Iowa State Daily (March 6, 2012)

Contents'Juggling Act'Market determines Iowa State's payrollCandidates vie for 437 delegates on Super TuesdayBe smart about sun on Spring Break 2012Obama doesn't control prices at gas pumpsCyclones turn focus toward Kansas City

Proceedings of the Seventh Annual Biochemical Engineering Symposium

This is the seventh in a series of symposia devoted to talks by students on their biochemical engineering research. The first four meetings were held alternately at Kansas State University and the University of Nebraska–Lincoln, with participants from those two schools. The next two took place at Kansas State and then in conjunction with the 8lst American Institute of Chemical Engineers National Meeting in Kansas City, with attendees from Kansas State and Iowa State Universities. This meeting, at Iowa State, was the first to include participation from the University of Missouri–Columbia. Contents"Properties of Soluble and In:anoblized Dextransucrase," Hossein Kaboli and Yah Eric Chen, Iowa State University "Growth of Lipid-Producing Organisms on Formic and Acetic Acid-Containing Waste Waters," Lin-Chang Chiang, University of Missouri–Columbia "Design of an Automated Alkaline Copper Reducing Sugar Assay," Alfred R. Fratzke and James R. Frederick, Iowa State University "Determination of Oxygen Transfer Coefficients in Hydrocarbon Fermentations Using a Material Balance Method," Sarafin N. Sanchez and J. R. Gutierrez, Kansas State University "Oxygen Transfer Characteristics in One Stage and Two Stage Air-Lift Towers," Mark E. Orazem, Kansas State University "A Comparison of Biological Digestibility Tests for Cellulose," Dou-Houng Hwang, University of Missouri–Columbia "Mechanism of Enzymatic Hydrolysis of Cellulose," L. T. Fan, Yong-Hyun Lee, and Liang-Shih Fan, Kansas State University "Purification of Xylan-Hydrolyzing Enzymes," James R. Frederick, Alfred R. Fratzke, and Mary M. Frederick, Iowa State University "Cellulase Production from Bagasse and Pith," A. Ferrer, Y. Alroy, and I. Brito, Kansas State University

Fortaleciéndo la soberanía alimentaria mediante la revalorización de saberes ecológicos locales: experiencia en los Andes bolivianos

Ethnobiology research contributes significantly to initiatives that aim to enhance food sovereignty among indigenous and/or traditional people. In Bolivia, one of the Latin-American countries that shows the highest poverty and undernourishment levels, the purpose of this research-action project was to enhance food sovereignty through the revitalization of the local ecological knowledge and to promote local technological innovation processes in the Andean community of Tallija-Confital. During a first step the endogenous knowledge and strategies related to food security and sovereignty were investigated, based on the principles and tools of the Revitalizing Participatory Research (RPR). In a second step local technical innovation processes were supported through a “knowledge dialogue” between exogenous and endogenous knowledge systems, focusing on the processing of the cañahua (Chenopodium pallidicaule Aellen) gluten. The research results demonstrate that Andean people have developed complex endogenous knowledge and strategies to adapt to socio-environmental changes that show a great potential to contribute to the enhancement of food sovereignty. Nevertheless, in the current globalized context that translates into new challenges for local communities, beyond the revitalization of local ecological knowledge, a dialogue between different knowledge systems can lead to important local technological innovation for the improvement of their well-being. Key words: food sovereignty, knowledge dialogue, endogenous development, technological innovation

