Search results for: Collaboration in Palliative Care Networks in Urban and Rural Regions of Switzerland

Authors: R. Schweighoffer, N. Nagy, E. Reeves, B. Liebig

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Due to aging populations, the need for seamless palliative care provision is of central interest for western societies. An essential aspect of palliative care delivery is the quality of collaboration amongst palliative care providers. Therefore, the current research is based on Bainbridge’s conceptual framework, which provides an outline for the evaluation of palliative care provision. This study is the first one to investigate the predictive validity of spatial distribution on the quantity of interaction amongst various palliative care providers. Furthermore, based on the familiarity principle, we examine whether the extent of collaboration influences the perceived quality of collaboration among palliative care providers in urban versus rural areas of Switzerland. Based on a population-representative survey of Swiss palliative care providers, the results of the current study show that professionals in densely populated areas report higher absolute numbers of interactions and are more satisfied with their collaborative practice. This indicates that palliative care providers who work in urban areas are better embedded into networks than their counterparts in more rural areas. The findings are especially important, considering that efficient collaboration is a prerequisite to achieve satisfactory patient outcomes. Conclusively, measures should be taken to foster collaboration in weakly interconnected palliative care networks.

Keywords: Collaboration, healthcare networks, palliative care, Switzerland.

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Authors: Novita Verayanti Manalu, Alvin Salim, Esti Yunitasari

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Background: Palliative care is caring holistically for patients and families to improve their quality of life. The approach by a multidisciplinary team requires integrated collaboration based on sufficient knowledge of the principles of palliative care as a whole, especially for nurses. Therefore, this study wants to find out the level of knowledge about palliative care of the nurses along the relationship with attitude and performance. Method: This study applies cross-sectional survey design and allows the respondents to fill two questionnaires to determine the level of knowledge and attitude toward palliative care, while one questionnaire is filled by the head nurse to evaluate nurses’ performance. The relationship was analyzed by Spearman rho’s correlation in alpha < 0.05 by SPSS. Results: The majority of respondents were females, age above 25 years old, and married. Most of the nurses are staff nurses and the ratio of education level is not significantly different. The knowledge level is poor, while the attitude and performance are in adequate level. Knowledge may affect attitude, but it does not happen toward performance. Conclusion: There is a need for increased knowledge about palliative care to improve attitude and work performance. Future researchers might use this finding as reference to conduct further study in improving knowledge of palliative care.

Keywords: Knowledge, attitude, work performance, palliative care.

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Authors: Ehrenstorfer Barbara, Peherstorfer Tanja, Nový Jan

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Urbanization and regionalization are two different approaches when it comes to economical structures and development, infrastructure and mobility, quality of life and living, education, social cohesion and many other topics. At first glance, the structures associated with urbanization and regionalization seems to be contradicting. This paper discusses possibilities of transfer and cooperation between rural and urban structures. An empirical investigation contributed to reveal scenarios of supposable forms of exchange and cooperation of remote rural areas and big cities.

Keywords: Learning Regions, Quality of Life and Living, Regional and Rural Development, Social Innovation.

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Authors: R. Bužgová, R. Kozáková, M. Škutová, M. Bar, P. Ressner, P. Bártová

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Introduction: Currently, there has been an increasing concern about the provision of palliative care in non-oncological patients in both professional literature and clinical practice. However, there is not much scientific information on how to provide neurological and palliative care together. The main objective of the project is to create and to verify a concept of neuro-palliative and rehabilitative care for patients with selected neurological diseases in an advanced stage of the disease and also to evaluate bio-psychosocial and spiritual needs of these patients and their caregivers related to the quality of life using created standardized tools. Methodology: Triangulation of research methods (qualitative and quantitative) will be used. A concept of care and assessment tools will be developed by analyzing interviews and focus groups. Qualitative data will be analyzed using grounded theory. The concept of care will be tested in the context of the intervention study. Using quantitative analysis, we will assess the effect of an intervention provided on the saturation of needs, quality of life, and quality of care. A research sample will be made up of the patients with selected neurological diseases (Parkinson´s syndrome, motor neuron disease, multiple sclerosis, Huntington’s disease), together with patients´ family members. Based on the results, educational materials and a certified course for health care professionals will be created. Findings: Based on qualitative data analysis, we will propose the concept of integrated care model combining neurological, rehabilitative and specialist palliative care for patients with selected neurological diseases in different settings of care and services. Patients´ needs related to quality of life will be described by newly created and validated measuring tools before the start of intervention (application of neuro-palliative and palliative approach) and then in the time interval. Conclusion: Based on the results, educational materials and a certified course for doctors and health care professionals will be created.

