Medication regimen complexity in institutionalized elderly people in an aging society

Background: Complex medication regimens may adversely affect compliance and treatment outcomes. Complexity can be assessed with the medication regimen complexity index (MRCI), which has proved to be a valid, reliable tool, with potential uses in both practice and research. Objective: To use the MRCI to assess medication regimen complexity in institutionalized elderly people. Setting: Five nursing homes in mainland Portugal. Methods: A descriptive, cross-sectional study of institutionalized elderly people (n = 415) was performed from March to June 2009, including all inpatients aged 65 and over taking at least one medication per day. Main outcome measure: Medication regimen complexity index. Results: The mean age of the sample was 83.9 years (±6.6 years), and 60.2 % were women. The elderly patients were taking a large number of drugs, with 76.6 % taking more than five medications per day. The average medication regimen complexity was 18.2 (±SD = 9.6), and was higher in the females (p < 0.001). The most decisive factors contributing to the complexity were the number of drugs and dosage frequency. In regimens with the same number of medications, schedule was the most relevant factor in the final score (r = 0.922), followed by pharmaceutical forms (r = 0.768) and additional instructions (r = 0.742). Conclusion: Medication regimen complexity proved to be high. There is certainly potential for the pharmacist's intervention to reduce it as part as the medication review routine in all the patients.

LSP communication in a digital age: the outcomes of teaching and learning in tertiary education

This paper discusses the changes brought by the communication revolution in teaching and learning in the scope of LSP. Its aim is to provide an insight on how teaching which was bi-dimensional, turned into a multidimensional system, gathering other complementary resources that have transformed, in a incredibly short time, the ways we receive share and store information, for instance as professionals, and keep in touch with our peers. The increasing rise of electronic publications, the incredible boom of social and professional networks, search engines, blogs, list servs, forums, e-mail blasts, Facebook pages, YouTube contents, Tweets and Apps, have twisted the way information is conveyed. Classes ceased to be predictable and have been empowered by digital platforms, innumerous and different data repositories (TILDE, IATE, LINGUEE, and so many other terminological data banks) that have definitely transformed the academic world in general and tertiary education in particular. There is a bulk of information to be digested by students, who are no longer passive but instead responsible and active for their academic outcomes. The question is whether they possess the tools to select only what is accurate and important for a certain subject or assignment, due to that overflow? Due to the reduction of the number of course years in most degrees, after the implementation of Bologna and the shrinking of the curricula contents, have students the possibility of developing critical thinking? Both teaching and learning rely on digital resources to improve the speed of the spreading of knowledge. But have those changes been effective to promote really communication? Furthermore, with the increasing Apps that have already been developed and will continue to appear for learning foreign languages, for translation among others, will the students feel the need of learning them once they have those Apps. These are some the questions we would like to discuss in our paper.

‘Thy love afar is spite at home' Emerson, Thoreau and Carey: an alternative perspective of communication in US

The conquest of the West by the stagecoaches and then by railway, Ford and the automobile civilization, the Moon landing by Apollo 11, Microsoft, Apple, CNN, Google and Facebook have appeared to us as celebratory examples of the willingness and ability of the US to overcome the distance and the absence through so-called modern progress of transportation and communication. Undoubtedly, the imaginary and the instrumental power associated to transports and communication of the last century and a half are identified with the mental images that the world has of the US. A world that has eagerly imported and copy their technology and technological culture. Beyond the illusions, this attempting, which has always been praised to transcende space and eclipse the time to get to places and peole increasingly distant and fast, has always a dark side: the political control of population, commercial advertising, the spread of the rumors, noise and gossip. However, since at least the nineteenth century, the political project incorporated in modern transportation and communication technologies was not shared by some of the most remarkable thinkers in the US not only in that century, but also in the 20th century. This paper begins by rescue Ralph W. Emerson and Henry D. Thoreau legacy regarding to communication. Emerson conceived communication as a give-and-take with no coordination between the two, and does not involve contact with the other. Thoreau, in turn, argued that modern trasnportation and communications inventions are but pretty toys which distract attention from serious things, nothing more than 'improved means to an end that is not perfected.' Secondly, we show that this skeptical view of the techological improvement of transport and communication was proceed in an original way with James W. Carey, a media studies thinker who became known for his criticism of the transmission view of communication.

Group-to-group bidirectional Wi-Fi direct communication with two relay nodes

The current capabilities of mobile phones in terms of communication, processing and storage, enables its use to form autonomous networks of devices that can be used in case of collapse or inexistent support from a communication infrastructure. In this paper, we propose a network configuration of nodes that provides high-speed bidirectional device-to-device communication, with symmetrical data transfer rates, in Wi-Fi Direct multi-group scenarios, without using performance hindering broadcasts. Copyright © 2015 ICST.