Proceedings of the 13th Annual Biochemical Engineering Symposium

The symposium reported here was the thirteenth of a series devoted to talks by students on their biochemical engineering research. The first, third, fifth, ninth, and twelfth were at Kansas State University, the second and fourth were at the University of Nebraska–Lincoln, the sixth was in Kansas City and was hosted by Iowa State University, the seventh and tenth were at Iowa State, and the eighth and eleventh were at the University of Missouri–Columbia and Colorado State University, respectively. All symposia have been followed by proceedings edited by faculty of the host institution. Because final publication usually takes place elsewhere, papers here are brief, and often cover research in progress. ContentSequential Utilization of Mixed Sugars by Clostridium acetobutylicum, B. Hong, N. H. Choi, and L. T. Fan, Kansas State University The Effects of Dilution Rate on the Kinetics. of Anaerobic Acidogenesis, C. J. Huang, Colorado State University Ethanol Production by Zymomonas mobilis in Anaerobic Glucose-Limited Culture: A Yield Study, Mehmet D. Oner, Kansas State University Hydrolysis of Cellulosics by Enterobacteria, Michael R. Sierks, Iowa State University The Cellulase System of Chaetomium cellulolyticum, Nikhil Mehta, Colorado State University DNA Measurement as a Tool for Estimating Biomass Concentration in the Presence of Interfering Solids, Bamidele 0. Solomon, Kansas State University The Effect of Cellulose Crystallinity on Enzymatic Hydrolysis, Maria S. Bertran, Colorado State University High Performance Liquid Chromatography of Di- and Trisaccharides, Michael M. Meagher, Iowa State University Dynamics of Bubble Size .Distributions in Air-Lift Fermentors, c. H. Lee and Snehal A. Patel, Kansas State University A Thermal Coagulation Study of Alfalfa Leaf Proteins by Differential Scanning Calorimeter, Khalif Ahmed and Bruce Dale, Colorado State University Thermodynamic Efficiency of Photoautotrophic Growth, Hyeon Y. Lee, Kansas State University

Proceedings of the Seventeenth Annual Biochemical Engineering Symposium

This is the seventeenth of a series of symposia devoted to talks by students about their biochemical engineering research. The first, third, fifth, ninth, twelfth, and sixteenth were at Kansas State University, the second and fourth were at the University of Nebraska-Lincoln, the sixth was in Kansas City and was hosted by Iowa State University, the seventh, tenth, thirteenth, and seventeenth were at Iowa State University, the eighth and fourteenth were at the University of Missouri–Columbia, and the eleventh and fifteenth were at Colorado State University. Next year's symposium will be at the University of Colorado. Symposium proceedings are edited by faculty of the host institution. Because final publication usually takes place elsewhere, papers here are brief, and often cover work in progress. ContentsThe Effect of Polymer Dosage Conditions on the Properties of ProteinPolyelectrolyte Precipitates, K. H. Clark and C. E. Glatz, Iowa State University An Immobilized Enzyme Reactor/Separator for the Hydrolysis of Casein by Subtilisin Carlsberg, A. J. Bream, R. A. Yoshisato, and G. R. Carmichael, University of Iowa Cell Density Measurements in Hollow Fiber Bioreactors, Thomas Blute, Colorado State University The Hydrodynamics in an Air-Lift Reactor, Peter Sohn, George Y. Preckshot, and Rakesh K. Bajpai, University of Missouri–Columbia Local Liquid Velocity Measurements in a Split Cylinder Airlift Column, G. Travis Jones, Kansas State University Fluidized Bed Solid Substrate Trichoderma reesei Fermentation, S. Adisasmito, H. N. Karim, and R. P. Tengerdy, Colorado State University The Effect of 2,4-D Concentration on the Growth of Streptanthus tortuosis Cells in Shake Flask and Air-Lift Permenter Culture, I. C. Kong, R. D. Sjolund, and R. A. Yoshisato, University of Iowa Protein Engineering of Aspergillus niger Glucoamylase, Michael R. Sierks, Iowa State University Structured Kinetic Modeling of Hybidoma Growth and Monoclonal Antibody Production in Suspension Cultures, Brian C. Batt and Dhinakar S. Kampala, University of Colorado Modelling and Control of a Zymomonas mobilis Fermentation, John F. Kramer, M. N. Karim, and J. Linden, Colorado State University Modeling of Brettanomyces clausenii Fermentation on Mixtures of Glucose and Cellobiose, Max T. Bynum and Dhinakar S. Kampala, University of Colorado, Karel Grohmann and Charles E. Yyman, Solar Energy Research Institute Master Equation Modeling and Monte Carlo Simulation of Predator-Prey Interactions, R. 0. Fox, Y. Y. Huang, and L. T. Fan, Kansas State University Kinetics and Equilibria of Condensation Reactions Between Two Different Monosaccharides Catalyzed by Aspergillus niger Glucoamylase, Sabine Pestlin, Iowa State University Biodegradation of Metalworking Fluids, S. M. Lee, Ayush Gupta, L. E. Erickson, and L. T. Fan, Kansas State University Redox Potential, Toxicity and Oscillations in Solvent Fermentations, Kim Joong, Rakesh Bajpai, and Eugene L. Iannotti, University of Missouri–Columbia Using Structured Kinetic Models for Analyzing Instability in Recombinant Bacterial Cultures, William E. Bentley and Dhinakar S. Kompala, University of Colorado