Keywords: Multidisciplinary approach, neuropalliative care, research, quality of life.

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Authors: Shorena Tsiklauri, Avtandil Sulaberidze, Nino Gomelauri

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In the years followed independence, an economic crisis and some conflicts led to the displacement of many people inside Georgia. The growing poverty, unemployment, low income and its unequal distribution limited access to basic social service have had a clear direct impact on Georgian population dynamics and its age-sex structure. Factors influencing the changing population age structure and urbanization include mortality, fertility, migration and expansion of urban. In this paper presents the main factors of changing the distribution by urban and rural areas. How different are the urban and rural age and sex structures? Does Georgia have the same age-sex structure among their urban and rural populations since 1950s?

Keywords: Age and sex structure of population, Georgia, migration, urban-rural population.

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Authors: Zane Bulderberga

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Spatial dimension in development planning is becoming more topical in 21^st century as a result of changes in population structure. Sustainable spatial development focuses on identifying and using territorial advantages to foster the harmonized development of the entire country, reducing negative effects of population concentration, increasing availability and mobility. EU and national development planning documents state polycentrism as main tool for balance spatial development, including investment concentration in growth centres. If mutual cooperation of growth centres as well as urban–rural cooperation is not fostered, then territorial differences can deepen and create unbalanced development.

The aim of research: to evaluate the urban–rural interaction, elaborating spatial development scenarios in framework of Latvian regional policy. To perform the research monographic, comparison, abstract–logical method, synthesis and analysis will be used when studying the theoretical aspects of research aiming at collecting the ideas of scientists from different countries, concepts, regulations as well as to create meaningful scientific discussion. Hierarchy analysis process (AHP) will be used to state further scenarios of spatial development in Latvia.

Experts from various institutions recognized urban – rural interaction and co-operation as an essential tool for the development. The most important factors for balanced spatial development in Latvia are availability of public transportation and improvement of service availability. Evaluating the three alternative scenarios, it was concluded that the urban – rural partnership will ensure a balanced development in Latvian regions.

Keywords: Rural – urban interaction, rural – urban cooperation, spatial development, AHP.

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Authors: Thiago M. R Dias, Gray F. Moita

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The analysis of scientific collaboration networks has contributed significantly to improving the understanding of how does the process of collaboration between researchers and also to understand how the evolution of scientific production of researchers or research groups occurs. However, the identification of collaborations in large scientific databases is not a trivial task given the high computational cost of the methods commonly used. This paper proposes a method for identifying collaboration in large data base of curriculum researchers. The proposed method has low computational cost with satisfactory results, proving to be an interesting alternative for the modeling and characterization of large scientific collaboration networks.

Keywords: Extraction and data integration, Information Retrieval, Scientific Collaboration.

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Authors: J. K. Shrestha, A. Benta, R. B. Lopes, N. Lopes

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This work provides a practical method for the development of rural road networks in rural areas of developing countries. The proposed methodology enables to determine obligatory points in the rural road network maximizing the number of settlements that have access to basic services within a given maximum distance. The proposed methodology is simple and practical, hence, highly applicable to real-world scenarios, as demonstrated in the definition of the road network for the rural areas of Nepal.

Keywords: Minimum spanning tree, nodal points, rural road network.

