New tools for cognitive and motor rehabilitation: development and clinical validation

Nervous system disorders are associated with cognitive and motor deficits, and are responsible for the highest disability rates and global burden of disease. Their recovery paths are vulnerable and dependent on the effective combination of plastic brain tissue properties, with complex, lengthy and expensive neurorehabilitation programs. This work explores two lines of research, envisioning sustainable solutions to improve treatment of cognitive and motor deficits. Both projects were developed in parallel and shared a new sensible approach, where low-cost technologies were integrated with common clinical operative procedures. The aim was to achieve more intensive treatments under specialized monitoring, improve clinical decision-making and increase access to healthcare. The first project (articles I – III) concerned the development and evaluation of a web-based cognitive training platform (COGWEB), suitable for intensive use, either at home or at institutions, and across a wide spectrum of ages and diseases that impair cognitive functioning. It was tested for usability in a memory clinic setting and implemented in a collaborative network, comprising 41 centers and 60 professionals. An adherence and intensity study revealed a compliance of 82.8% at six months and an average of six hours/week of continued online cognitive training activities. The second project (articles IV – VI) was designed to create and validate an intelligent rehabilitation device to administer proprioceptive stimuli on the hemiparetic side of stroke patients while performing ambulatory movement characterization (SWORD). Targeted vibratory stimulation was found to be well tolerated and an automatic motor characterization system retrieved results comparable to the first items of the Wolf Motor Function Test. The global system was tested in a randomized placebo controlled trial to assess its impact on a common motor rehabilitation task in a relevant clinical environment (early post-stroke). The number of correct movements on a hand-to-mouth task was increased by an average of 7.2/minute while the probability to perform an error decreased from 1:3 to 1:9. Neurorehabilitation and neuroplasticity are shifting to more neuroscience driven approaches. Simultaneously, their final utility for patients and society is largely dependent on the development of more effective technologies that facilitate the dissemination of knowledge produced during the process. The results attained through this work represent a step forward in that direction. Their impact on the quality of rehabilitation services and public health is discussed according to clinical, technological and organizational perspectives. Such a process of thinking and oriented speculation has led to the debate of subsequent hypotheses, already being explored in novel research paths.

Master in Innovative Tourism Development: a blended learning experience in the Polytechnic Institute of Viana do Castelo

This chapter analyses a Portuguese HEI’s first experience with blended learning. Focusing on the Master in Innovative Tourism Development currently being held at the Superior School of Technology and Management of the Polytechnic Institute of Viana do Castelo, it presents the institutional background and rationale behind the course’s implementation, identifying its strengths and weaknesses, as well as areas of potential development. Based on an evaluation research carried out throughout the course’s first three editions and that involved students, faculty and institutional leaders, it summarizes the main results of a long term-study, putting forth a set of recommendations for improvements and defining potential areas of intervention in future editions of the course.

Audio games: investigation of the potential through prototype development

This article discusses the potential of audio games based on the evaluation of three projects: a story-driven audio role-playing game (RPG), an interactive audiobook with RPG elements, and a set of casual sound-based games. The potential is understood, both in popularity and playability terms. The first factor is connected to the degree of players’ interest, while the second one to the degree of their engagement in sound-based game worlds. Although presented projects are embedded within the landscape of past and contemporary audio games and gaming platforms, the authors reach into the near future, concluding with possible development directions for this non-visual interactive entertainment.

Structural Time Series Modeling: an Application to Environmental Variables

A structural time series model is one which is set up in terms of components which have a direct interpretation. In this paper, the discussion focuses on the dynamic modeling procedure based on the state space approach (associated to the Kalman filter), in the context of surface water quality monitoring, in order to analyze and evaluate the temporal evolution of the environmental variables, and thus identify trends or possible changes in water quality (change point detection). The approach is applied to environmental time series: time series of surface water quality variables in a river basin. The statistical modeling procedure is applied to monthly values of physico- chemical variables measured in a network of 8 water monitoring sites over a 15-year period (1999-2014) in the River Ave hydrological basin located in the Northwest region of Portugal.