El problema del héroe cómico en Avispas

A pesar de que la crítica se inclinado por sostener que Filocleón es el héroe cómico de Avispas, en este trabajo nos proponemos demostrar que esa función es ejercida por su hijo Bdelicleón. Hay numerosos factores que permiten vincular a Bdelicleón con otros héroes de la comedia temprana: su papel de portavoz del discurso positivo avalado en la pieza, su superioridad moral e intelectual respecto de su antagonista, su acción benéfica para la ciudad, sus victorias sucesivas en las escenas agonales, entre otras razones. La hipótesis de que Bdelicleón es en verdad el héroe cómico permite reconocer un modelo común en la producción temprana de Aristófanes y sostener que el héroe sigue cumpliendo en Avispas una función argumentativa estratégica. Su condición superior lo convierte en un portavoz legitimado de la ideología sustentada en la pieza y favorece los efectos persuasivos de la obra.

El problema del héroe cómico en Avispas

A pesar de que la crítica se inclinado por sostener que Filocleón es el héroe cómico de Avispas, en este trabajo nos proponemos demostrar que esa función es ejercida por su hijo Bdelicleón. Hay numerosos factores que permiten vincular a Bdelicleón con otros héroes de la comedia temprana: su papel de portavoz del discurso positivo avalado en la pieza, su superioridad moral e intelectual respecto de su antagonista, su acción benéfica para la ciudad, sus victorias sucesivas en las escenas agonales, entre otras razones. La hipótesis de que Bdelicleón es en verdad el héroe cómico permite reconocer un modelo común en la producción temprana de Aristófanes y sostener que el héroe sigue cumpliendo en Avispas una función argumentativa estratégica. Su condición superior lo convierte en un portavoz legitimado de la ideología sustentada en la pieza y favorece los efectos persuasivos de la obra.

El problema del héroe cómico en Avispas

A pesar de que la crítica se inclinado por sostener que Filocleón es el héroe cómico de Avispas, en este trabajo nos proponemos demostrar que esa función es ejercida por su hijo Bdelicleón. Hay numerosos factores que permiten vincular a Bdelicleón con otros héroes de la comedia temprana: su papel de portavoz del discurso positivo avalado en la pieza, su superioridad moral e intelectual respecto de su antagonista, su acción benéfica para la ciudad, sus victorias sucesivas en las escenas agonales, entre otras razones. La hipótesis de que Bdelicleón es en verdad el héroe cómico permite reconocer un modelo común en la producción temprana de Aristófanes y sostener que el héroe sigue cumpliendo en Avispas una función argumentativa estratégica. Su condición superior lo convierte en un portavoz legitimado de la ideología sustentada en la pieza y favorece los efectos persuasivos de la obra.

A comparative analysis of ABE Bachelor of Science programs in European and US Universities.

