Functional Magnetic Resonance Imaging Neurofeedback and Motor training for Parkinson’s Disease: Randomised Trial

Objective: Real-time functional magnetic resonance imaging (rt-fMRI) neurofeedback (NF) uses feedback of the patient’s own brain activity to self-regulate brain networks which in turn could lead to a change in behaviour and clinical symptoms. The objective was to determine the effect of neurofeedback and motor training and motor training (MOT) alone on motor and non-motor functions in Parkinson’s disease (PD) in a 10-week small Phase I randomised controlled trial. Methods: 30 patients with PD (Hoehn & Yahr I-III) and no significant comorbidity took part in the trial with random allocation to two groups. Group 1 (NF: 15 patients) received rt-fMRI-NF with motor training. Group 2 (MOT: 15 patients) received motor training alone. The primary outcome measure was the Movement Disorder Society – Unified Parkinson’s Disease Rating Scale-Motor scale (MDS-UPDRS-MS), administered pre- and post-intervention ‘off-medication’. The secondary outcome measures were the ‘on-medication’ MDS-UPDRS, the Parkinson’s disease Questionnaire-39, and quantitative motor assessments after 4 and 10 weeks. Results: Patients in the NF group were able to upregulate activity in the supplementary motor area by using motor imagery. They improved by an average of 4.5 points on the MDS-UPDRS-MS in the ‘off-medication’ state (95% confidence interval: -2.5 to -6.6), whereas the MOT group improved only by 1.9 points (95% confidence interval +3.2 to -6.8). However, the improvement did not differ significantly between the groups. No adverse events were reported in either group. Interpretation: This Phase I study suggests that NF combined with motor training is safe and improves motor symptoms immediately after treatment, but larger trials are needed to explore its superiority over active control conditions. Clinical Trial website : Unique Identifier: NCT01867827 URL: https://clinicaltrials.gov/ct2/show/NCT01867827?term=NCT01867827&rank=1

Compassion and its role in the clinical encounter – An argument for compassion training

Empathic communication, (i.e. emotionally engaging with a patient), is an important part of the therapeutic relationship. It has been shown to improve the health and therapeutic outcomes for patients by improving diagnosis and compliance. In the West, front-line medical professionals, including herbal medicine practitioners, put themselves at risk of burnout and compassion fatigue by giving emotionally intensive care. While treatments for compassion fatigue and burnout are available, another way forward is needed to ensure healthcare professionals do not become ill; one that will enable both patients and healthcare professionals to receive the care needed. In this paper it is argued that compassion, which is defined in this paper, involves different neural circuitry to empathy and can protect healthcare professionals from the effects of stress that can, if not addressed, lead to burnout. Traditional Buddhist meditation techniques such as loving-kindness meditation have been shown to increase compassion in non-meditative states. Short daily sessions of such mediation practices have been shown to improve compassion in a way that protects healthcare professionals from burnout.

Integration of learning and practice as part of the educational system development in Eritrea. "School Management" - a distance learning program by technical university of Kaiserslautern

The distance learning program "School Management" supports decision makers at the school and ministerial levels in the shaping of formal and informal learning processes at different levels in schools and curricula in Eritrea. This paper examines how the distance learning program is interconnected to educational system development. (DIPF/Orig.)

