How do older people with sight loss manage their general health? A qualitative study

Purpose: Older people with sight loss experience a number of barriers to managing their health. The purpose of this qualitative study was to explore how older people with sight loss manage their general health and explore the techniques used and strategies employed for health management. Methods: Semi-structured face-to-face interviews were conducted with 30 participants. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Results: Health management challenges experienced included: managing multiple health conditions; accessing information; engaging in health behaviours and maintaining wellbeing. Positive strategies included: joining support groups, clubs and societies; using low vision aids; seeking support from family and friends and accessing support through health and social care services. Conclusion: Healthcare professionals need to be more aware of the challenges faced by older people with sight loss. Improved promotion of group support and charity services which are best placed to share information, provide fora to learn about coping techniques and strategies, and give older people social support to prevent isolation is needed. Rehabilitation and support services and equipment can only be beneficial if patients know what is available and how to access them. Over-reliance on self-advocacy in current healthcare systems is not conducive to patient-centred care. Implications for Rehabilitation Sight loss in older people can impact on many factors including health management. This study identifies challenges to health management and highlights strategies used by older people with sight loss to manage their health. Access to support often relies on patients seeking information for themselves. However, self-advocacy is challenging due to information accessibility barriers. Informal groups and charities play an important role in educating patients about their condition and advising on available support to facilitate health management.

Experimental investigation of inter-modal cross-gain modulation and transient effects in a two mode group erbium doped fiber amplifier

We report what we believe to be the first experimental study of inter-modal cross-gain modulation and associated transient effects as different spatial modes and wavelength channels are added and dropped within a two-mode amplifier for SDM transmission.

Impact of online channel use on customer revenues and costs to serve:considering product portfolios and self-selection

Developing a strategy for online channels requires knowledge of the effects of customers' online use on their revenue and cost to serve, which ultimately influence customer profitability. The authors theoretically discuss and empirically examine these effects. An empirical study of retail banking customers reveals that online use improves customer profitability by increasing customer revenue and decreasing cost to serve. Moreover, the revenue effects of online use are substantially larger than the cost-to-serve effects, although the effects of online use on customer revenue and cost to serve vary by product portfolio. Self-selection effects also emerge and can be even greater than online use effects. Ignoring self-selection effects thus can lead to poor managerial decision-making.

Classroom implications of recent research into literacy development: from predictors to assessment

We outline how research into predictors of literacy underpins the development of increasingly accurate and informative assessments. We report three studies that emphasize the crucial role of speech and auditory skills on literacy development throughout primary and secondary school. Our first study addresses the effects of early childhood middle ear infections, the potential consequences for speech processing difficulties and the impact on early literacy development. Our second study outlines how speech and auditory skills are crucially related to early literacy in normally developing readers, whereas other skills such as motor, memory and IQ are only indirectly related. Our third study outlines the on-going impact of phonological awareness on reading and wider academic achievement in secondary-school pupils. Finally, we outline how teachers can use the current research to inform them about which assessments to conduct, and how to interpret the results. Copyright © 2008 John Wiley & Sons, Ltd.

Experimental investigation of inter-modal cross-gain modulation and transient effects in a two mode group erbium doped fiber amplifier

We report what we believe to be the first experimental study of inter-modal cross-gain modulation and associated transient effects as different spatial modes and wavelength channels are added and dropped within a two-mode amplifier for SDM transmission.

