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.

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.

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.

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.

Risk of Plastic Shrinkage Cracking in Recycled Aggregate Concrete

The intensive use of natural aggregates, near cities and towns, associated to the increase of the global population, leads to its depletion and increases the transport distances. The uncontrolled deposition of construction and demolition waste in landfills and city outskirts, causes pollution and takes up space. The use of recycled aggregates in concrete preparation would contribute to mitigate the problem. However, it arises the problem that the high water absorption of recycled aggregate decreases the bleeding rate of concrete, and when this gets lower than the evaporation rate, plastic shrinkage cracking occurs. This phenomenon can be particularly problematic in hot and windy curing environments. Cracking facilitates the flow of liquid and gas into concrete which attacks the reinforcement and degrades the concrete. These factors reduce the durability of concrete structures and consequently the lifetime of buildings. A ring test was used, cured in a wind tunnel, to evaluate the plastic shrinkage cracking sensitivity of recycled aggregate concrete, in order to implement preventive means to control this phenomenon. The role of several aggregate properties on the concrete segregation and cracking mechanisms were also discussed.

Landcover Mapping Using Lidar Data and Aerial Image and Soil Fertility Degradation Assessment for Rice Production Area in Quezon, Nueva Ecija, Philippines

Land-cover maps were important for many scientific, ecological and land management purposes and during the last decades, rapid decrease of soil fertility was observed to be due to land use practices such as rice cultivation. High-precision land-cover maps are not yet available in the area which is important in an economy management. To assure   accurate mapping of land cover to provide information, remote sensing is a very suitable tool to carry out this task and automatic land use and cover detection. The study did not only provide high precision land cover maps but it also provides estimates of rice production area that had undergone chemical degradation due to fertility decline. Land-cover were delineated and classified into pre-defined classes to achieve proper detection features. After generation of Land-cover map, of high intensity of rice cultivation, soil fertility degradation assessment in rice production area due to fertility decline was created to assess the impact of soils used in agricultural production. Using Simple spatial analysis functions and ArcGIS, the Land-cover map of Municipality of Quezon in Nueva Ecija, Philippines was overlaid to the fertility decline maps from Land Degradation Assessment Philippines- Bureau of Soils and Water Management (LADA-Philippines-BSWM) to determine the area of rice crops that were most likely where nitrogen, phosphorus, zinc and sulfur deficiencies were induced by high dosage of urea and imbalance N:P fertilization. The result found out that 80.00 % of fallow and 99.81% of rice production area has high soil fertility decline.

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.

Run-Time Customisation of Soft-Core CPUs on Field Programmable Gate Array

The use of customised soft-core processors in which instructions can be integrated into a system in application hardware is increasing in the Field Programmable Gate Array (FPGA) field. Specifically, the partial run-time reconfiguration of FPGAs in specialised processors for a particular domain can be very beneficial. In this report, the design and implementation for the customisation of a soft-core MIPS processor using an FPGA and partial reconfiguration (PR) of FPGA technology will be addressed to achieve efficient resource use. This can be achieved using a PR design flow that helps the design fit into a smaller device. Moreover, the impact of static power consumption could be reduced due to runtime reconfiguration. This will be done by configurable custom instructions implemented in the hardware as an extension on the MIPS CPU. The aim of this project is to investigate the PR of FPGAs for run-time adaptations of the instruction set of a soft-core CPU, including the integration of custom instructions and the exploration of the potential to use the MultiBoot feature available in Xilinx FPGAs to carry out the PR process. The system will be evaluated and tested on a Nexus 3 development board featuring a Xilinx Spartran-6 FPGA. The system will be able to load reconfigurable custom instructions dynamically into user programs with the help of the trap handler when the custom instruction is called by the MIPS CPU. The results of this experiment demonstrate that custom instructions in hardware can speed up a certain function and many instructions can be saved when compared to a software implementation of the same function. Implementing custom instructions in hardware is perfectly possible and worth exploring.

