Rich media content adaptation in e-learning systems

The wide use of e-technologies represents a great opportunity for underserved segments of the population, especially with the aim of reintegrating excluded individuals back into society through education. This is particularly true for people with different types of disabilities who may have difficulties while attending traditional on-site learning programs that are typically based on printed learning resources. The creation and provision of accessible e-learning contents may therefore become a key factor in enabling people with different access needs to enjoy quality learning experiences and services. Another e-learning challenge is represented by m-learning (which stands for mobile learning), which is emerging as a consequence of mobile terminals diffusion and provides the opportunity to browse didactical materials everywhere, outside places that are traditionally devoted to education. Both such situations share the need to access materials in limited conditions and collide with the growing use of rich media in didactical contents, which are designed to be enjoyed without any restriction. Nowadays, Web-based teaching makes great use of multimedia technologies, ranging from Flash animations to prerecorded video-lectures. Rich media in e-learning can offer significant potential in enhancing the learning environment, through helping to increase access to education, enhance the learning experience and support multiple learning styles. Moreover, they can often be used to improve the structure of Web-based courses. These highly variegated and structured contents may significantly improve the quality and the effectiveness of educational activities for learners. For example, rich media contents allow us to describe complex concepts and process flows. Audio and video elements may be utilized to add a “human touch” to distance-learning courses. Finally, real lectures may be recorded and distributed to integrate or enrich on line materials. A confirmation of the advantages of these approaches can be seen in the exponential growth of video-lecture availability on the net, due to the ease of recording and delivering activities which take place in a traditional classroom. Furthermore, the wide use of assistive technologies for learners with disabilities injects new life into e-learning systems. E-learning allows distance and flexible educational activities, thus helping disabled learners to access resources which would otherwise present significant barriers for them. For instance, students with visual impairments have difficulties in reading traditional visual materials, deaf learners have trouble in following traditional (spoken) lectures, people with motion disabilities have problems in attending on-site programs. As already mentioned, the use of wireless technologies and pervasive computing may really enhance the educational learner experience by offering mobile e-learning services that can be accessed by handheld devices. This new paradigm of educational content distribution maximizes the benefits for learners since it enables users to overcome constraints imposed by the surrounding environment. While certainly helpful for users without disabilities, we believe that the use of newmobile technologies may also become a fundamental tool for impaired learners, since it frees them from sitting in front of a PC. In this way, educational activities can be enjoyed by all the users, without hindrance, thus increasing the social inclusion of non-typical learners. While the provision of fully accessible and portable video-lectures may be extremely useful for students, it is widely recognized that structuring and managing rich media contents for mobile learning services are complex and expensive tasks. Indeed, major difficulties originate from the basic need to provide a textual equivalent for each media resource composing a rich media Learning Object (LO). Moreover, tests need to be carried out to establish whether a given LO is fully accessible to all kinds of learners. Unfortunately, both these tasks are truly time-consuming processes, depending on the type of contents the teacher is writing and on the authoring tool he/she is using. Due to these difficulties, online LOs are often distributed as partially accessible or totally inaccessible content. Bearing this in mind, this thesis aims to discuss the key issues of a system we have developed to deliver accessible, customized or nomadic learning experiences to learners with different access needs and skills. To reduce the risk of excluding users with particular access capabilities, our system exploits Learning Objects (LOs) which are dynamically adapted and transcoded based on the specific needs of non-typical users and on the barriers that they can encounter in the environment. The basic idea is to dynamically adapt contents, by selecting them from a set of media resources packaged in SCORM-compliant LOs and stored in a self-adapting format. The system schedules and orchestrates a set of transcoding processes based on specific learner needs, so as to produce a customized LO that can be fully enjoyed by any (impaired or mobile) student.

Development of Clinical Decision Support Systems based on Mathematical Models of Physiological Systems