Petri net model decomposition - a model based approach supporting distributed execution

Dissertação apresentada para obtenção do Grau de Doutor em Engenharia Electrotécnica, Especialidade de Sistemas Digitais, pela Universidade Nova de Lisboa, Faculdade de Ciências e Tecnologia

Server to Mobile Device Communication: A Case Study

Develop a client-server application for a mobile environment can bring many challenges because of the mobile devices limitations. So, in this paper is discussed what can be the more reliable way to exchange information between a server and an Android mobile application, since it is important for users to have an application that really works in a responsive way and preferably without any errors. In this discussion two data transfer protocols (Socket and HTTP) and three serialization data formats (XML, JSON and Protocol Buffers) were tested using some metrics to evaluate which is the most practical and fast to use.

Communication and choice in yeast mating

Dissertação apresentada para obtenção do grau de doutor em Biologia de Sistemas pelo Instituto de Tecnologia Química e Biológica da Universidade Nova de Lisboa.

Smart Grid Communication Technologies in the Brazilian Electrical Sector

Intelligent electrical grids can be considered as the next generation of electrical energy transportation. The enormous potential leads to worldwide focus of research on the technology of smart grids. This paper aims to present a review of the Brazilian electricity sector in context with the integration of communication technologies for smart grids. The work gives an overview of the generation, transmission and distribution of electrical energy in the Brazil and a brief summary of the current electricity market. Smart grid technologies are introduced and the requirements for the Brazilian power system are pointed out. Various technologies for communication within an intelligent network are presented and their characteristics, advantages and disadvantages are compared to the Brazilian conditions. In addition, a summary is given of current pilot projects for Smart Grid technologies within Brazil, as well as a presentation of individual selected projects.

A Communication and Resources Management Scheme to Support the Smart Grid Integration of Multiplayers Access to Resources Information

The increasing and intensive integration of distributed energy resources into distribution systems requires adequate methodologies to ensure a secure operation according to the smart grid paradigm. In this context, SCADA (Supervisory Control and Data Acquisition) systems are an essential infrastructure. This paper presents a conceptual design of a communication and resources management scheme based on an intelligent SCADA with a decentralized, flexible, and intelligent approach, adaptive to the context (context awareness). The methodology is used to support the energy resource management considering all the involved costs, power flows, and electricity prices leading to the network reconfiguration. The methodology also addresses the definition of the information access permissions of each player to each resource. The paper includes a 33-bus network used in a case study that considers an intensive use of distributed energy resources in five distinct implemented operation contexts.

Simulador de sistema de informação ao público para rede de transportes metro-ferroviária

O aumento da complexidade e das funcionalidades a fornecer pelos equipamentos de apoio à exploração de sistemas de redes de transporte criou um novo paradigma no qual vários intervenientes são chamados a fornecer módulos. Estes devem comunicar entre si de forma transparente, não devendo haver limitações colocadas pela tecnologia utilizada ou pelo facto de serem de fabricantes distintos. Este projeto de dissertação resulta de uma proposta da empresa EFACEC para a construção de um Simulador de um Sistema de Informação ao Público numa rede de transportes metro-ferroviária, que utilize como interface para comunicação com a plataforma de gestão EFARail a tecnologia de Web Services. Nesta dissertação faz-se um levantamento dos principais equipamentos utilizados em Sistemas de Informação ao Público e das funcionalidades disponibilizadas, assim como dastecnologias de Web Services que permitem responder aos requisitos e funcionalidades gerais do sistema. A aplicação desenvolvida permite a simulação duma rede de equipamentos visuais e sonoros de informação ao público que compõem uma linha metro-ferroviária. Desta forma é possível testar novos módulos sem necessidade de uma integração em ambiente real. Com isto pretende-se otimizar o processo de desenvolvimento, diminuindo os custos associados ao teste dos sub-sistemas que compõem a solução.

CDIO and the European Project Semester: a match for capstone projects?