European Universities are involved in series of great changes regarding teaching and education organization during the last few years. The origin of these changes is the creation of the so-called European Higher Education Area (EHEA), which main target is to harmonize the different University studies throughout Europe. As a consequence, most of the programs of studies in all degrees are suffering changes in order to converge to common structures. Taking advantage of the actual process, some European universities are moving from traditional Agricultural Engineering programs to a more wide discipline named recently as Biosystems Engineering, which is a science- based engineering discipline that integrates engineering science and design with applied biological, environmental and agricultural sciences, broadening in this way the area of application of Engineering sciences not strictly to agricultural sciences, but to the biologic al sciences in general, including the agricultural sciences. This paper presents a comparative study of different Bachelor of Science degrees offered by American and European Universities in the field of Agricultural/Biosystems Engineering. To carry out the analysis 40 programs accredited by ABET in American Universities and 50 European programs. Among other questions, the total number of credits, the number of semesters, the kind of modules and the distribution of subjects in groups (Basic Sciences, Engineering Fundamentals, Agricultural/Biological Sciences, Humanities & Economic Sciences, Applied Agricultural/Biological Engineering and electives) are discussed in the paper. The information provided can be an useful starting point in future definitions of new or renewed degrees with the aim of advancing in internationalization of the programs and helping student’s mobility.

Arquitectura antidesertización. Fluidez, biodiversidad, hidrofilia y transpirabilidad