Does a peer model’s task proficiency influence children’s solution choice and innovation?

The current study investigated whether 4- to 6-year-old children’s task solution choice was influenced by the past proficiency of familiar peer models and the children’s personal prior task experience. Peer past proficiency was established through behavioral assessments of interactions with novel tasks alongside peer and teacher predictions of each child’s proficiency. Based on these assessments, one peer model with high past proficiency and one age-, sex-, dominance-, and popularity-matched peer model with lower past proficiency were trained to remove a capsule using alternative solutions from a three-solution artificial fruit task. Video demonstrations of the models were shown to children after they had either a personal successful interaction or no interaction with the task. In general, there was not a strong bias toward the high past-proficiency model, perhaps due to a motivation to acquire multiple methods and the salience of other transmission biases. However, there was some evidence of a model-based past-proficiency bias; when the high past-proficiency peer matched the participants’ original solution, there was increased use of that solution, whereas if the high past-proficiency peer demonstrated an alternative solution, there was increased use of the alternative social solution and novel solutions. Thus, model proficiency influenced innovation.

PICTOAPRENDE: Design and evaluation of a tool that contributes to the personal autonomy of children and youth diagnosed with autism spectrum disorder in Ecuador

This paper presents the development and evaluation of PICTOAPRENDE, which is an interactive software designed to improve oral communication. Additionally, it contributes to the development of children and youth who are diagnosed with autism spectrum disorder (ASD) in Ecuador. To fulfill this purpose initially analyzes the intervention area where the general characteristics of people with ASD and their status in Ecuador is described. Statistical techniques used for this evaluation constitutes the basis of this study. A section that presents the development of research-based cognitive and social parameters of the area of intervention is also shown. Finally, the algorithms to obtain the measurements and experimental results along with the analysis of them are presented.

On Growth Rate of Wind Waves: Impact of Short-Scale Breaking Modulations

The wave generation model based on the rapid distortion concept significantly underestimates empirical values of the wave growth rate. As suggested before, inclusion of the aerodynamic roughness modulations effect on the amplitude of the slope-correlated surface pressure could potentially reconcile this model approach with observations. This study explores the role of short-scale breaking modulations to amplify the growth rate of modulating longer waves. As developed, airflow separations from modulated breaking waves result in strong modulations of the turbulent stress in the inner region of the modulating waves. In turn, this leads to amplifying the slope-correlated surface pressure anomalies. As evaluated, such a mechanism can be very efficient for enhancing the wind-wave growth rate by a factor of 2-3.

LA ESCOLARIZACIÓN DE LA BIBLIOTECA PÚBLICA, CON UNA PROPUESTA PARA EXTENDER LA COBERTURA DE LAS BIBLIOTECAS PÚBLICAS OFICIALES DE COSTA RICA A LA COMUNIDAD

De acuerdo con los resultados obtenidos por medio del diagnóstico y a fin de reducir el fenómeno de la escolarización en las bibliotecas públicas estudiadas, se elaboró una propuesta que gira en torno a la fase de organización, distribución, promoción y evaluación de un nuevo modelo de gestión fundamentado en el desarrollo de un servicio de información a la comunidad (SIC). 

Predicting Plant Performance Under Simultaneously Changing Environmental Conditions-The Interplay Between Temperature, Light, and Internode Growth

Plant performance is significantly influenced by prevailing light and temperature conditions during plant growth and development. For plants exposed to natural fluctuations in abiotic environmental conditions it is however laborious and cumbersome to experimentally assign any contribution of individual environmental factors to plant responses. This study aimed at analyzing the interplay between light, temperature and internode growth based on model approaches. We extended the light-sensitive virtual plant model L-Cucumber by implementing a common Arrhenius function for appearance rates, growth rates, and growth durations. For two greenhouse experiments, the temperature-sensitive model approach resulted in a precise prediction of cucumber mean internode lengths and number of internodes, as well as in accurately predicted patterns of individual internode lengths along the main stem. In addition, a system's analysis revealed that environmental data averaged over the experimental period were not necessarily related to internode performance. Finally, the need for a species-specific parameterization of the temperature response function and related aspects in modeling temperature effects on plant development and growth is discussed.