Building peace by supporting post-conflict electoral processes

Les élections post-conflit ou élections de sortie de crise organisées sous l’égide de la communauté internationale en vue de rétablir la paix dans les pays sortant de violents conflits armés ont un bilan mixte caractérisé par le succès ou l’échec selon les cas. Ce bilan mitigé représente le problème principal auquel cette recherche tente de répondre à travers les questions suivantes : l’assistance électorale étrangère est-elle efficace comme outil de rétablissement de la paix dans les sociétés post-conflit? Qu’est ce qui détermine le succès ou l’échec des élections post-conflit à contribuer efficacement au rétablissement de la paix dans les sociétés déchirées par la guerre? Pour résoudre cette problématique, cette thèse développe une théorie de l’assistance électorale en période post-conflit centrée sur les parties prenantes à la fois du conflit armé et du processus électoral. Cette théorie affirme que l’élément clé pour le succès des élections post-conflit dans le rétablissement de la paix est le renforcement de la capacité de négociation des parties prenantes à la fois dans le processus de paix et dans le processus électoral post-conflit. Dans les situations post-conflit, une assistance électorale qui se voudrait complète et efficace devra combiner à la fois le processus électoral et le processus de paix. L’assistance électorale sera inefficace si elle se concentre uniquement sur les aspects techniques du processus électoral visant à garantir des élections libres, transparentes et équitables. Pour être efficace, l’accent devra également être mis sur les facteurs supplémentaires qui peuvent empêcher la récurrence de la guerre, tels que l’habilité des individus et des groupes à négocier et à faire des compromis sur les grandes questions qui peuvent menacer le processus de paix. De fait, même des élections transparentes comme celles de 1997 au Liberia saluées par la communauté internationale n’avaient pas réussi à établir des conditions suffisantes pour éviter la reprise des hostilités. C’est pourquoi, pour être efficace, l’assistance électorale dans les situations de post-conflit doit prendre une approche globale qui priorise l’éducation civique, la sensibilisation sur les droits et responsabilités des citoyens dans une société démocratique, le débat public sur les questions qui divisent, la participation politique, la formation au dialogue politique, et toute autre activité qui pourrait aider les différentes parties à renforcer leur capacité de négociation et de compromis. Une telle assistance électorale fera une contribution à la consolidation de la paix, même dans le contexte des élections imparfaites, comme celles qui se sont détenues en Sierra Leone en 2002 ou au Libéria en 2005. Bien que la littérature sur l’assistance électorale n’ignore guère l’importance des parties prenantes aux processus électoraux post-conflit (K. Kumar, 1998, 2005), elle a fortement mis l’accent sur les mécanismes institutionnels. En effet, la recherche académique et professionnelle est abondante sur la réforme des lois électorales, la reforme constitutionnelle, et le développement des administrations électorales tels que les commissions électorales, ainsi que l’observation électorale et autres mécanismes de prévention de la fraude électorale, etc. (Carothers & Gloppen, 2007). En d’autres termes, les décideurs et les chercheurs ont attribué jusqu’à présent plus d’importance à la conception et au fonctionnement du cadre institutionnel et des procédures électorales. Cette thèse affirme qu’il est désormais temps de prendre en compte les participants eux-mêmes au processus électoral à travers des types d’assistance électorale qui favoriseraient leur capacité à participer à un débat pacifique et à trouver des compromis aux questions litigieuses. Cette approche plus globale de l’assistance électorale qui replace l’élection post-conflit dans le contexte plus englobant du processus de paix a l’avantage de transformer le processus électoral non pas seulement en une expérience d’élection de dirigeants légitimes, mais aussi, et surtout, en un processus au cours duquel les participants apprennent à régler leurs points de vue contradictoires à travers le débat politique dans un cadre institutionnel avec des moyens légaux et légitimes. Car, si le cadre institutionnel électoral est important, il reste que le résultat du processus électoral dépendra essentiellement de la volonté des participants à se conformer au cadre institutionnel et aux règles électorales.