La escasez de recursos, la desertización creciente y el previsible calentamiento global forman un escenario físico sin precedentes que urge la revisión de las relaciones entre arquitectura y agua en la urbanización de los paisajes secos, donde la aridez es el factor limitante principal. Cuestionar la idea de escasez, la de residuo o la de confort es el punto de partida para analizar la hidrología urbana. La condición ubicua y dinámica del agua, sus continuos cambios de estado y las implicaciones energéticas y ambientales involucradas argumentan a favor de un entendimiento integral, holístico, que aborda el diseño en relación a lo paisajístico, lo infraestructural y lo ambiental como un único ámbito de investigación, planteado en términos no solo de materia o de escasez, sino de energía. Este trabajo se interesa por el rol de la arquitectura en este proyecto conjunto, integral, del espacio físico con el ciclo hidrológico donde lo orgánico, lo geológico y lo atmosférico están ligados, y donde las categorías de lo hidrológico y lo hidráulico se confunden. Las profundas implicaciones culturales en la construcción de la naturaleza urbana y en la relación con el cuerpo humano adquieren especial notoriedad en los modelos de paisaje y de espacio público adoptados, importados desde las geografías húmedas, y en la estigmatización del agua desde los presupuestos del higienismo decimonónico, que conduce al hidrofugado general de una ciudad aséptica y estéril, que se extiende hasta las envolventes de fachadas estancas y los interiores blancos y satinados. La búsqueda de referentes salta la modernidad hacia contextos de baja energía como el oasis tradicional de las tierras áridas, que concilia la formación de un ecosistema productivo con la climatización de un espacio público exterior, o los ambientes aislados de la investigación aeroespacial, con ciclos cerrados de materia. Las condiciones del ciclo del agua, como la vinculación con el suelo y el territorio, la capacidad de disolver, de mezclarse y de lavar, su volumen variable y su papel como termorregulador señalan el interés que características físicas como la fluidez, la biodiversidad, la hidrofilia y la transpirabilidad tienen para una arquitectura con competencias hidráulicas y un espacio urbano transparente a los procesos del agua. La morfología y localización, la elección de escalas, jerarquías y relaciones entre espacios y la reformulación de los sistemas constructivos aparecen como herramientas y categorías propias desde las que proponer mejores respuestas a problemas como la deshidratación, la erosión y la contaminación. Una urbanización permeable e hidrófila que absorba el agua como un recurso valioso, nuevos ensamblajes para la bioquímica urbana (que introduzcan una idea de limpieza más próxima a fertilidad que a la desinfección), y el diseño de las condiciones atmosféricas a través de una arquitectura transpirable, que se empapa y rezuma frescor, son las claves de este nuevo proyecto. La ciudad se piensa como una síntesis multiescalar de espacios hidráulicos que aporta mayor resiliencia frente a la desertificación y las condiciones climáticas extremas, y mayor visibilidad en la escena pública al agua y a las inevitables conexiones entre ecología y economía. Pero también es una oportunidad para revisar las categorías disciplinares, para renovar las consistencias materiales, las calidades ambientales y las relaciones entre el cuerpo y el espacio. ABSTRACT The shortage of resources, foreseeable global warming and increasing desertification create an unprecedented prospect that question the existing relationships between water and architecture, in the urbanization of the arid lands. The awareness of the huge volumes of water that pierce unnoticed through urban space, their impact on the landscape as well as on environmental qualities, promote a design field where cultural, social and political considerations intersect, related to the body and the physical experience of space within the built environment. Fluidity and ubiquity, solution ability, variability and cyclical processes are characteristic of water as material, directly related with the fields of potential, chemical and thermal energy and the reality of its mass, as it occupies a changing volume in space. These are also the imposing cross sections that water introduces into the project, that argue in favor of a comprehensive and holistic understanding, of addressing design in relationship to landscape, infrastructure and environmental issues as a one single area of research. This work attempts to investigate how architecture, with its specific tools, can partake in the design of water cycle in the space, linking the organic, geological, and atmospheric, blurring the lines between hydrology and hydraulic. It aims to identify issues, within the continuous query associated with water, that deal with the architectural project and may have here better results. The deep cultural implications in the construction of urban nature and the relationship with the body, acquire special notoriety in the models of landscape and public space adopted, imported from humid geographies. Also in the stigmatization of water from the premises of nineteenth- century hygienics, which lead to the entire waterproofing of an aseptic and sterile city, to the sealed facades and white and polished interiors. The search for alternative references goes beyond modernity towards a mindset of low energy, as the traditional oasis of arid lands, which aims to reconcile the formation of a productive ecosystem with the conditioning of an outdoor public space, or the controlled environments of aerospace research, with closed cycles of matter. Fluidity, biodiversity, hydrophilicity and breathability are characteristic of an architecture with hydraulic competences. The distributing phenomenon of water, its necessary connectivity to the ground and to small cycles in the ecosystems, shows strong affinities with an infrastructural architecture, as an alternative to large-scale centralized networks. Its volume has approximated to the dimensions of the built space, promoting a new found condition of coexistence. A permeable and hydrophilic urbanization absorbs water as a valuable resource; new assemblies for urban biochemistry introduce an idea of sanitation closer to fertility than to disinfection; a breathable architecture that soaks and exudes freshness design the atmospheric conditions: these are the essential components of this new project. The city is understood as a synthesis of multi-scale hydraulic spaces that provides greater resilience against desertification and increases the visibility of water and the linkages between ecology and economy in the public scene. It is also an opportunity to review the disciplinary categories of architecture, the material consistencies, the environmental qualities and the relationship between body and space.

Capacity Building through education, research and collaboration: AFRICA BUILD, an eHealth Case Study

AFRICA BUILD (AB) is a Coordination Action project under the 7th European Framework Programme having the aim of improving the capacities for health research and education in Africa through Information and Communication Technologies (ICT). This project, started in 2012, has promoted health research, education and evidence-based practice in Africa through the creation of centers of excellence, by using ICT,?know-how?, eLearning and knowledge sharing, through Web-enabled virtual communities.

