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.

Spatial Distribution of Socio-Economic Factors in Kogi State, Nigeria: Development Issues and Implication(s)

This study analyzed the spatial distribution of socio-economic factors in Kogi state with a view to examining its implications on the development of the state. Consequently, questionnaires were administered on both the selected individual respondents (784) in the state and on the administrative offices (local council offices, 21) to solicit relevant information on the spatial distribution of socio-economic factors in their areas. The collected data were tabulated and analyzed using percentages. The study revealed commerce/trade, education, and health care, etc. as the major socio-economic factors in the state but with marked variation/imbalance in their spatial distribution across the study area. The rural-based local government areas have far less of such important facilities. Conclusively, it was recommended that there is need for socio-economic transformation of living conditions of people in the study area especially by positively redistributing local political power and the resources that are abound in the state will be felt by everybody including the commoners.

Forensic Science in Dr. Jekyll and Mr. Hyde: Trails of Utterson's Quest

This paper focuses on investigating The Strange Case of Dr Jekyll and Mr Hyde from Utterson’s point of view, referring to: Gabriel John Utterson, a central character in the book. Utterson is no different from a forensic investigator, as he tries to collect evidence on the mysterious Mr. Hyde’s relationship to Dr. Jekyll. From Utterson's perspective, Jekyll is the 'victim' of a potential scandal and blackmail, and Hyde is the 'suspect' of a possible 'crime'. Utterson intends to figure out Hyde's identity, connect his motive with his actions, and gather witness accounts. During Utterson’s quest, the outside materials available to him along with the social backgrounds of Hyde and Jekyll will be analyzed. The archives left from Jekyll’s chamber will also play a part providing evidence. Utterson will investigate, based on what he already knows about Jekyll his whole life, and how Jekyll had acted in his eyes until he was gone, and finding out possible explanations for Jekyll's actions. The relationship between Jekyll and Hyde becomes the major question, as the social background offers clues pointing in the direction of illegitimacy and prostitution. There is still a possibility that Jekyll and Hyde were, in fact, completely different people. Utterson received a full statement and confession from Jekyll himself at the end of the story, which gives the reader the possible truth on what happened. Stevenson’s Dr. Jekyll and Mr. Hyde led readers, as it did Utterson, to find the connection between Hyde and Jekyll using methods of history, culture, and science. Utterson's quest to uncover Hyde shows an example of applying the various fields to in his act to see if Hyde's inheritance was legal. All of this taken together could technically be considered forensic investigation.

Reliable Line-of-Sight and Non-Line-of-Sight Propagation Channel Identification in Ultra-Wideband Wireless Networks

The paper addresses the problem of line-of-sight (LOS) vs. non-line-of-sight (NLOS) propagation link identification in ultra-wideband (UWB) wireless networks, which is necessary for improving the accuracy of radiolocation and positioning applications. A LOS/NLOS likelihood hypothesis testing approach is applied based on exploiting distinctive statistical features of the channel impulse response (CIR) using parameters related to the “skewness” of the CIR and its root mean square (RMS) delay spread. A log-normal fit is presented for the probability densities of the CIR parameters. Simulation results show that different environments (residential, office, outdoor, etc.) have measurable differences in their CIR parameters’ statistics, which is then exploited in determining the nature of the propagation channels. Correct LOS/NLOS channel identification rates exceeding 90% are shown to be achievable for most types of environments. Additional improvement is also obtained by combining both CIR skewness and RMS delay statistics.

Microstructural and Electrochemical Investigation of Carbon Coated Nanograined LiFePO4 as Cathode Material for Li-Batteries

Lithium iron phosphate (LiFePO4) is a potential cathode material for lithium-ion batteries due to its promising characteristics. In this study, pure LiFePO4 (LFP) and carbon-coated nanograined LiFePO4 (LFP-C) is synthesized and characterized for its microstructural properties. X-ray diffraction patterns of the synthesized samples can be indexed to an orthorhombic LFP structure with about 63 nm crystallite size as calculated by using Scherrer’s equation. Agglomerated particles that range from 200 nm to 300 nm are observed from scanning electron microscopy images. Transmission electron microscopy images confirm the crystalline structure of LFP and coating of amorphous carbon layer. Elemental mapping using energy dispersive spectroscopy analysis revealed the homogeneous dispersion of the compositional elements. In addition, galvanostatic charge and discharge measurements were investigated for the cathode performance of the synthesized LFP and LFP-C samples. The results showed that the carbon-coated sample demonstrated the highest capacity of about 140 mAhg-1 as compared to non-coated and micrograined sized commercial LFP.

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.

Evaluating Factors Influencing Information Quality in Large Firms

Information quality is a major performance measure for an Enterprise Resource Planning (ERP) system of any firm. This study identifies various critical success factors of information quality. The effect of various critical success factors like project management, reengineering efforts and interdepartmental communications on information quality is analyzed using a multiple regression model. Here quantitative data are collected from respondents from various firms through structured questionnaire for assessment of the information quality, project management, reengineering efforts and interdepartmental communications. The validity and reliability of the data are ensured using techniques like factor analysis, computing of Cronbach’s alpha. This study gives relative importance of each of the critical success factors. The findings suggest that among the various factors influencing information quality careful reengineering efforts are the most influencing factor. This paper gives clear insight to managers and practitioners regarding the relative importance of critical success factors influencing information quality so that they can formulate a strategy at the beginning of ERP system implementation.