In the last years of research, I focused my studies on different physiological problems. Together with my supervisors, I developed/improved different mathematical models in order to create valid tools useful for a better understanding of important clinical issues. The aim of all this work is to develop tools for learning and understanding cardiac and cerebrovascular physiology as well as pathology, generating research questions and developing clinical decision support systems useful for intensive care unit patients. I. ICP-model Designed for Medical Education We developed a comprehensive cerebral blood flow and intracranial pressure model to simulate and study the complex interactions in cerebrovascular dynamics caused by multiple simultaneous alterations, including normal and abnormal functional states of auto-regulation of the brain. Individual published equations (derived from prior animal and human studies) were implemented into a comprehensive simulation program. Included in the normal physiological modelling was: intracranial pressure, cerebral blood flow, blood pressure, and carbon dioxide (CO2) partial pressure. We also added external and pathological perturbations, such as head up position and intracranial haemorrhage. The model performed clinically realistically given inputs of published traumatized patients, and cases encountered by clinicians. The pulsatile nature of the output graphics was easy for clinicians to interpret. The manoeuvres simulated include changes of basic physiological inputs (e.g. blood pressure, central venous pressure, CO2 tension, head up position, and respiratory effects on vascular pressures) as well as pathological inputs (e.g. acute intracranial bleeding, and obstruction of cerebrospinal outflow). Based on the results, we believe the model would be useful to teach complex relationships of brain haemodynamics and study clinical research questions such as the optimal head-up position, the effects of intracranial haemorrhage on cerebral haemodynamics, as well as the best CO2 concentration to reach the optimal compromise between intracranial pressure and perfusion. We believe this model would be useful for both beginners and advanced learners. It could be used by practicing clinicians to model individual patients (entering the effects of needed clinical manipulations, and then running the model to test for optimal combinations of therapeutic manoeuvres). II. A Heterogeneous Cerebrovascular Mathematical Model Cerebrovascular pathologies are extremely complex, due to the multitude of factors acting simultaneously on cerebral haemodynamics. In this work, the mathematical model of cerebral haemodynamics and intracranial pressure dynamics, described in the point I, is extended to account for heterogeneity in cerebral blood flow. The model includes the Circle of Willis, six regional districts independently regulated by autoregulation and CO2 reactivity, distal cortical anastomoses, venous circulation, the cerebrospinal fluid circulation, and the intracranial pressure-volume relationship. Results agree with data in the literature and highlight the existence of a monotonic relationship between transient hyperemic response and the autoregulation gain. During unilateral internal carotid artery stenosis, local blood flow regulation is progressively lost in the ipsilateral territory with the presence of a steal phenomenon, while the anterior communicating artery plays the major role to redistribute the available blood flow. Conversely, distal collateral circulation plays a major role during unilateral occlusion of the middle cerebral artery. In conclusion, the model is able to reproduce several different pathological conditions characterized by heterogeneity in cerebrovascular haemodynamics and can not only explain generalized results in terms of physiological mechanisms involved, but also, by individualizing parameters, may represent a valuable tool to help with difficult clinical decisions. III. Effect of Cushing Response on Systemic Arterial Pressure. During cerebral hypoxic conditions, the sympathetic system causes an increase in arterial pressure (Cushing response), creating a link between the cerebral and the systemic circulation. This work investigates the complex relationships among cerebrovascular dynamics, intracranial pressure, Cushing response, and short-term systemic regulation, during plateau waves, by means of an original mathematical model. The model incorporates the pulsating heart, the pulmonary circulation and the systemic circulation, with an accurate description of the cerebral circulation and the intracranial pressure dynamics (same model as in the first paragraph). Various regulatory mechanisms are included: cerebral autoregulation, local blood flow control by oxygen (O2) and/or CO2 changes, sympathetic and vagal regulation of cardiovascular parameters by several reflex mechanisms (chemoreceptors, lung-stretch receptors, baroreceptors). The Cushing response has been described assuming a dramatic increase in sympathetic activity to vessels during a fall in brain O2 delivery. With this assumption, the model is able to simulate the cardiovascular effects experimentally observed when intracranial pressure is artificially elevated and maintained at constant level (arterial pressure increase and bradicardia). According to the model, these effects arise from the interaction between the Cushing response and the baroreflex response (secondary to arterial pressure increase). Then, patients with severe head injury have been simulated by reducing intracranial compliance and cerebrospinal fluid reabsorption. With these changes, oscillations with plateau waves developed. In these conditions, model results indicate that the Cushing response may have both positive effects, reducing the duration of the plateau phase via an increase in cerebral perfusion pressure, and negative effects, increasing the intracranial pressure plateau level, with a risk of greater compression of the cerebral vessels. This model may be of value to assist clinicians in finding the balance between clinical benefits of the Cushing response and its shortcomings. IV. Comprehensive Cardiopulmonary Simulation Model for the Analysis of Hypercapnic Respiratory Failure We developed a new comprehensive cardiopulmonary model that takes into account the mutual interactions between the cardiovascular and the respiratory systems along with their short-term regulatory mechanisms. The model includes the heart, systemic and pulmonary circulations, lung mechanics, gas exchange and transport equations, and cardio-ventilatory control. Results show good agreement with published patient data in case of normoxic and hyperoxic hypercapnia simulations. In particular, simulations predict a moderate increase in mean systemic arterial pressure and heart rate, with almost no change in cardiac output, paralleled by a relevant increase in minute ventilation, tidal volume and respiratory rate. The model can represent a valid tool for clinical practice and medical research, providing an alternative way to experience-based clinical decisions. In conclusion, models are not only capable of summarizing current knowledge, but also identifying missing knowledge. In the former case they can serve as training aids for teaching the operation of complex systems, especially if the model can be used to demonstrate the outcome of experiments. In the latter case they generate experiments to be performed to gather the missing data.