Performance Evaluation of a ‘Priority-Controlled’ Intersection Converted to Signal-Controlled Intersection

There is a call to ensure that the issues of safety and efficient throughput are considered during design; the solutions to these issues can also be retrofitted at locations where they were not captured during design, but have become problems to road users over time. This paper adopts several methods to analyze the performance of an intersection which was formerly a ‘priority-controlled’ intersection, but has now been converted to a ‘signal-controlled’ intersection. Extensive review of literature helped form the basis for result analysis and discussion. The Ikot-Ekpene/Anagha-Ezikpe intersection, located at the heart of Umuahia was adopted as case study; considering the high traffic volume on the route. Anecdotal evidence revealed that traffic signals imposed enormous delays at the intersection, especially for traffic on the major road. The major road has arrival flow which surpasses the saturation flow obtained from modelling of the isolated signalized intersection. Similarly, there were several geometric elements that did not agree with the specific function of the road. A roundabout, particularly flower roundabout was recommended as a better traffic control measure.

Characterisation of Fractions Extracted from Sorghum Byproducts

Sorghum byproducts, namely bran, stalk, and panicle are examples of lignocellulosic biomass. These raw materials contain large amounts of polysaccharides, in particular hemicelluloses, celluloses, and lignins, which if efficiently extracted, can be utilised for the development of a range of added value products with potential applications in agriculture and food packaging sectors. The aim of this study was to characterise fractions extracted from sorghum bran and stalk with regards to their physicochemical properties that could determine their applicability as food-packaging materials. A sequential alkaline extraction was applied for the isolation of cellulosic, hemicellulosic and lignin fractions from sorghum stalk and bran. Lignin content, phenolic content and antioxidant capacity were also investigated in the case of the lignin fraction. Thermal analysis using differential scanning calorimetry (DSC) and X-Ray Diffraction (XRD) revealed that the glass transition temperature (Tg) of cellulose fraction of the stalk was ~78.33 oC at amorphous state (~65%) and water content of ~5%. In terms of hemicellulose, the Tg value of stalk was slightly lower compared to bran at amorphous state (~54%) and had less water content (~2%). It is evident that hemicelluloses generally showed a lower thermal stability compared to cellulose, probably due to their lack of crystallinity. Additionally, bran had higher arabinose-to-xylose ratio (0.82) than the stalk, a fact that indicated its low crystallinity. Furthermore, lignin fraction had Tg value of ~93 oC at amorphous state (~11%). Stalk-derived lignin fraction contained more phenolic compounds (mainly consisting of p-coumaric and ferulic acid) and had higher lignin content and antioxidant capacity compared to bran-derived lignin fraction.

An Intelligent Transportation System for Safety and Integrated Management of Railway Crossings

Railway crossings are complex entities whose optimal management cannot be addressed unless with the help of an intelligent transportation system integrating information both on train and vehicular flows. In this paper, we propose an integrated system named SIMPLE (Railway Safety and Infrastructure for Mobility applied at level crossings) that, while providing unparalleled safety in railway level crossings, collects data on rail and road traffic and provides value-added services to citizens and commuters. Such services include for example alerts, via variable message signs to drivers and suggestions for alternative routes, towards a more sustainable, eco-friendly and efficient urban mobility. To achieve these goals, SIMPLE is organized as a System of Systems (SoS), with a modular architecture whose components range from specially-designed radar sensors for obstacle detection to smart ETSI M2M-compliant camera networks for urban traffic monitoring. Computational unit for performing forecast according to adaptive models of train and vehicular traffic are also included. The proposed system has been tested and validated during an extensive trial held in the mid-sized Italian town of Montecatini, a paradigmatic case where the rail network is inextricably linked with the fabric of the city. Results of the tests are reported and discussed.

