis within the range of 0.1 to 100 Hz. The experimental results from different testing methods were grouped and interpreted by using different time temperature shift approaches. In this regard, Williams-Landel-Ferry and Arrhenius approach based on kinetics have been used. As the theoretical shift factor follows an arctan function, an empirical approach was also taken into consideration. It could be shown that this approach describes best the time and temperature superposition for glass fiber reinforced polypropylene manufactured by D-LFT processing.

Investigation on the Bogie Pseudo-Hunting Motion of a Reduced-Scale Model Railway Vehicle Running on Double-Curved Rails

In this paper, an experimental and theoretical study on the bogie pseudo-hunting motion of a reduced-scale model railway vehicle, running on double-curved rails, is presented. Since the actual bogie hunting motion, occurring for real railway vehicles running on straight rails at high travelling speeds, cannot be obtained in laboratory conditions, due to the speed and wavelength limitations, a pseudo- hunting motion was induced by employing double-curved rails. Firstly, the test rig and the experimental procedure are described. Then, a geometrical model of the double-curved rails is presented. Based on such model, the variation of the carriage rotation angle relative to the bogies and the working conditions of the yaw damper are clarified. Vibration spectra recorded during vehicle travelling, on straight and double-curved rails, are presented and interpreted based on a simple vibration model of the railway vehicle. Ride comfort of the vehicle is evaluated according to the ISO 2631 standard, and also by using some particular frequency weightings, which account for the discomfort perceived during the reading and writing activities. Results obtained in this work are useful for the adequate design of the yaw dampers, which are used to attenuate the lateral vibration of the train car bodies.

Frictional Effects on the Dynamics of a Truncated Double-Cone Gravitational Motor

In this work, effects of the friction and truncation on the dynamics of a double-cone gravitational motor, self-propelled on a straight V-shaped horizontal rail, are evaluated. Such mechanism has a variable radius of contact, and, on one hand, it is similar to a pulley mechanism that changes the potential energy into the kinetic energy of rotation, but on the other hand, it is similar to a pendulum mechanism that converts the potential energy of the suspended body into the kinetic energy of translation along a circular path. Movies of the self- propelled double-cones, made of S45C carbon steel and wood, along rails made of aluminum alloy, were shot for various opening angles of the rails. Kinematical features of the double-cones were estimated through the slow-motion processing of the recorded movies. Then, a kinematical model is derived under assumption that the distance traveled by the contact points on the rectilinear rails is identical with the distance traveled by the contact points on the truncated conical surface. Additionally, a dynamic model, for this particular contact problem, was proposed and validated against the experimental results. Based on such model, the traction force and the traction torque acting on the double-cone are identified. One proved that the rolling traction force is always smaller than the sliding friction force; i.e., the double-cone is rolling without slipping. Results obtained in this work can be used to achieve the proper design of such gravitational motor.