IntelliChair: a non-intrusive sitting posture and sitting activity recognition system

Current Ambient Intelligence and Intelligent Environment research focuses on the interpretation of a subject’s behaviour at the activity level by logging the Activity of Daily Living (ADL) such as eating, cooking, etc. In general, the sensors employed (e.g. PIR sensors, contact sensors) provide low resolution information. Meanwhile, the expansion of ubiquitous computing allows researchers to gather additional information from different types of sensor which is possible to improve activity analysis. Based on the previous research about sitting posture detection, this research attempts to further analyses human sitting activity. The aim of this research is to use non-intrusive low cost pressure sensor embedded chair system to recognize a subject’s activity by using their detected postures. There are three steps for this research, the first step is to find a hardware solution for low cost sitting posture detection, second step is to find a suitable strategy of sitting posture detection and the last step is to correlate the time-ordered sitting posture sequences with sitting activity. The author initiated a prototype type of sensing system called IntelliChair for sitting posture detection. Two experiments are proceeded in order to determine the hardware architecture of IntelliChair system. The prototype looks at the sensor selection and integration of various sensor and indicates the best for a low cost, non-intrusive system. Subsequently, this research implements signal process theory to explore the frequency feature of sitting posture, for the purpose of determining a suitable sampling rate for IntelliChair system. For second and third step, ten subjects are recruited for the sitting posture data and sitting activity data collection. The former dataset is collected byasking subjects to perform certain pre-defined sitting postures on IntelliChair and it is used for posture recognition experiment. The latter dataset is collected by asking the subjects to perform their normal sitting activity routine on IntelliChair for four hours, and the dataset is used for activity modelling and recognition experiment. For the posture recognition experiment, two Support Vector Machine (SVM) based classifiers are trained (one for spine postures and the other one for leg postures), and their performance evaluated. Hidden Markov Model is utilized for sitting activity modelling and recognition in order to establish the selected sitting activities from sitting posture sequences.2. After experimenting with possible sensors, Force Sensing Resistor (FSR) is selected as the pressure sensing unit for IntelliChair. Eight FSRs are mounted on the seat and back of a chair to gather haptic (i.e., touch-based) posture information. Furthermore, the research explores the possibility of using alternative non-intrusive sensing technology (i.e. vision based Kinect Sensor from Microsoft) and find out the Kinect sensor is not reliable for sitting posture detection due to the joint drifting problem. A suitable sampling rate for IntelliChair is determined according to the experiment result which is 6 Hz. The posture classification performance shows that the SVM based classifier is robust to “familiar” subject data (accuracy is 99.8% with spine postures and 99.9% with leg postures). When dealing with “unfamiliar” subject data, the accuracy is 80.7% for spine posture classification and 42.3% for leg posture classification. The result of activity recognition achieves 41.27% accuracy among four selected activities (i.e. relax, play game, working with PC and watching video). The result of this thesis shows that different individual body characteristics and sitting habits influence both sitting posture and sitting activity recognition. In this case, it suggests that IntelliChair is suitable for individual usage but a training stage is required.

Developmental TVET rhetoric in-action: the White Paper for post-school education and training in South Africa

This paper explores the extent to which latest developments in the Technical and Vocational Education and Training System in South Africa respond to key principles espoused for a developmental, democratic and inclusionary ideal. The White Paper for post school education and training approved by Cabinet in November, 2013 is referred to by the Minister as the “definitive statement of the governments vision for the post school system” and as such represents a crucial strategy document intended to chart the TVET direction to 2030. Using key theoretical constructs from development theory, this paper provides an assessment of the TVET strategy contained is the paper and explores the extent to which it does respond to the agenda defined by the promise. It is argued that the challenges outlined are not yet able to provide the blueprint for a TVET transformative vision. It is concluded that while the development rhetoric contained in the paper is plausible, the creative tinkering of the system is unlikely to lead to the radical revisioning necessary for a truly transformative TVET system. The underlying assumptions regarding purpose, impact and outcome will need to be carefully reconsidered if the system is to be responsive to the promises of the democratic developmental ideal to which the government is committed. (DIPF/Orig.)

Non-medical prescribers and benzodiazepines: A qualitative study.