An ICT-based closed-loop model to improve care for heart failure patients

Durante las últimas décadas se ha producido un fenómeno global de envejecimiento en la población. Esta tendencia se puede observar prácticamente en todos los países del mundo y se debe principalmente a los avances en la medicina, y a los descensos en las tasas de fertilidad y mortalidad. El envejecimiento de la población tiene un gran impacto en la salud de los ciudadanos, y a menudo es la causa de aparición de enfermedades crónicas. Este tipo de enfermedades supone una amenaza y una carga importantes para la sociedad, especialmente en aspectos como la mortalidad o los gastos en los sistemas sanitarios. Entre las enfermedades cardiovasculares, la insuficiencia cardíaca es probablemente la condición con mayor prevalencia y afecta a 23-26 millones de personas en todo el mundo. Normalmente, la insuficiencia cardíaca presenta un mal pronóstico y una tasa de supervivencia bajas, en algunos casos peores que algún tipo de cáncer. Además, suele ser la causa de hospitalizaciones frecuentes y es una de las enfermedades más costosas para los sistemas sanitarios. La tendencia al envejecimiento de la población y la creciente incidencia de las enfermedades crónicas están llevando a una situación en la que los sistemas de salud no son capaces de hacer frente a la demanda de la sociedad. Los servicios de salud existentes tendrán que adaptarse para ser efectivos y sostenibles en el futuro. Es necesario identificar nuevos paradigmas de cuidado de pacientes, así como mecanismos para la provisión de servicios que ayuden a transformar estos sistemas sanitarios. En este contexto, esta tesis se plantea la búsqueda de soluciones, basadas en las Tecnologías de la Información y la Comunicación (TIC), que contribuyan a realizar la transformación en los sistemas sanitarios. En concreto, la tesis se centra en abordar los problemas de una de las enfermedades con mayor impacto en estos sistemas: la insuficiencia cardíaca. Las siguientes hipótesis constituyen la base para la realización de este trabajo de investigación: 1. Es posible definir un modelo basado en el paradigma de lazo cerrado y herramientas TIC que formalice el diseño de mejores servicios para pacientes con insuficiencia cardíaca. 2. El modelo de lazo cerrado definido se puede utilizar para definir un servicio real que ayude a gestionar la insuficiencia cardíaca crónica. 3. La introducción, la adopción y el uso de un servicio basado en el modelo definido se traducirá en mejoras en el estado de salud de los pacientes que sufren insuficiencia cardíaca. a. La utilización de un sistema basado en el modelo de lazo cerrado definido mejorará la experiencia del usuario de los pacientes. La definición del modelo planteado se ha basado en el estándar ISO / EN 13940- Sistema de conceptos para dar soporte a la continuidad de la asistencia. Comprende un conjunto de conceptos, procesos, flujos de trabajo, y servicios como componentes principales, y representa una formalización de los servicios para los pacientes con insuficiencia cardíaca. Para evaluar el modelo definido se ha definido un servicio real basado en el mismo, además de la implementación de un sistema de apoyo a dicho servicio. El diseño e implementación de dicho sistema se realizó siguiendo la metodología de Diseño Orientado a Objetivos. El objetivo de la evaluación consistía en investigar el efecto que tiene un servicio basado en el modelo de lazo cerrado sobre el estado de salud de los pacientes con insuficiencia cardíaca. La evaluación se realizó en el marco de un estudio clínico observacional. El análisis de los resultados ha comprendido métodos de análisis cuantitativos y cualitativos. El análisis cuantitativo se ha centrado en determinar el estado de salud de los pacientes en base a datos objetivos (obtenidos en pruebas de laboratorio o exámenes médicos). Para realizar este análisis se definieron dos índices específicos: el índice de estabilidad y el índice de la evolución del estado de salud. El análisis cualitativo ha evaluado la autopercepción del estado de salud de los pacientes en términos de calidad de vida, auto-cuidado, el conocimiento, la ansiedad y la depresión, así como niveles de conocimiento. Se ha basado en los datos recogidos mediante varios cuestionarios o instrumentos estándar (i.e. EQ-5D, la Escala de Ansiedad y Depresión (HADS), el Cuestionario de Cardiomiopatía de Kansas City (KCCQ), la Escala Holandesa de Conocimiento de Insuficiencia Cardíaca (DHFKS), y la Escala Europea de Autocuidado en Insuficiencia Cardíaca (EHFScBS), así como cuestionarios dedicados no estandarizados de experiencia de usuario. Los resultados obtenidos en ambos análisis, cuantitativo y cualitativo, se compararon con el fin de evaluar la correlación entre el estado de salud objetivo y subjetivo de los pacientes. Los resultados