Granger Causal Nexus between Financial Development and Energy Consumption: Evidence from Cross Country Panel Data

This paper examines the Granger causal nexus between financial development and energy consumption in the group of 35 Financial Action Task Force (FATF) Countries over the period 1988-2012. The study uses two financial development indicators such as private sector credit and stock market capitalization and seven energy consumption indicators such as coal, oil, gas, electricity, hydro-electrical, nuclear and biomass. Using panel cointegration tests, the study finds that financial development and energy consumption are cointegrated, indicating the presence of a long-run relationship between the two. Using a panel vector error correction model (VECM), the study detects both bidirectional and unidirectional causality between financial development and energy consumption. The variation of this causality is due to the use of different proxies for both financial development and energy consumption. The policy implication of this study is that economic policies should recognize the differences in the financial development-energy consumption nexus in order to maintain sustainable development in the selected 35 FATF countries.

Paddy/Rice Singulation for Determination of Husking Efficiency and Damage Using Machine Vision

In this study a system of machine vision and singulation was developed to separate paddy from rice and determine paddy husking and rice breakage percentages. The machine vision system consists of three main components including an imaging chamber, a digital camera, a computer equipped with image processing software. The singulation device consists of a kernel holding surface, a motor with vacuum fan, and a dimmer. For separation of paddy from rice (in the image), it was necessary to set a threshold. Therefore, some images of paddy and rice were sampled and the RGB values of the images were extracted using MATLAB software. Then mean and standard deviation of the data were determined. An Image processing algorithm was developed using MATLAB to determine paddy/rice separation and rice breakage and paddy husking percentages, using blue to red ratio. Tests showed that, a threshold of 0.75 is suitable for separating paddy from rice kernels. Results from the evaluation of the image processing algorithm showed that the accuracies obtained with the algorithm were 98.36% and 91.81% for paddy husking and rice breakage percentage, respectively. Analysis also showed that a suction of 45 mmHg to 50 mmHg yielding 81.3% separation efficiency is appropriate for operation of the kernel singulation system.

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.

Investigation about Structural and Optical Properties of Bulk and Thin Film of 1H-CaAlSi by Density Functional Method

Optical properties of bulk and thin film of 1H-CaAlSi for two directions (1,0,0) and (0,0,1) were studied. The calculations are carried out by Density Functional Theory (DFT) method using full potential. GGA approximation was used to calculate exchange-correlation energy. The calculations are performed by WIEN2k package. The results showed that the absorption edge is shifted backward 0.82eV in the thin film than the bulk for both directions. The static values of the real part of dielectric function for four cases were obtained. The static values of the refractive index for four cases are calculated too. The reflectivity graphs have shown an intensive difference between the reflectivity of the thin film and the bulk in the ultraviolet region.

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.

Effects of Intake Temperature and Intake Pressure on Combustion and Exhaust Emissions of HCCI Engine

In this paper, the effect of the intake temperature (IT) and intake pressure (IP) on ignition timing and pollutants emission of Homogeneous Charge Compression Ignition (HCCI) engine is investigated. Numerical computations are performed using the CHEMKIN computer code. The numerical temperature obtained using different boundary conditions is compared to published data and a good agreement is assigned. Results show that the HCCI combustion engine is significantly improved by increasing the IT. With a value of IT lower than 390 K, combustion cannot occur. However, with an IT greater than 420 K, the cylinder pressure decreases. An optimum crank rotation angle is achieved by using IT of 420 K. So, we can conclude that the variation of the IT and IP influence notably the emission concentration.

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.

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.

A Sentence-to-Sentence Relation Network for Recognizing Textual Entailment

Over the past decade, there have been promising developments in Natural Language Processing (NLP) with several investigations of approaches focusing on Recognizing Textual Entailment (RTE). These models include models based on lexical similarities, models based on formal reasoning, and most recently deep neural models. In this paper, we present a sentence encoding model that exploits the sentence-to-sentence relation information for RTE. In terms of sentence modeling, Convolutional neural network (CNN) and recurrent neural networks (RNNs) adopt different approaches. RNNs are known to be well suited for sequence modeling, whilst CNN is suited for the extraction of n-gram features through the filters and can learn ranges of relations via the pooling mechanism. We combine the strength of RNN and CNN as stated above to present a unified model for the RTE task. Our model basically combines relation vectors computed from the phrasal representation of each sentence and final encoded sentence representations. Firstly, we pass each sentence through a convolutional layer to extract a sequence of higher-level phrase representation for each sentence from which the first relation vector is computed. Secondly, the phrasal representation of each sentence from the convolutional layer is fed into a Bidirectional Long Short Term Memory (Bi-LSTM) to obtain the final sentence representations from which a second relation vector is computed. The relations vectors are combined and then used in then used in the same fashion as attention mechanism over the Bi-LSTM outputs to yield the final sentence representations for the classification. Experiment on the Stanford Natural Language Inference (SNLI) corpus suggests that this is a promising technique for RTE.

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.

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.