Benzodiazepines continue to be widely prescribed in primary care for longer than guidelines advise and can cause adverse consequences for those who have long-term prescriptions. The aim of this study was to explore the experience of nonmedical prescribers (NMPs) in relation to their role in improving benzodiazepine prescribing management in primary care. A qualitative study using a thematic analysis framework, in which face-to-face interviews with eight NMPs from the disciplines of nursing and pharmacy were conducted in their areas of practice in 2011 in rural localities in southern Scotland. The NMPs view their qualification as rigorous in its capacity to promote more focused and confident practice, and provide detailed knowledge about medications and the ability to question the appropriateness of medicines. As medication review is an integral part of the role of the NMP they are suited to contribute positively to benzodiazepine prescribing management. Although several obstacles to the successful integration and full utilization of non-medical prescribing currently exist, more training in the recognition of mild-to-moderate mental health problems, psychopharmacology and alternative interventions would allow this role to be assumed with confidence. NMPs may have a useful role to play in benzodiazepine prescribing. NMPs have regular contact with patients in the older age group and those with chronic illnesses, and are in a prime position to utilize opportunistic medication review to improve concordance in this area of prescribing.

Assessment of faculty training program for the use of e-learning platforms: analysis of current use

5th International Conference on Education and New Learning Technologies (Barcelona, Spain. 1-3 July, 2013)

Swimming training repercussion on metabolic and structural bone development: benefits of the incorporation of whole body vibration or pilometric training; the RENACIMIENTO project

Introduction: Enviromental factors such as exercise participation and nutrition have often been linked to bone improvements. However, not all sports have the same effects, being non-osteogenic sports such as swimming defined as negative or neutral sports to practice regarding bone mass by some authors, similarly exercise-diet interaction in especific groups is still not clear. Objective: To present the methodology of the RENACIMENTO project that aims to evaluate body composition and more specifically bone mass by several techniques in adolescent swimmers and to observe the effects and perdurability of whole body vibration (WBV) and jumping intervention (JIN) on body composition and fitness on this population and explore posible diet interactions. Design: Randomized controlled trial. Methods: 78 swimmers (12-17 y) and 26 sex- and age-matched controls will participate in this study. Dual energy X-ray, peripheral Quantitative Computed Tomography, Quantitative Ultrasound, Bioelectrical Impedance Analysis, and anthropometry measurements will be performed in order to evaluate body composition. Physical activity, nutrition, pubertal development and socio-economical status may act as confounders of body composition and therefore will also be registered. Several fitness factors regarding strength, endurance, performance and others will also be registered to evaluate differences with controls and act as confounders. A 7-month WBV therapy will be performed by 26 swimmers consisting of a training of 15 minutes 3 times per week. An 8 month JIM will also be performed by 26 swimmers 3 times per week. The remaining 26 swimmers will continue their normal swimming training. Four evaluations will be performed, the first one in order to describe differences between swimmers and controls. The second one to describe the effects of the interventions and the third and fourth evaluations to describe the perdurability of the effects of the WBV and JIN. Conclusion: The RENACIMIENTO project will allow to answer several questions regarding body composition, fitness, bone mass and interaction with diet of adolescent swimmers, describe swimming as a positive, negative or neutral sport to practice regarding these parameters and elucidate the effects and perdurability of WBV and JIM on body composition.

Relação supervisiva e desenvolvimento da identidade profissional: acompanhamento das práticas clínicas dos estudantes de enfermagem