Impfung gegen humane Papillomaviren (HPV) zur Prävention HPV 16/18 induzierter Zervixkarzinome und derer Vorstufen

Einleitung: Notwendige Voraussetzung für die Entstehung von Zervixkarzinomen ist eine persistierende Infektion mit humanen Papillomaviren (HPV). Die HPV-Typen 16 und 18 verursachen mit etwa 70% den überwiegenden Teil der Zervixkarzinome. Seit 2006/2007 stehen zwei Impfstoffe gegen HPV 16 und 18 zur Verfügung. Fragestellung: Wie effektiv ist die HPV-Impfung hinsichtlich der Reduktion von Zervixkarzinomen bzw. ihren Vorstufen (CIN)? Stellt die HPV-Impfung eine kosteneffektive Ergänzung zur derzeitigen Screeningpraxis dar? Gibt es Unterschiede bezüglich der Kosten-Effektivität zwischen den beiden verfügbaren Impfstoffen? Sollte aus gesundheitsökonomischer Perspektive eine Empfehlung für den Einsatz der HPV-Impfung gegeben werden? Falls ja, welche Empfehlungen bezüglich der Ausgestaltung einer Impfstrategie lassen sich ableiten? Welche ethischen, sozialen und juristischen Implikationen sind zu berücksichtigen? Methoden: Basierend auf einer systematischen Literaturrecherche werden randomisierte kontrollierte Studien zur Wirksamkeit der HPV-Impfungen für die Prävention von Zervixkarzinomen bzw. deren Vorstufen, den zervikalen intraepithelialen Neoplasien, identifiziert. Gesundheitsökonomische Modellierungen werden zur Beantwortung der ökonomischen Fragestellungen herangezogen. Die Beurteilung der Qualität der medizinischen und ökonomischen Studien erfolgt mittels anerkannter Standards zur systematischen Bewertung wissenschaftlicher Studien Ergebnisse: Bei zu Studienbeginn HPV 16/18 negativen Frauen, die alle Impfdosen erhalten haben, liegt die Wirksamkeit der Impfungen gegen HPV 16/18-induzierten CIN 2 oder höher bei 98% bis 100%. Nebenwirkungen der Impfung sind vor allem mit der Injektion assoziierte Beschwerden (Rötungen, Schwellungen, Schmerzen). Es gibt keine signifikanten Unterschiede für schwerwiegende unerwünschte Ereignisse zwischen Impf- und Placebogruppe. Die Ergebnisse der Basisfallanalysen der gesundheitsökonomischen Modellierungen reichen bei ausschließlicher Berücksichtigung direkter Kostenkomponenten von ca. 3.000 Euro bis ca. 40.000 Euro pro QALY (QALY = Qualitätskorrigiertes Lebensjahr), bzw. von ca. 9.000 Euro bis ca. 65.000 Euro pro LYG (LYG = Gewonnenes Lebensjahr). Diskussion: Nach den Ergebnissen der eingeschlossenen Studien sind die verfügbaren HPV-Impfstoffe wirksam zur Prävention gegen durch HPV 16/18 verursachte prämaligne Läsionen der Zervix. Unklar ist derzeit noch die Dauer des Impfschutzes. Hinsichtlich der Nebenwirkungen ist die Impfung als sicher einzustufen. Allerdings ist die Fallzahl der Studien nicht ausreichend groß, um das Auftreten sehr seltener Nebenwirkungen zuverlässig zu bestimmen. Inwieweit die HPV-Impfung zur Reduktion der Inzidenz und Mortalität des Zervixkarzinoms in Deutschland führen wird, hängt nicht allein von der klinischen Wirksamkeit der Impfstoffe ab, sondern wird von einer Reihe weiterer Faktoren wie der Impfquote oder den Auswirkungen der Impfungen auf die Teilnahmerate an den bestehenden Screeningprogrammen determiniert. Infolge der Heterogenität der methodischen Rahmenbedingungen und Inputparameter variieren die Ergebnisse der gesundheitsökonomischen Modellierungen erheblich. Fast alle Modellanalysen lassen jedoch den Schluss zu, dass die Einführung einer Impfung mit lebenslanger Schutzdauer bei Fortführung der derzeitigen Screeningpraxis als kosteneffektiv zu bewerten ist. Eine Gegenüberstellung der beiden verschiedenen Impfstoffe ergab, dass die Modellierung der tetravalenten Impfung bei der Berücksichtigung von QALY als Ergebnisparameter in der Regel mit einem niedrigeren (besseren) Kosten-Effektivitäts-Verhältnis einhergeht als die Modellierung der bivalenten Impfung, da auch Genitalwarzen berücksichtigt werden. In Sensitivitätsanalysen stellten sich sowohl die Schutzdauer der Impfung als auch die Höhe der Diskontierungsrate als wesentliche Einflussparameter der Kosten-Effektivität heraus. Schlussfolgerung: Die Einführung der HPV-Impfung kann zu einem verringerten Auftreten von Zervixkarzinomen bei geimpften Frauen führen. Jedoch sollten die Impfprogramme von weiteren Evaluationen begleitet werden, um die langfristige Wirksamkeit und Sicherheit beurteilen sowie die Umsetzung der Impfprogramme optimieren zu können. Von zentraler Bedeutung sind hohe Teilnahmeraten sowohl an den Impfprogrammen als auch - auch bei geimpften Frauen - an den Früherkennungsuntersuchungen. Da die Kosten-Effektivität entscheidend von der Schutzdauer, die bislang ungewiss ist, beeinflusst wird, ist eine abschließende Beurteilung der Kosten-Effektivität der HPV-Impfung nicht möglich. Eine langfristige Schutzdauer ist eine bedeutende Vorraussetzung für die Kosten-Effektivität der Impfung. Der Abschluss einer Risk-Sharing-Vereinbarung zwischen Kostenträgern und Herstellerfirmen stellt eine Option dar, um die Auswirkungen der Unsicherheit der Schutzdauer auf die Kosten-Effektivität zu begrenzen.