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Authors: J. F. Pollo Gaspary, F. Peron Gaspary, E. M. Simão, R. Concatto Beltrame, G. Orengo de Oliveira, M. S. Ristow Ferreira, J.C. Mairesse Siluk, I. F. Minello, F. dos Santos de Oliveira

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Background: Although palliative care policies and services have been developed, research in this area continues to lag. An integrated model of palliative care is suggested, which includes complementary and alternative services aimed at improving the well-being of patients and their families. The palliative aquatics care multi-device (AuBento) uses several electromagnetic techniques to decrease pain and promote well-being through relaxation and interaction among patients, specialists, and family members. Aim: The scope of this paper is to present a preliminary design study of a device capable of exploring the various existing theories on the biomedical application of magnetic fields. This will be achieved by standardizing clinical data collection with sensory integration, and adding new therapeutic options to develop an advanced palliative aquatics care, innovating in symptom and pain management. Methods: The research methodology was based on the Work Package Methodology for the development of projects, separating the activities into seven different Work Packages. The theoretical basis was carried out through an integrative literature review according to the specific objectives of each Work Package and provided a broad analysis, which, together with the multiplicity of proposals and the interdisciplinarity of the research team involved, generated consistent and understandable complex concepts in the biomedical application of magnetic fields for palliative care. Results: Aubento ambience was idealized with restricted electromagnetic exposure (avoiding data collection bias) and sensory integration (allowing relaxation associated with hydrotherapy, music therapy, and chromotherapy or like floating tank). This device has a multipurpose configuration enabling classic or exploratory options on the use of the biomedical application of magnetic fields at the researcher's discretion. Conclusions: Several patients in diverse therapeutic contexts may benefit from the use of magnetic fields or fluids, thus validating the stimuli to clinical research in this area. A device in controlled and multipurpose environments may contribute to standardizing research and exploring new theories. Future research may demonstrate the possible benefits of the aquatics care multi-device AuBento to improve the well-being and symptom control in palliative care patients and their families.

Keywords: Advanced palliative aquatics care, magnetic field therapy, medical device, research design.

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Authors: Nazym Shedenova, Aigul Beimisheva

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The market transformation in Kazakhstan during the last two decades has essentially strengthened a gap between development of urban and rural areas. Implementation of market institutes, transition from public financing to paid rendering of social services, change of forms of financing of social and economic infrastructure have led to strengthening of an economic inequality of social groups, including growth of stratification of the city and the village. Sociological survey of urban and rural households in Almaty city and villages of Almaty region has been carried out within the international research project “Livelihoods Strategies of Private Households in Central Asia: A Rural–Urban Comparison in Kazakhstan and Kyrgyzstan" (Germany, Kazakhstan, Kyrgyzstan). The analysis of statistical data and results of sociological research of urban and rural households allows us to reveal issues of territorial development, to investigate an availability of medical, educational and other services in the city and the village, to reveal an evaluation urban and rural dwellers of living conditions, to compare economic strategies of households in the city and the village.

Keywords: Urban and rural households, social and economic infrastructure, territorial availability.

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Authors: Henning Bjornlund, Alec Zuo, Sarah Wheeler, Rob de Loë

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There is currently intensive debate in Alberta, Canada, regarding rural to urban water reallocation. This paper explores the demographic and attitudinal influences that are associated with the acceptance of water reallocation policies and whether such acceptance differs between urban and rural residents. We investigate three policy orientations in regards to water policies: i) government intervention; ii) environmental protection; and iii) protecting irrigators- water rights. We find that urban dwellers are more likely to favour government intervention while rural dwellers are more likely to support policies that aim at protecting irrigators- water rights. While urban dwellers are also more likely to favour environmental protection, the difference is not statistically significant. We also find that other factors have a significant impact on policy choice irrespective of residence such as demographic and socioeconomic factors as well as the values people hold toward water and the environment.

Keywords: Canada, rural, urban, water transfers.