de la validación demostraron que el modelo propuesto tiene efectos positivos en el cuidado de los pacientes con insuficiencia cardíaca y contribuye a mejorar su estado de salud. Asimismo, ratificaron al modelo como instrumento válido para la definición de servicios mejorados para la gestión de esta enfermedad. ABSTRACT During the last decades we have witnessed a global aging phenomenon in the population. This can be observed in practically every country in the world, and it is mainly caused by the advances in medicine, and the decrease of mortality and fertility rates. Population aging has an important impact on citizens’ health and it is often the cause for chronic diseases, which constitute global burden and threat to the society in terms of mortality and healthcare expenditure. Among chronic diseases, Chronic Heart Failure (CHF) or Heart Failure (HF) is probably the one with highest prevalence, affecting between 23 and 26 million people worldwide. Heart failure is a chronic, long-term and serious condition with very poor prognosis and worse survival rates than some type of cancers. Additionally, it is often the cause of frequent hospitalizations and one of the most expensive conditions for the healthcare systems. The aging trends in the population and the increasing incidence of chronic diseases are leading to a situation where healthcare systems are not able to cope with the society demand. Current healthcare services will have to be adapted and redefined in order to be effective and sustainable in the future. There is a need to find new paradigms for patients’ care, and to identify new mechanisms for services’ provision that help to transform the healthcare systems. In this context, this thesis aims to explore new solutions, based on ICT, that contribute to achieve the needed transformation within the healthcare systems. In particular, it focuses on addressing the problems of one of the diseases with higher impact within these systems: Heart Failure. The following hypotheses represent the basis to the elaboration of this research: 1. It is possible to define a model based on a closed-loop paradigm and ICT tools that formalises the design of enhanced healthcare services for chronic heart failure patients. 2. The described closed-loop model can be exemplified in a real service that supports the management of chronic heart failure disease. 3. The introduction, adoption and use of a service based on the outlined model will result in improvements in the health status of patients suffering heart failure. 4. The user experience of patients when utilizing a system based on the defined closed-loop model will be enhanced. The definition of the closed-loop model for health care support of heart failure patients have been based on the standard ISO/EN 13940 System of concepts to support continuity of care. It includes a set of concept, processes and workflows, and services as main components, and it represent a formalization of services for heart failure patients. In order to be validated, the proposed closed-loop model has been instantiated into a real service and a supporting IT system. The design and implementation of the system followed the user centred design methodology Goal Oriented Design. The validation, that included an observational clinical study, aimed to investigate the effect that a service based on the closed-loop model had on heart failure patients’ health status. The analysis of results comprised quantitative and qualitative analysis methods. The quantitative analysis was focused on determining the health status of patients based on objective data (obtained in lab tests or physical examinations). Two specific indexes where defined and considered in this analysis: the stability index and the health status evolution index. The qualitative analysis assessed the self-perception of patients’ health status in terms of quality of life, self-care, knowledge, anxiety and depression, as well as knowledge levels. It was based on the data gathered through several standard instruments (i.e. EQ-5D, the Hospital Anxiety and Depression Scale, the Kansas City Cardiomyopathy Questionnaire, the Dutch Heart Failure Knowledge Scale, and the European Heart Failure Self-care Behaviour Scale) as well as dedicated non-standardized user experience questionnaires. The results obtained in both analyses, quantitative and qualitative, were compared in order to assess the correlation between the objective and subjective health status of patients. The results of the validation showed that the proposed model contributed to improve the health status of the patients and had a positive effect on the patients’ care. It also proved that the model is a valid instrument for designing enhanced healthcare services for heart failure patients.

Annual report of the State Horticultural Society of Missouri.

37, 1895