Modeling height-diameter relationship in pinus pinaster ait. in the forest intervention zone of Lomba, NE-Portugal

In this work, the relationship between diameter at breast height (d) and total height (h) of individual-tree was modeled with the aim to establish provisory height-diameter (h-d) equations for maritime pine (Pinus pinaster Ait.) stands in the Lomba ZIF, Northeast Portugal. Using data collected locally, several local and generalized h-d equations from the literature were tested and adaptations were also considered. Model fitting was conducted by using usual nonlinear least squares (nls) methods. The best local and generalized models selected, were also tested as mixed models applying a first-order conditional expectation (FOCE) approximation procedure and maximum likelihood methods to estimate fixed and random effects. For the calibration of the mixed models and in order to be consistent with the fitting procedure, the FOCE method was also used to test different sampling designs. The results showed that the local h-d equations with two parameters performed better than the analogous models with three parameters. However a unique set of parameter values for the local model can not be used to all maritime pine stands in Lomba ZIF and thus, a generalized model including covariates from the stand, in addition to d, was necessary to obtain an adequate predictive performance. No evident superiority of the generalized mixed model in comparison to the generalized model with nonlinear least squares parameters estimates was observed. On the other hand, in the case of the local model, the predictive performance greatly improved when random effects were included. The results showed that the mixed model based in the local h-d equation selected is a viable alternative for estimating h if variables from the stand are not available. Moreover, it was observed that it is possible to obtain an adequate calibrated response using only 2 to 5 additional h-d measurements in quantile (or random) trees from the distribution of d in the plot (stand). Balancing sampling effort, accuracy and straightforwardness in practical applications, the generalized model from nls fit is recommended. Examples of applications of the selected generalized equation to the forest management are presented, namely how to use it to complete missing information from forest inventory and also showing how such an equation can be incorporated in a stand-level decision support system that aims to optimize the forest management for the maximization of wood volume production in Lomba ZIF maritime pine stands.