Editorial

This time of year we look back at the year that has passed and make plans for the next year. I like to reflect on things that I have learnt and people that I have met, especially those who facilitated that learning. In 2009 I went to various conferences, The BCLA conference in Manchester, The Romanian Optical Society meeting in Brasov, Transylvania (where the university is actually on Vlad Tepes Street), The European Council for Optometry and Optics (ECOO) in Brno, Czech Republic, The American Academy of Optometry (AAO) in Orlando USA, The International Association of Contact Lens Educators (IACLE) meeting in Tianjin China and finally The Vereinigung Deutscher Contactlinsen-Spezialisten (VDCO) meeting in Jena. All were interesting places and thoroughly all were enjoyable conferences with their own highlights but I wanted to focus on Jena and one person I met there and his inspirational search for knowledge and the contributions he made in the field of contact lenses. Jena itself is a fascinating place and should be on the ‘must visit’ list of anyone involved in eye care. It is the birth place of Carl Zeiss of course and where he started his company. It is also the birth place of Ernst Abbe (physicist and optometrist and expert lens maker), and Otto Schott (chemist and technologist who made high quality glass. There are many road signs bearing witness to these famous pioneers. The optical museum is worth spending a few hours looking around too. I was invited to speak at the VDCO at the kind invitation from colleagues at the Jena School of Optometry, Professor Wolfgang Sickenberger and Professor Sebastian Marx. At this meeting I met 87-year-old Willi KAUE who was being awarded the Adolf Wilhelm Müller-Welt prize by the VDCO for contribution to contact lenses over his 60-year career. At the age of 15 Willi Kaue took up an apprenticeship to become an Optician in Germany in 1937. At this time he first heard about the scleral glass lenses made by the Carl Zeiss Company in Jena. This started his lifelong fascination which was to become his passion but not yet his career. During the war he was enlisted into military service but immediately after was back to his former career. In 1950 Willi corrected his own 3.5 dioptres of myopia with a plastic scleral lens. His fascination strengthened as for the first time he himself could experience a wider field of view than his spectacles gave him, less aberrations and less retinal minification. He also appreciated the fact that contact lenses did not cause pressure on the nose or ears and did not slide down his nose plus remained optically centred with his eye movements. He decided that form now on he would make fitting contact lenses his career. He travelled to London to learn more about contact lenses and how to fit them but initially did not find many willing teachers and to start with became largely self-taught. He wanted to know how to make scleral lenses. So far he only knew that pulverized polymethyl methacrylate (PMMA) was pressed and moulded. In 1951 he met Berlin optician Otto Marzock. He made his only scleral lenses from using military PMMA windshields. His process involved lathe cutting the lenses and resulted in lenses that were thinner than moulded ones. Willi developed a manufacturing method, using a rotary diamond drill, starting form the outer edge and towards the centre at a constant cut speed. This enabled him to make more reproducible lenses and in less time. His enthusiasm in the field was clear from the travels he made in the pursuit of advancement - travelling around Europe, South America, North America and Asia. In 1963 he visited George Nissel in Hemel Hempstead, England. Constantly thriving towards innovations Willi came across the new Naturalens from the USA made from HEMA at a congress in Marseille in 1969. Amongst his contributions to the field, was his own technique of fitting ocular prosthetics, using an alginate impression of the orbit. I was fortunate enough to have dinner with Willi Kaue and learnt more about his fascinating career through the patient interpreting skills of Hilmar Bussacker (the 2008 winner of the same award and the 2007 winner of the European Federation of the Contact Lens and IOL Industries Award). I look forward to 2010 with eager anticipation as to what I may learn and who I might meet!!! Copyright © 2009 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

Towards e+Learning or How to Increase the Learning into e-Learning

It is discussed some changes in the traditional e-learning notion on the point of view of R. Koper’s question 'where is the learning in e-learning?’. We put a focus on the conception of learning as a management process and present the project Bulgarian Educational Site (BEST) – a possible answer to Koper’s question. The BEST is a virtual learning environment, based on the following principles: learning is a goal-directed and didactics-managed process; learners may define their own learning objectives, monitor and regulate the learning process; collaborative e-learning is more effective; etc. The BEST is based on two famous e-learning systems (Moodle, LAMS) and Plovdiv e-University (versions 1.0 and 2.0). The paper brings up a mater about the new ‘electronic’ pedagogy and proposes an approach for pedagogical modeling and interpretation of e-learning applied in the BEST.

Fast Information Retrieval in the Open Grid Service Architecture

This is an extended version of an article presented at the Second International Conference on Software, Services and Semantic Technologies, Sofia, Bulgaria, 11–12 September 2010.

Quality assessment of video transmission in heterogeneous networks as applied to real-time telecare

This work looks into video quality assessment applied to the field of telecare and proposes an alternative metric to the more traditionally used PSNR based on the requirements of such an application. We show that the Pause Intensity metric introduced in [1] is also relevant and applicable to heterogeneous networks with a wireless last hop connected to a wired TCP backbone. We demonstrate through our emulation testbed that the impairments experienced in such a network architecture are dominated by continuity based impairments rather than artifacts, such as motion drift or blockiness. We also look into the implication of using Pause Intensity as a metric in terms of the overall video latency, which is potentially problematic should the video be sent and acted upon in real-time. We conclude that Pause Intensity may be used alongside the video characteristics which have been suggested as a measure of the overall video quality. © 2012 IEEE.

Cumplimiento gubernamental y estilos de gobernar. Análisis de los gobiernos de los municipios semi-urbanos de Michoacán, México

Con la construcción y operación de indicadores se calcularon dos índices, uno para determinar el nivel de cumplimiento de los procesos elementales que tienen que realizar los gobiernos de los municipios semiurbanos de Michoacán, y otro para fi jar su estilo de gobernar. El índice de cumplimiento gubernamental muestra que estas municipalidades atienden parcialmente la mayoría de sus labores básicas. Su ejercicio prácticamente se da por inercia. El otro índice muestra que siguen trabajando con la visión tradicional de gobernar. Se trata de un estilo donde el protagonismo del alcalde es alto con nulas prácticas estables de participación social. Correlacionando ambos índices, se puede plantear -hasta cierto punto- que el bajo cumplimiento se debe al estilo de gobernar. Los índices además explican que la posición estratégica de semi-urbanidad no es aprovechada por el gobierno para promover otros estilos de gobernar en busca de mejorar su cumplimiento. Diversos grupos ciudadanos -en estos municipios- han formado gobiernos alternativos que sustituyen al gobierno formal, en otros se han constituido gobiernos paralelos.

La enseñanza de las construcciones pasivas e impersonales con "se" en español como L2. ¿Cuántas distinciones son necesarias?