A mixed methods inquiry into the political economy of agriculture and rural areas in Lebanon

The present work, then, is concerned with the forgotten elements of the Lebanese economy, agriculture and rural development. It investigates the main problematic which arose from these forgotten components, in particular the structure of the agricultural sector, production technology, income distribution, poverty, food security, territorial development and local livelihood strategies. It will do so using quantitative Computable General Equilibrium (CGE) modeling and a qualitative phenomenological case study analysis, both embedded in a critical review of the historical development of the political economy of Lebanon, and a structural analysis of its economy. The research shows that under-development in Lebanese rural areas is not due to lack of resources, but rather is the consequence of political choices. It further suggests that agriculture – in both its mainstream conventional and its innovative locally initiated forms of production – still represents important potential for inducing economic growth and development. In order to do so, Lebanon has to take full advantage of its human and territorial capital, by developing a rural development strategy based on two parallel sets of actions: one directed toward the support of local rural development initiatives, and the other directed toward intensive form of production. In addition to its economic returns, such a strategy would promote social and political stability.

Per un'indagine comparata della relazione voce-movimento nel performer

The present study investigates the principles that effect the relationship between voice and movement in performance. The topic stresses a contemporary tendency, which emerges from the work of numerous artits and looks into a research field that has not yet been well explored. The research arises from what I observed and experienced during my performance practical work and what I deepened after theorical studies: expression through movement and voice reflects constant principles. The first two chapters of the former study analyze the compared lines of the inquiry, from a theoretical point of view (interior and exterior voice-movement spatial patterns, and temporal patterns) and a practical point of view referring to body, action and relation. The third one is a survey on 'vocal gesture' as devised by Francesca della Monica, a topic that finds here the first academic investigation, built after nine years sudies with the artist on the oral sources of her teaching. The research is based on practical and theorical sources (especially philosophical studies of Giovanni Piana, Carlo Serra, Merleau-Ponty; performing studies of Grotowski, Laban, Dalcroze, Tomatis; ancient greek philosophy and literature; bodywork tecqniques as Kineseology, Body-mind centering, Alexander, Feldenkrais). The purpose of the study is to theorize, sistematyze and expose clear lines of compared investigation awakening the performer's interest on a central issue of his work and drawing the researcher's attention to make further focusing on the matter. Abstract (Italian) La ricerca va incontro a una tendenza che la contemporaneità pone in risalto con l'opera di numerosi artisti, investigando un campo ancora poco visitato a livello critico. Essa teorizza, sistematizza ed espone le costanti riscontrate nella relazione tra voce e movimento. L'indagine deriva dal presupposto, a me suggerito dalla pratica e dallo scambio con maestri e performer, e qui approfondito e restituito a livello teorico, che nella danza e nel canto, nell'espressione attraverso il movimento o attraverso la voce, si riflettono gli stessi principi. La tesi è articolata in tre capitoli: i primi due sviluppano le linee di indagine comparata, prima da un punto di vista filosofico e poi da un punto di vista pratico, il terzo porta alla luce il concetto di gesto-vocale come inteso da Francesca della Monica, di cui questo studio rappresenta il primo contributo scientifico, aprendo una ricerca nuova agli studi di settore. Il primo capitolo, 'Risonanze', sviluppa le premesse filosofiche della questione, introduce il corpo come veicolo di voce e movimento, affronta il tema del movimento della voce nello spazio interno del corpo e nello spazio di relazione. Legge poi il movimento in termini temporali, secondo i concetti di istante, ritmo, forma e flusso. Il secondo capitolo, 'Costanti', espone le costanti concrete della relazione voce-movimento in riferimento allo spazio interno del corpo, all'azione, allo spazio esterno di relazione. Il terzo capitolo, 'Confini', analizza il gesto vocale, come inteso da Francesca della Monica, concetto sintesi dell'intera ricerca poiché integra, nella sua essenza, il movimento fisico e vocale, restituendo e approfondendo lo spettro di riflessioni emerse nei primi due capitoli. Il gesto vocale, nella sua accezione espressiva, così come il lavoro di Francesca della Monica, è ancora estraneo agli studi di settore e trova in questo studio un primo contributo accademico. Le fonti sono quelle dell'insegnamento orale di Francesca della Monica, che ho seguito per nove anni, fino a desumerne una mia personale sistematizzazione, integrata con altri punti di vista critici. Analizzo i diversi livelli di profondità del gesto vocale scandendo il tema secondo la categoria della relazione: relazioni motorie, relazioni materiche, relazioni spaziali, temporali, compositive e sinestesiche. Le fonti della ricerca sono scaturite da due sorgenti, quella sul campo, e quella della teoria, confluite qui in un unico flusso. Le fonti 'in presa diretta' sono state avvalorate e confrontate con le fonti relative agli studi di settore (in particolare per la filosofia Giovanni Piana, Carlo Serra, Merleau-Ponty, per il teatro, il canto e la danza Grotowski, Laban, Dalcroze, Tomatis) e le bodywork techniques (Kinesiologia, Body-mind centering, metodo Alexander, metodo Feldenkrais). Ampio spazio viene dato alla grecità antica, che propone sull'espressione di voce e movimento un pensiero integrato carico di speculazioni che racchiudono in nuce i principi sviluppati. Lo studio tenta di offrire un livello di lettura idoneo a suscitare l'interesse del performer, e a valere come momento di indagine per lo studioso, che possa da queste basi operare approfondimenti sulle connessioni proposte. L'obiettivo è restituire la conoscenza, intuita in virtù della pratica, elaborata ed arricchita grazie alla teoria, su un nodo fondamentale per gli studi teatrali e recente oggetto di attenzione da parte di critici e artisti.