The CDIO Initiative is an open innovative educational framework for engineering graduation degrees set in the context of Conceiving – Designing – Implementing – Operating real-world systems and products, which is embraced by a network of worldwide universities, the CDIO collaborators. A CDIO compliant engineering degree programme typically includes a capstone module on the final semester. Its purpose is to expose students to problems of a greater dimension and complexity than those faced throughout the degree programme as well as to put them in contact with the so-called real world, in opposition to the academic world. However, even in the CDIO context, there are barriers that separate engineering capstone students from the real world context of an engineering professional: (i) limited interaction with experts from diverse scientific areas; (ii) reduced cultural and scientific diversity within the teams; and (iii) lack of a project supportive framework to foster the complementary technical and non-technical skills required in an engineering professional. To address these shortcomings, we propose the adoption of the European Project Semester (EPS) framework, a one semester student centred international capstone programme offered by a group of European engineering schools (the EPS Providers) as part of their student exchange programme portfolio. The EPS package is organised around a central module – the EPS project – and a set of complementary supportive modules. Project proposals refer to open multidisciplinary real world problems and supervision becomes coaching. The students are organised in teams, grouping individuals from diverse academic backgrounds and nationalities, and each team is fully responsible for conducting its project. EPS complies with the CDIO directives on Design-Implement experiences and provides an integrated framework for undertaking capstone projects, which is focussed on multicultural and multidisciplinary teamwork, problem-solving, communication, creativity, leadership, entrepreneurship, ethical reasoning and global contextual analysis. As a result, we recommend the adoption of the EPS within CDIO capstone modules for the benefit of engineering students.

Development of Biomimetic Robots in the EPS Engineering Programme Capstone Project

This paper proposes the development of biologically inspired robots as the capstone project of the European Project Semester (EPS) framework. EPS is a one semester student centred international programme offered by a group of European engineering schools (EPS Providers) as part of their student exchange programme portfolio. EPS is organized around a central module (the EPS project) and a set of complementary supportive modules. Project proposals refer to open multidisciplinary real world problems. Its purpose is to expose students to problems of a greater dimension and complexity than those faced throughout the degree programme as well as to put them in contact with the socalled real world, in opposition to the academic world. Students are organized in teams, grouping individuals from diverse academic backgrounds and nationalities, and each team is fully responsible for conducting its project. EPS provides an integrated framework for undertaking capstone projects, which is focused on multicultural and multidisciplinary teamwork, communication, problem-solving, creativity, leadership, entrepreneurship, ethical reasoning and global contextual analysis. The design and development of biologically inspired robots allows the students to fulfil the previously described requirements and objectives and, as a result, we recommend the adoption of these projects within the EPS project capstone module for the benefit of engineering students.