Este artículo sugiere un enfoque nuevo a la enseñanza de las dos estructuras gramaticales la pasiva refleja y el “se” impersonal para las clases universitarias de E/LE. Concretamente, se argumenta que las dos se deberían tratar como construcciones pasivas, basada en un análisis léxico-funcional de ellas que enfoca la lingüística contrastiva. Incluso para la instrucción de E/LE, se recomienda una aproximación contrastiva en la que se enfocan tanto la reflexión metalingüística como la competencia del estudiante en el L2. Específicamente, el uso de córpora lingüísticos en la clase forma una parte integral de la instrucción. El uso de un corpus estimula la curiosidad del estudiante, le expone a material de lengua auténtica, y promulga la reflexión inductiva independiente.

D2.5 - First bundle of dashboard components

This document describes the core components to create customizable game analytics and dashboards: their present status; links to their full designs and downloadable versions; and how to configure them, and take advantage of the analytics visualizations and the underlying architecture of the platform. All the dashboard components are working with data collected using the xAPI data format that the RAGE project has developed in collaboration with ADL Co-Lab.

From the human rights-based approach to an ecological approach on how to achieve successful inclusion in international disability education

The barriers that people with disabilities face around the world are not only inherent to the limitations resulting from the disability itself, but, more importantly, these barriers rest with the societal technologies of exclusion. Using a mixed methodology approach, I conduct a quest to revealing several societal factors that limit full participation of people with disabilities in their communities, which will contribute to understanding and developing a more comprehensive framework for full inclusion of people with disabilities into the society. First, I conduct a multiple regression analysis to seek whether there is a statistical relationship between the national level of development, the level of democratization, and the level of education within a country’s population on one hand, and expressed concern for and preparedness to improve the quality of life for people of disabilities on another hand. The results from the quantitative methodology reveal that people without disabilities are more prepared to take care of people with disabilities when the level of development of the country is higher, when the people have more freedom of expression and hold the government accountable for its actions, and when the level of corruption is under control. However, a greater concern for the well-being of people with disabilities is correlated with a high level of country development, a decreased value of political stability and absence of violence, a decreased level of government effectiveness, and a greater level of law enforcement. None of the dependent variables are significantly correlated with the level of education from a given country. Then, I delve into an interpretive analysis to understand multiple factors that contribute to the construction of attitudes and practices towards people with disabilities. In doing this, I build upon the four main principles outlined by the United Nations as strongly recommended to be embedded in all international programmes: (1) identification of claims of human rights and the corresponding obligations of governments, hence, I assess and analyze disability rights in education, looking at United Nation, United States, and European Union Perspectives Educational Rights Provisions for People with Disabilities (Ch. 3); (2) estimated capacity of individuals to claim their rights and of governments to fulfill their obligations, hence, I look at the people with disabilities as rights-holders and duty-bearers and discuss the importance of investing in special capital in the context of global development (Ch. 4); (3) programmes monitor and evaluate the outcomes and the processes under the auspices of human rights standards, hence, I look at the importance of evaluating the UN World Programme of Action Concerning People with Disabilities from multiple perspectives, as an example of why and how to monitor and evaluate educational human rights outcomes and processes (Ch. 5); and (4) programming should reflect the recommendations of international human rights bodies and mechanisms, hence, I focus on programming that fosters development of the capacity of people with disabilities, that is, planning for an ecology of disabilities and ecoducation for people with disabilities (Ch. 6). Results from both methodologies converge to a certain point, and they further complement each other. One common result for the two methodologies employed is that disability is an evolving concept when viewed in a broader context, which integrates the four spaces that the ecological framework incorporates. Another common result is that factors such as economic, social, legal, political, and natural resources and contexts contribute to the health, education and employment opportunities, and to the overall well-being of people with disabilities. The ecological framework sees all these factors from a meta-systemic perspective, where bi-directional interactions are expected and desired, and also from a human rights point of view, where the inherent value of people is upheld at its highest standard.

Gestão estratégica numa unidade privada de saúde: a perspetiva do balanced scorecard

Dissertação de Mestrado, Gestão de Unidades de Saúde, Faculdade de Economia, Universidade do Algarve, 2016

Spanish Rheumatology Society and Hospital Pharmacy Society Consensus on recommendations for biologics optimization in patients with rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis

The aim of this study was to establish guidelines for the optimization of biologic therapies for health professionals involved in the management of patients with RA, AS and PsA. Recommendations were established via consensus by a panel of experts in rheumatology and hospital pharmacy, based on analysis of available scientific evidence obtained from four systematic reviews and on the clinical experience of panellists. The Delphi method was used to evaluate these recommendations, both between panellists and among a wider group of rheumatologists. Previous concepts concerning better management of RA, AS and PsA were reviewed and, more specifically, guidelines for the optimization of biologic therapies used to treat these diseases were formulated. Recommendations were made with the aim of establishing a plan for when and how to taper biologic treatment in patients with these diseases. The recommendations established herein aim not only to provide advice on how to improve the risk:benefit ratio and efficiency of such treatments, but also to reduce variability in daily clinical practice in the use of biologic therapies for rheumatic diseases