Determinants of cesarean delivery, a population-based study in the Emilia Romagna Region

Cesarean Delivery (CD) rates are rising in many parts of the world. In order to define strategies to reduce them, it is important to explore the role of clinical and organizational factors. This thesis has the objective to describe the contemporary CD practice and study clinical and organizational variables as determinants of CD in all women who gave birth between 2005 and June 2010 in the Emilia Romagna region (Italy). All hospital discharge abstracts of women who delivered between 2005 and mid 2010 in the region were selected and linked with birth certificates. In addition to descriptive statistics, in order to study the role of clinical and organizational variables (teaching or non-teaching hospital, birth volumes, time and day of delivery) multilevel Poisson regression models and a classification tree were used. A substantial inter-hospital variability in CD rate was found, and this was only partially explained by the considered variables. The most important risk factors of CD were: previous CD (RR 4,95; 95%CI: 4,85-5,05), cord prolapse (RR 3,51; 95% CI:2,96-4,16), and malposition/malpresentation (RR 2,72; 95%CI: 2,66-2,77). Delivery between 7 pm and 7 am and during non working days protect against CD in all subgroups including those with a small number of elective CDs while delivery at a teaching hospital and birth volumes were not statistically significant risk factors. The classification tree shows that previous CD and malposition/malpresentation are the most important variables discriminating between high and low risk of CD. These results indicate that other not considered factors might explain CD variability and do not provide clear evidence that small hospitals have a poor performance in terms of CD rate. Some strategies to reduce CD could be found by focusing on the differences in delivery practice between day and night and between working and no-working day deliveries.

Credit-Default-Swaps and the 2008 Financial Crisis: An Inquiry into the Underlying Legal Origins and the European Union’s Regulatory Reforms

After the 2008 financial crisis, the financial innovation product Credit-Default-Swap (CDS) was widely blamed as the main cause of this crisis. CDS is one type of over-the-counter (OTC) traded derivatives. Before the crisis, the trading of CDS was very popular among the financial institutions. But meanwhile, excessive speculative CDSs transactions in a legal environment of scant regulation accumulated huge risks in the financial system. This dissertation is divided into three parts. In Part I, we discussed the primers of the CDSs and its market development, then we analyzed in detail the roles CDSs had played in this crisis based on economic studies. It is advanced that CDSs not just promoted the eruption of the crisis in 2007 but also exacerbated it in 2008. In part II, we asked ourselves what are the legal origins of this crisis in relation with CDSs, as we believe that financial instruments could only function, positive or negative, under certain legal institutional environment. After an in-depth inquiry, we observed that at least three traditional legal doctrines were eroded or circumvented by OTC derivatives. It is argued that the malfunction of these doctrines, on the one hand, facilitated the proliferation of speculative CDSs transactions; on the other hand, eroded the original risk-control legal mechanism. Therefore, the 2008 crisis could escalate rapidly into a global financial tsunami, which was out of control of the regulators. In Part III, we focused on the European Union’s regulatory reform towards the OTC derivatives market. In specific, EU introduced mandatory central counterparty clearing obligation for qualified OTC derivatives, and requires that all OTC derivatives shall be reported to a trade repository. It is observable that EU’s approach in re-regulating the derivatives market is different with the traditional administrative regulation, but aiming at constructing a new market infrastructure for OTC derivatives.