Epidemiologia e Saúde Públi

RESUMO - Visa-se explicitar a origem, a razão de ser, a natureza e o que se perspectiva da relação entre a Epidemiologia e a Saúde Pública, através de uma leitura histórica. As duas entidades foram-se definindo e fazendo sentido em conjunto, com sucessos e, também, muita polémica, desde há milénios e até meados do século XIX. Nesta época, uma combinação de circunstâncias proporcionou-lhes uma explosão de crescimento e de definição, de par com várias outras áreas disciplinares. Desde o antigo relato bíblico de como boa alimentação explica o bom estado de saúde, até à valorização científica das condicionantes sociais e económicas da saúde por Marmot e Rose, passando por «miasmas» causando doença e pela deslocação do conceito de risco individual de saúde para o de risco populacional — com as implicações inerentes a essa importante inovação —, este percurso permite identificar as fundações de tão notável simbiose, explicar o estado presente, vê-la evoluir e achar nela o significado do património hoje disponível, e o que ele promete. Algumas discrepâncias quanto à designação dos seus métodos, bem como a contínua discussão quanto à sua verdadeira natureza e orientação futura, atestam a juventude da Epidemiologia como disciplina científica. Entretanto, a Saúde Pública esforça-se por manter a sua essência integradora, à medida que outras disciplinas contribuem mais para que concretize os seus objectivos; é desafiada pela exposição das populações, em larga escala, a factores de doença, por vezes de intensidade mínima, e pelo surgimento de novas doenças ou a ampliação do volume de outras na população, muitas vezes não respeitando fronteiras. A história dessa simbiose mostra bem que conhecer o modo como uma doença se origina permite controlá-la na população, ou mesmo evitá-la, e que é grande o número de problemas que, em sinergia, as duas disciplinas podem clarificar e resolver. Assim, a Epidemiologia oferece à Saúde Pública explicações (olhos, inteligência e linguagem) para os problemas de saúde das populações — o que permite à segunda saber sobre o quê agir —, cenários de possível evolução dos problemas — o que permite aos decisores optarem em função de diferentes pressupostos, sobre como agir — e capacidade de juízo sobre os resultados das acções empreendidas, em simultâneo com a elevação do nível de consciência, de compreensão e de intervenção quanto ao que se está a passar, tanto pelos profissionais, como pela população — transferência do conhecimento. Facilmente se antecipa que a relação entre as duas disciplinas irá evoluir para maior complexidade e, também, solicitação e exigência da Saúde Pública sobre a Epidemiologia, que terá que corresponder em utilidade. E esta, continuando a subespecializar-se e a sofisticar-se tanto nos métodos, como nos enfoques sobre categorias específicas de factores, precisará de progredir muito na gestão da sua consistência enquanto corpo de conhecimento integrado e com peculiaridades metodológicas, à semelhança da Saúde Pública.O modo como evoluirá a relação entre ambas depende ainda da evolução dos próprios problemas, conceitos, teorias e soluções relacionados com a saúde das populações, e ainda do desenvolvimento das demais disciplinas chamadas à integração por ambas, para enfrentarem esses desafios. Nomeadamente, a Epidemiologia terá que gerir com perícia dificuldades já identificadas, como: incorporar métodos qualitativos de investigação na sua fortíssima tradição e cultura quantitativa; operacionalizar satisfatoriamente o conceito de «risco atribuível na população», ao serviço da definição de prioridades de acção dirigida às necessidades de saúde; aperfeiçoar modelos de interpretação causal que respeitem a multicausalidade; aproveitar as técnicas estatísticas de análise multivariada, sem se perder na abstracção dos seus modelos; desenvolver a investigação nas dimensões positivas de saúde, além da doença, para contribuir melhor para a realização da Saúde Pública, sua principal cliente e fornecedora de oportunidades.--------------------------ABSTRACT - The aim of the author is to explicit the origin, the rationale, the nature and the prospects of the relationship between Epidemiology and Public health, through an historic approach. The two entities have been defining and making sense together, by achieving successes, but also with much controversy, since millennia ago, until mid XIX century. A combination of circumstances provided them the opportunity for an explosion of growth and definition, then, alongside several other disciplines. From the ancient biblical report on how good food explains good health, up to the scientific appreciation of both social and economical constraints to health by Marmot and Rose, passing through «miasma» causing disease and through displacing from individual health risk to population risk — with the inherent implications of that important innovation —, this route allows the identification of the foundations of such remarkable symbiosis, the explanation of current status, to see its evolution and find in it the meaning of today’s heritage and what it promises. Some discrepancies on the name of its methods, as well as the continuing discussion about its true nature and future orientation, attest Epidemiology’s youth as a scientific discipline. Meanwhile, Public Health strives to keep its integrating essence, while other disciplines increasingly contribute so that it achieves its objectives; it is challenged by large scale population exposure to disease factors, sometimes with a minimum intensity, and by new diseases emerging in the population or by old ones getting amplified, often not respecting regions boundaries. The history of such a symbiosis shows that knowing the way a disease is generated allows to control it in the population, or even to avoid it, and that the number of problems that the two disciplines are able to clarify and solve together in synergy is considerable. Therefore, Epidemiology offers Public Health explanations (eyes, intelligence and language) for populations’s health problems — allowing that the latter knows on what to act —, scenarios on how problems may tend to evolve — allowing decision-makers to make their choices as a function of different assumptions, on how to act — and judgement capabilities on the results of already undertaken actions, accompanied by the raising of conscience level, understanding and intervention of what is going on by both professionals and the population – knowledge transfer. It is easy to anticipate that the relationship between both disciplines will develop towards increasing complexity and demand from Public Health to Epidemiology, and that this one will have to correspond in usefulness. And the latter, while continuing its subspecialisation and sophistication either in its methods, or in its approaches to specific factor categories, will need to progress in managing its consistency as an integrated body of knowledge having methodological peculiarities, similarly to Public Health. Further, the way the relationship between both will evolve depends on the evolution of the problems themselves, of the concepts, theories and solutions related to the health of populations, and on the development of remaining disciplines called to integration by both, in other to face those problems. Namely, Epidemiology will have to manage with expertise some already known difficulties, as: the inclusion of qualitative research methods in its very strong quantitative tradition and culture; to grant satisfactory operation to the «population attributable risk» concept, in support to the definition of action priorities envisaging health needs; to improve causal interpretation models that comply with multicausality; to take advantage of multivariate statistical techniques, without get

AUV Control and Communication using Underwater Acoustic Networks

Underwater acoustic networks can be quite effective to establish communication links between autonomous underwater vehicles (AUVs) and other vehicles or control units, enabling complex vehicle applications and control scenarios. A communications and control framework to support the use of underwater acoustic networks and sample application scenarios are described for single and multi-AUV operation.