External school evaluation : teachers’ perspectives : two case studies from Northern Portugal

The external evaluation of non-higher education schools in Portugal has been developed by the General Inspectorate of Education since 2006. A first cycle of evaluation was completed, covering all educational units in continental Portugal up to 2011. The model of evaluation has since been subject to alterations, and a second cycle of evaluation is now coming to an end. The current model of evaluation is based on documental analysis, analysis of students’ results, and panel interviews with a variety of representatives of the school community, and addresses three domains: results, provision of educational service and management. This paper is part of an ongoing research project, developed by 6 universities and supported by the Portuguese Foundation for Science and Technology (PTDC/CPE-CED/116674/2010) which intends to analyse the impacts and effects this process of external evaluation has had on Portuguese schools. This project includes a variety of perspectives and methodologies. In particular, we will focus on two case studies undertaken in two schools from the northern region of Portugal, and more specifically on the perspectives expressed by the teachers of those schools. These particular schools were chosen because they have been evaluated twice and represent different educational levels (basic and secondary), contexts and results. These case studies included the analysis of documental data, interviews to key informants and a questionnaire directed to teachers (n = 141) – the latter will be the main focus of this paper. Teachers are essential elements of the school community when considering the impacts of external evaluation, as any changes directed at teaching practices, student evaluation, among others are only possible through their direct action and implication. Therefore, their perceptions on the process and its impacts are crucial to the understanding of what does and does not change in schools as a consequence of external evaluation. Although teachers’ opinions are not homogenous and each school reveals a number of differences when it comes to teachers’ perceptions of School Evaluation, it was possible to stress some areas as the most and as the least consensual. Teachers in both schools agree External School Evaluation (ESE) is useful for the identification of the schools’ strengths and weaknesses, values students’ external evaluation results, imposes a model for schools internal evaluation (and in fact contributes to the very existence of internal evaluation practices), and contributes to schools improvement. However teachers in both schools do not believe ESE contributes to teachers’ autonomy produces changes in how curriculum is managed, or leads to innovative teaching practices. These results point to a greater emphasis on change at the levels of school management, self-evaluation and particularly internal evaluation, but little impact on the teaching practices. We believe the classroom is at the core of school practices and teaching processes are essential to any measure of school quality and to their impacts on student learning.

Innovative approaches of regional policy of rural tourism development

The present work intends to study Rural Tourism. More specifically: regional policy of Rural Tourism development. Purpose of this research is creation of innovative qualitative model of regional policy of Rural Tourism development for Ukraine. With this aim literature review was made, developed a research methodology and analysis made. It was established a way of creation of qualitative model, based on studied information and scientific papers. Research methodology was described in next part. Decided to do it in three stages: (1) justification of analytical research; (2) data sample collection and analysis; (3) creating of innovative model of regional policy of Rural Tourism development. Each of these stages have sub stages supported by results of previous. In accordance to methodology, analytical part was made in two steps: (1) analysis of statistical information about rural houses availability; (2) analysis of resources needed for successfully Rural Tourism activity. This part gave information about placement of rural houses by geographical regions and defined most attractive geographical regions for Rural Tourism development. The results showed that the highest rural houses availability is in Western geographical region. Other regions have low level of rural houses availability. However, analysis of resources needed for successful Rural Tourism development showed, that all geographical regions are attractive for organizing Rural Tourism activity. Based on this information an innovative qualitative model of Rural Tourism development was created.

XML-Intensive software development

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Contribuição à estabilidade transitória de sistemas elétricos industriais de unidades estacionárias de produção de petróleo

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Tecnologia, Departamento de Engenharia Elétrica, 2015.