Este estudo centrou-se num Curso de Licenciatura em Enfermagem e teve como objetivo compreender a influência da relação supervisiva no desenvolvimento da identidade profissional dos estudantes. Os eixos estruturantes que suportam esta investigação e que concorrem para a definição do seu objeto de estudo articulam-se em torno da relação supervisiva, do desenvolvimento de competências profissionais e do desenvolvimento da identidade pessoal e profissional em contexto clínico. A formação desenvolvida através da prática clínica destina-se a preparar indivíduos de acordo com a atual realidade socioprofissional, onde os sujeitos, independentemente da singularidade de cada um, desenvolvem saberes adquiridos em sala de aula. Quando comparada com o espaço escolar, a aprendizagem em contexto clínico é condicionada por fatores que se caraterizam por maior imprevisibilidade e obriga frequentemente o estudante a confrontar-se com situações únicas e impares. A identidade dos estudantes torna-se assim construída e vivida a partir de um conjunto de dimensões que ocorrem no decurso das vivências clínicas. Metodologicamente optou-se por um estudo etnográfico no âmbito do paradigma qualitativo, numa abordagem longitudinal segundo a lógica do estudo de caso. A natureza dos dados a recolher englobou ainda o recurso a procedimentos de natureza quantitativa. Como técnica de recolha de dados recorremos à observação participante, entrevistas semiestruturadas e questionários. O estudo desenvolveu-se numa Escola Superior de Enfermagem da Zona Norte do país e fizeram parte da população 69 estudantes de uma turma de segundo ano, quatro tutores e um professor. O plano de estudo da referida escola está organizado de forma a que a aprendizagem dos estudantes seja progressivamente integradora de saberes interligando a componente teórica com a componente prática. Assim, os ensinos clínicos estão distribuídos entre o 2º e o 4º ano. Da análise e discussão dos dados e subsequentes conclusões ressalta que, quer a relação supervisiva, quer os contextos clínicos, foram influenciadores do desenvolvimento de competências profissionais, bem como da identidade pessoal e profissional dos estudantes. Verificamos que os dois contextos clínicos estudados – medicina e cirurgia – favoreceram o desenvolvimento de competências distintas, no entanto complementares. Tornou-se visível que, os supervisores do contexto de medicina, possuidores de uma visão holística da profissão de enfermagem, promoveram nos estudantes uma visão integradora do doente, resultante de uma contínua atitude reflexiva sobre a Pessoa Humana. Por sua vez, no contexto de cirurgia, caraterizada por intervenções mais invasivas e mais centradas no tratar, as competências mais valorizadas pelos tutores, embora que de uma forma não verbalmente assumida, foram do domínio técnicocientífico, com especial relevo pelas competências instrumentais.

Effect of haptic guidance and error amplification robotic training interventions on the immediate improvement of timing among individuals that had a stroke

Abstract : Many individuals that had a stroke have motor impairments such as timing deficits that hinder their ability to complete daily activities like getting dressed. Robotic rehabilitation is an increasingly popular therapeutic avenue in order to improve motor recovery among this population. Yet, most studies have focused on improving the spatial aspect of movement (e.g. reaching), and not the temporal one (e.g. timing). Hence, the main aim of this study was to compare two types of robotic rehabilitation on the immediate improvement of timing accuracy: haptic guidance (HG), which consists of guiding the person to make the correct movement, and thus decreasing his or her movement errors, and error amplification (EA), which consists of increasing the person’s movement errors. The secondary objective consisted of exploring whether the side of the stroke lesion had an effect on timing accuracy following HG and EA training. Thirty-four persons that had a stroke (average age 67 ± 7 years) participated in a single training session of a timing-based task (simulated pinball-like task), where they had to activate a robot at the correct moment to successfully hit targets that were presented a random on a computer screen. Participants were randomly divided into two groups, receiving either HG or EA. During the same session, a baseline phase and a retention phase were given before and after each training, and these phases were compared in order to evaluate and compare the immediate impact of HG and EA on movement timing accuracy. The results showed that HG helped improve the immediate timing accuracy (p=0.03), but not EA (p=0.45). After comparing both trainings, HG was revealed to be superior to EA at improving timing (p=0.04). Furthermore, a significant correlation was found between the side of stroke lesion and the change in timing accuracy following EA (r[subscript pb]=0.7, p=0.001), but not HG (r[subscript pb]=0.18, p=0.24). In other words, a deterioration in timing accuracy was found for participants with a lesion in the left hemisphere that had trained with EA. On the other hand, for the participants having a right-sided stroke lesion, an improvement in timing accuracy was noted following EA. In sum, it seems that HG helps improve the immediate timing accuracy for individuals that had a stroke. Still, the side of the stroke lesion seems to play a part in the participants’ response to training. This remains to be further explored, in addition to the impact of providing more training sessions in order to assess any long-term benefits of HG or EA.