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Authors: Arsalan Jabbar, Wajiha Javed, Nelofer Mehboob, Zahid Memon

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Introduction: There are multiple social, individual and cultural factors that influence an individual’s decision to adopt family planning methods especially among non-users in patriarchal societies like Pakistan. Non-users, if targeted efficiently, can contribute significantly to country’s CPR. A research study showed that nonusers if convinced to adopt lactational amenorrhea method can shift to long term methods in future. Research shows that if non users are targeted efficiently a 59% reduction in unintended pregnancies in Saharan Africa and South-Central and South-East Asia is anticipated. Methods: We did secondary data analysis on Pakistan Demographic Heath Survey (2012-13) dataset. Use of contraception (never-use/ever-use) was the outcome variable. At univariate level Chi-square/Fisher Exact test was used to assess relationship of baseline covariates with contraception use. Then variables to be incorporated in the model were checked for multicollinearity, confounding and interaction. Then binary logistic regression (with an urban-rural stratification) was done to find relationship between contraception use and baseline demographic and social variables. Results: The multivariate analyses of the study showed that younger women (≤ 29 years)were more prone to be never users as compared to those who were >30 years and this trend was seen in urban areas (AOR 1.92, CI 1.453-2.536) as well as rural areas (AOR 1.809, CI 1.421-2.303). While looking at regional variation, women from urban Sindh (AOR 1.548, CI 1.142-2.099) and urban Balochistan (AOR 2.403, CI 1.504-3.839) had more never users as compared to other urban regions. Women in the rich wealth quintile were more never users and this was seen both in urban and rural localities (urban (AOR 1.106 CI .753-1.624); rural areas (AOR 1.162, CI .887-1.524)) even though these were not statistically significant. Women idealizing more children (>4) are more never users as compared to those idealizing less children in both urban (AOR 1.854, CI 1.275-2.697) and rural areas (AOR 2.101, CI 1.514-2.916). Women who never lost a pregnancy were more inclined to be nonusers in rural areas (AOR 1.394, CI 1.127-1.723) .Women familiar with only traditional or no method had more never users in rural areas (AOR 1.717, CI 1.127-1.723) but in urban areas it wasn’t significant. Women unaware of Lady Health Worker’s presence in their area were more never users especially in rural areas (AOR 1.276, CI 1.014-1.607). Women who did not visit any care provider were more never users (urban (AOR 11.738, CI 9.112-15.121) rural areas (AOR 7.832, CI 6.243-9.826)). Discussion/Conclusion: This study concluded that government, policy makers and private sector family planning programs should focus on the untapped pool of never users (younger women from underserved provinces, in higher wealth quintiles, who desire more children.). We need to make sure to cover catchment areas where there are less LHWs and less providers as ignorance to modern methods and never been visited by an LHW are important determinants of never use. This all is in sync with previous literate from similar developing countries.

Keywords: Contraception, Demographic and Health Survey, Family Planning, Never users.

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Authors: Chen Zhang, Jiwu Wang

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With China's urbanization continuing to accelerate, a amount of rural people flood into China's cities in recent years, and the issue of agriculture, rural areas and farmers is getting more and more serious. In 2005, the Chinese government put forward a plan for “the construction of new rural village", in order to coordinate the development of both urban and rural areas. The planning method of rural region differs sharply from that of urban areas, as same as village social structure and habits of farmer-s life, so the studies which can consider the special needs of village construction in China are absolutely essential. This paper expresses explore current situation and problems existing in the construction of China-s new rural village, such as bigger gap between urban and rural areas, excessive new construction projects, extinct traditional village style and so on. It tries to analyze the deep reason of the present situation of the village from law system, industrial structure, financial sources and planning method. Then it also provides a guide for developing policies and procedures promoting the development of china-s rural areas.

Keywords: Rural areas, village construction, physical planning, law system, financial sources, Public participation, China.

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Authors: Federico Cabitza, Marco P. Locatelli, Marcello Sarini, Carla Simone

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The paper shows how the CASMAS modeling language, and its associated pervasive computing architecture, can be used to facilitate continuity of care by providing members of patientcentered communities of care with a support to cooperation and knowledge sharing through the usage of electronic documents and digital devices. We consider a scenario of clearly fragmented care to show how proper mechanisms can be defined to facilitate a better integration of practices and information across heterogeneous care networks. The scenario is declined in terms of architectural components and cooperation-oriented mechanisms that make the support reactive to the evolution of the context where these communities operate.

Keywords: Pervasive Computing, Communities of Care, HeterogeneousCare Networks, Multi-Agent System.