Towards Natively Context-Aware Web Services

With the ubiquitous computing’s emergence and the evolution of enterprises’ needs, one of the main challenges is to build context-aware applications based on Web services. These applications have become particularly relevant in the pervasive computing domain. In this paper, we introduce our approach that optimizes the use of Web services with context notions when dealing with contextual environments. We focus particularly on making Web services autonomous and natively context-aware. We implement and evaluate the proposed approach with a pedagogical example of a context-aware Web service treating temperature values. 

Effect of Flour Concentration and Retrogradation Treatment on Physical Properties of Instant Sinlek Brown Rice

Sinlek rice flour beverage or instant product is a dietary supplement for dysphagia, or difficulty swallowing. It is also consumed by individuals who need to consume supplements to maintain their calorific needs. This product provides protein, fat, iron, and a high concentration of carbohydrate from rice flour. However, the application of native flour is limited due to its high viscosity. Starch modification by controlling starch retrogradation was used in this study. The research studies the effects of rice flour concentration and retrogradation treatment on the physical properties of instant Sinlek brown rice. The native rice flour, gelatinized rice flour, and flour gels retrograded under 4 °C for 3 and 7 days were investigated. From the statistical results, significant differences between native and retrograded flour were observed. The concentration of rice flour was the main factor influencing the swelling power, solubility, and pasting properties. With the increase in rice flour content from 10 to 15%, swelling power, peak viscosity, trough, and final viscosity decreased; but, solubility, pasting temperature, peak time, breakdown, and setback increased. The peak time, pasting temperature, peak viscosity, trough, and final viscosity decreased as the storage period increased from 3 to 7 days. The retrograded rice flour powders had lower pasting temperature, peak viscosity, breakdown, and final viscosity than the gelatinized and native flour powders. Reduction of starch viscosity by gelatinization and controlling starch retrogradation could allow for increased quantities of rice flour in instant rice beverages. Also, the treatment could increase the energy and nutrient densities of rice beverages without affecting the viscosity of this product.

A Comparative Analysis of Heuristics Applied to Collecting Used Lubricant Oils Generated in the City of Pereira, Colombia

Currently, in Colombia is arising a problem related to collecting used lubricant oils which are generated by the increment of the vehicle fleet. This situation does not allow a proper disposal of this type of waste, which in turn results in a negative impact on the environment. Therefore, through the comparative analysis of various heuristics, the best solution to the VRP (Vehicle Routing Problem) was selected by comparing costs and times for the collection of used lubricant oils in the city of Pereira, Colombia; since there is no presence of management companies engaged in the direct administration of the collection of this pollutant. To achieve this aim, six proposals of through methods of solution of two phases were discussed. First, the assignment of the group of generator points of the residue was made (previously identified). Proposals one and four of through methods are based on the closeness of points. The proposals two and five are using the scanning method and the proposals three and six are considering the restriction of the capacity of collection vehicle. Subsequently, the routes were developed - in the first three proposals by the Clarke and Wright's savings algorithm and in the following proposals by the Traveling Salesman optimization mathematical model. After applying techniques, a comparative analysis of the results was performed and it was determined which of the proposals presented the most optimal values in terms of the distance, cost and travel time.

Evaluation of the Urban Regeneration Project: Land Use Transformation and SNS Big Data Analysis

Urban regeneration projects have been actively promoted in Korea. In particular, Jeonju Hanok Village is evaluated as one of representative cases in terms of utilizing local cultural heritage sits in the urban regeneration project. However, recently, there has been a growing concern in this area, due to the ‘gentrification’, caused by the excessive commercialization and surging tourists. This trend was changing land and building use and resulted in the loss of identity of the region. In this regard, this study analyzed the land use transformation between 2010 and 2016 to identify the commercialization trend in Jeonju Hanok Village. In addition, it conducted SNS big data analysis on Jeonju Hanok Village from February 14th, 2016 to March 31st, 2016 to identify visitors’ awareness of the village. The study results demonstrate that rapid commercialization was underway, unlikely the initial intention, so that planners and officials in city government should reconsider the project direction and rebuild deliberate management strategies. This study is meaningful in that it analyzed the land use transformation and SNS big data to identify the current situation in urban regeneration area. Furthermore, it is expected that the study results will contribute to the vitalization of regeneration area.