Engraulis encrasicolus (Linnaeus, 1758): technical report about extraction and recognition of the digestive tract contents in early stages of the life cycle

The study of ichthyio-plankton stages and its relations with the environment and other organisms is therefore crucial for a correct use of fishery resources. In this context, the extraction and the analysis of the content of the digestive tract, is a key method for the identification of the diet in early larval stages, the determination of the resources they rely on and possibly a comparison with the diet of other species. Additionally this approach could be useful in determination on occurrence of species competition. This technique is preceded by the analysis of morphometric data (Blackith & Reyment, 1971; Marcus, 1990), that is the acquisition of quantitative variables measured from the morphology of the object of study. They are linear distances, count, angles and ratios. The subsequent application of multivariate statistical methods, aims to quantify the changes in morphological measures between and within groups, relating them to the type and size of prey and evaluate if some changes appear in food choices along the larvae growth.

Leadership training and regular communication identified as key strategies for the development of the Australian pineapple industry

Changes in the circumstances of the Australian pineapple industry left growers with a leadership vacuum, limited technical support and no funds for conducting research and marketing. Inspirational leadership training together with regular district farm meetings were used to assist the Australian pineapple industry to successfully adapt to these challenges. All growers were assigned to one of a number of regional grower study groups and regular on-farm meetings commenced to facilitate communication between growers, transfer of technology, awareness of industry affairs and an opportunity to become involved in industry business. A leader was appointed within each study group and these leaders attended a leadership course consisting of three, three-day modules. These original course graduates formed the nucleus of a new grower representative group which subsequently instigated levies to fund research and marketing. Two more courses have since been conducted to provide the depth of leadership to satisfy the growers' desire to rotate industry leadership on a regular basis.

Participation Space Studies: a socio-technical exploration of activist and community groups’ use of online and offline spaces to support their work

Participation Space Studies explore eParticipation in the day-to-day activities of local, citizen-led groups, working to improve their communities. The focus is the relationship between activities and contexts. The concept of a participation space is introduced in order to reify online and offline contexts where people participate in democracy. Participation spaces include websites, blogs, email, social media presences, paper media, and physical spaces. They are understood as sociotechnical systems: assemblages of heterogeneous elements, with relevant histories and trajectories of development and use. This approach enables the parallel study of diverse spaces, on and offline. Participation spaces are investigated within three case studies, centred on interviews and participant observation. Each case concerns a community or activist group, in Scotland. The participation spaces are then modelled using a Socio-Technical Interaction Network (STIN) framework (Kling, McKim and King, 2003). The participation space concept effectively supports the parallel investigation of the diverse social and technical contexts of grassroots democracy and the relationship between the case-study groups and the technologies they use to support their work. Participants’ democratic participation is supported by online technologies, especially email, and they create online communities and networks around their goals. The studies illustrate the mutual shaping relationship between technology and democracy. Participants’ choice of technologies can be understood in spatial terms: boundaries, inhabitants, access, ownership, and cost. Participation spaces and infrastructures are used together and shared with other groups. Non-public online spaces, such as Facebook groups, are vital contexts for eParticipation; further, the majority of participants’ work is non-public, on and offline. It is informational, potentially invisible, work that supports public outputs. The groups involve people and influence events through emotional and symbolic impact, as well as rational argument. Images are powerful vehicles for this and digital images become an increasingly evident and important feature of participation spaces throughout the consecutively conducted case studies. Collaboration of diverse people via social media indicates that these spaces could be understood as boundary objects (Star and Griesemer, 1989). The Participation Space Studies draw from and contribute to eParticipation, social informatics, mediation, social shaping studies, and ethnographic studies of Internet use.