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Authors: Baubek B. Nogerbek, Alma M. Aidarova

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In this article the authors are researching cultural differences between rural and urban characters in case of contemporary Kazakh cinema.Two motion pictures are analyzed: “Strizh" (2007) by AbaiKulbai and “Seker" (2009) by SabitKurmanbekov.According to the authors- opinion ateenage girl characters in these two films reflect two cultures (urban and rural) of Kazakh society, which displays complicated socio-cultural processes of modern Kazakhstan.

Keywords: Culture (urban and rural), film characters, Kazakh cinema, Kazakh society

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Authors: J. K. Shrestha, A. Benta, R. B. Lopes, N. Lopes

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This paper presents a multi-objective model for addressing two main objectives in designing rural roads networks: minimization of user operation costs and maximization of population covered. As limited budgets often exist, a reasonable trade-off must be obtained in order to account for both cost and social benefits in this type of networks. For a real-world rural road network, the model is solved, where all non-dominated solutions were obtained. Afterwards, an analysis is made on the (possibly) most interesting solutions (the ones providing better trade-offs). This analysis, coupled with the knowledge of the real world scenario (typically provided by decision makers) provides a suitable method for the evaluation of road networks in rural areas of developing countries.

Keywords: Multi-objective, user operation cost, population covered, rural road network.

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Authors: J. F. Pollo Gaspary, F. Peron Gaspary, E. M. Simão, R. Concatto Beltrame, G. Orengo de Oliveira, M. S. Ristow Ferreira, F. Sartori Thies, I. F. Minello, F. dos Santos de Oliveira

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Background: The immune system has evolved several mechanisms to protect the host against cancer, and it has now been suggested that the expansion of its functions may prevent tumor growth and control the symptoms of cancer patients. Two techniques, ozone therapy and pulsed electromagnetic fields (PEMF), are independently associated with an increase in the immune system functions and they maybe help palliative care of patients in these conditions. Case Report: A patient with rectal adenocarcinoma with metastases decides to interrupt the clinical chemotherapy protocol due to refractoriness and side effects. As a palliative care alternative treatment it is suggested to the patient the use of ozone therapy associated with PEMF techniques. Results: The patient reports an improvement in well-being, in autonomy and in pain control. Imaging tests confirm a pause in tumor growth despite more than 60 days without using classic treatment. These results associated with palliative care alternative treatment stimulate the return to the chemotherapy protocol. Discussion: This case illustrates that these two techniques can contribute to the control of tumor growth and refractory symptoms, such as pain, probably by enhancing the immune system. Conclusions: The potential use of the combination of these two therapies, ozone therapy and PEMF therapy, can contribute to palliation of cancer patients, alone or in combination with pharmacological therapies. The conduct of future investigations on this paradigm can elucidate how much these techniques contribute to the survival and well-being of these patients.

Keywords: Cancer, complementary and alternative medicine, ozone therapy, palliative care, PEMF Therapy.

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Authors: Andrea Zielke-Nadkarni

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Pain management is a question of quality of life and an indicator for nursing quality. Chronic pain which is predominant in oncology and palliative nursing situations is perceived today as a multifactorial, individual emotional experience with specific characteristics including the sociocultural dimension when dealing with migrant patients. This dimension of chronic pain is of major importance in professional nursing of migrant patients in hospices or palliative care units. Objectives of the study are: 1. To find out more about the sociocultural views on pain and nursing care, on customs and nursing practices connected with pain of both Turkish Muslim and German Christian women, 2. To improve individual and family oriented nursing practice with view to sociocultural needs of patients in severe pain in palliative care. In a qualitative-explorative comparative study 4 groups of women, Turkish Muslims immigrants (4 from the first generation, 5 from the second generation) and German Christian women of two generations (5 of each age group) of the same age groups as the Turkish women and with similar educational backgrounds were interviewed (semistructured ethnographic interviews using Spradley, 1979) on their perceptions and experiences of pain and nursing care within their families. For both target groups the presentation will demonstrate the following results in detail: Utterance of pain as well as “private” and “public” pain vary within different societies and cultures. Permitted forms of pain utterance are learned in childhood and determine attitudes and expectations in adulthood. Language, especially when metaphors and symbols are used, plays a major role for misunderstandings. The sociocultural context of illness may include specific beliefs that are important to the patients and yet seem more than far-fetched from a biomedical perspective. Pain can be an influential factor in family relationships where respect or hierarchies do not allow the direct utterance of individual needs. Specific resources are often, although not exclusively, linked to religious convictions and are significantly helpful in reducing pain. The discussion will evaluate the results of the study with view to the relevant literature and present nursing interventions and instruments beyond medication that are helpful when dealing with patients from various socio-cultural backgrounds in painful end-oflife situations.