Numerical Analysis of Cold-Formed Steel Shear Wall Panels Subjected to Cyclic Loading

Shear walls made of cold formed steel are used as lateral force resisting components in residential and low-rise commercial and industrial constructions. The seismic design analysis of such structures is often complex due to the slenderness of members and their instability prevalence. In this context, a simplified modeling technique across the panel is proposed by using the finite element method. The approach is based on idealizing the whole panel by a nonlinear shear link element which reflects its shear behavior connected to rigid body elements which transmit the forces to the end elements (studs) that resist the tension and the compression. The numerical model of the shear wall panel was subjected to cyclic loads in order to evaluate the seismic performance of the structure in terms of lateral displacement and energy dissipation capacity. In order to validate this model, the numerical results were compared with those from literature tests. This modeling technique is particularly useful for the design of cold formed steel structures where the shear forces in each panel and the axial forces in the studs can be obtained using spectrum analysis.

Competitive Advantage Effecting Firm Performance: Case Study of Small and Medium Enterprises in Thailand

The objectives of this study are to examine the relationship between the competitive advantage of small and medium enterprises (SMEs) and their overall performance. A mixed method has been applied to identify the effect of determinants toward competitive advantage. The sample is composed of SMEs in product and service businesses. The study has been tested at an organizational level with samples of SME entrepreneurs, business successors, and board of directors or management team. Quantitative analysis has been conducted through multiple regression analysis with 400 samples. The findings illustrate that each aspect of competitive advantage needs a different set of driving factors to explain either the direct or the indirect effect on firm performance. Interestingly, technological capability is a perfect mediator and interorganizational cooperation toward competitive advantage. In addition, differentiation is difficult to be perceived by customers, as well as difficult to manage; however, it is considered important to develop an SMEs product or service for firm sustainably.

Surface and Drinking Water Quality Monitoring of Thomas Reservoir, Kano State, Nigeria

Drinking water is supplied to Danbatta, Makoda and some parts of Minjibir local government areas of Kano State from the surface water of Thomas Reservoir. The present land use in the catchment area of the reservoir indicates high agricultural activities, fishing, as well as domestic and small scale industrial activities. To study and monitor the quality of surface and drinking water of the area, water samples were collected from the reservoir, treated water at the treatment plant and potable water at the consumer end in three seasons November - February (cold season), March - June (dry season) and July - September (rainy season). The samples were analyzed for physical and chemical parameters, pH, temperature, total dissolved solids (TDS), conductivity, turbidity, total hardness, suspended solids, total solids, colour, dissolved oxygen (DO), biological oxygen demand (BOD), chloride ion (Cl-) nitrite (NO2-), nitrate (NO3-), chemical oxygen demand (COD) and phosphate (PO43-). The higher values obtained in some parameters with respect to the acceptable standard set by World Health Organization (WHO) and Nigerian Industrial Standards (NIS) indicate the pollution of both the surface and drinking water. These pollutants were observed to have a negative impact on water quality in terms of eutrophication, largely due to anthropogenic activities in the watershed.

Research of Database Curriculum Construction under the Environment of Massive Open Online Courses

Recently, Massive Open Online Courses (MOOCs) are becoming the new trend of education. There are many problems under the environment of Database Principle curriculum teaching process in MOOCs, such as teaching ideas and theories which are out of touch with the reality, how to carry out the technical teaching and interactive practice in the MOOCs environment, thus the methods of database course under the environment of MOOCs are proposed. There are three processes to deal with problem solving in the research, which are problems proposed, problems solved, and inductive analysis. The present research includes the design of teaching contents, teaching methods in classroom, flipped classroom teaching mode under the environment of MOOCs, learning flow method and large practice homework. The database designing ability is systematically improved based on the researching methods.