Keywords: Pain management, migrants, sociocultural context, palliative care.

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Authors: Ling Zheng, Yaping Wei, Kang Cao, Songpo Shi, Jinxing Wang

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It-s difficult for China-s current land transfer institutions limited to county-wide to solve the contradiction between urban-rural development and construction land shortage. On the basis of analyzing China-s construction land transfer system, and evaluation toward Transfer of development rights (TDR) practices in Anhui and Chongqing, the passage proposes: (1) we should establish a multi-level land indicators trade market under the guidance of regional spatial objectives, and allow land transfer paid across cities and counties within a specific area following the regulation of both government and market; (2) it would be better to combine organically the policy ntentions of land plan, regional plan, urban plan and economic plan, and link them with land indicators transfer to promote a wider range of urban-rural balance and regional coordination.

Keywords: China's land institutions, transfer of development rights, urban-rural balance, regional coordination.

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Authors: Negar Banan, Mohd Talib Latif

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This study investigated the relationship between urban and rural ozone concentrations and quantified the extent to which ambient rural conditions and the concentrations of other pollutants can be used to predict urban ozone concentrations. The study describes the variations of ozone in weekday and weekends as well as the daily maximum recorded at selected monitoring stations. The results showed that Putrajaya station had the highest concentrations of O3 on weekend due the titration of NO during the weekday. Additionally, Jerantut had the lowest average concentration with a reading value high on Wednesdays. The comparisons of average and maximum concentrations of ozone for the three stations showed that the strongest significant correlation is recorded in Jerantut station with the value R2= 0.769. Ozone concentrations originating from a neighbouring urban site form a better predictor to the urban ozone concentrations than widespread rural ozone at some levels of temporal averaging. It is found that in urban and rural of Malaysian peninsular, the concentration of ozone depends on the concentration of NOx and seasonal meteorological factors. The HYSPLIT Model (the northeast monsoon) showed that the wind direction can also influence the concentration of ozone in the atmosphere in the studied areas.

Keywords: Ozone, Hysplit model, Weekend effect, Daily Average and Daily maximum, Malaysia

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Authors: N. P. Tsephe, S. D. Eyono Obono

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Rural tourism has many economical, environmental, and socio-cultural benefits. However, the development of rural tourism compared to urban tourism is also faced with several challenges added to the disadvantages of rural tourism. The aim of this study is to design a model of the factors affecting the motivations of rural tourists, in an attempt to improve the understanding of rural tourism motivation for the development of that form of tourism. The proposed model is based on a sound theoretical framework. It was designed following a literature review of tourism motivation theoretical frameworks and of rural tourism motivation factors. The tourism motivation theoretical framework that fitted to the best all rural tourism motivation factors was then chosen as the basis for the proposed model. This study hence found that the push and pull tourism motivation framework and the inner and outer directed values theory are the most adequate theoretical frameworks for the modeling of rural tourism motivation.

Keywords: Motivation factors, rural tourism, tourism motivation theories.

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Authors: U. Tumaini, J. Msuya

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Food insecurity is a worrying challenge worldwide with sub-Saharan Africa including Tanzania being the most affected. Although factors that influence household food access security status and ways of coping with such factors have been examined, little has been reported on how these coping strategies vary along the urban-rural continuum especially in medium-sized towns. The purpose of this study was to identify food insecurity coping strategies employed by households and assess whether they are similar along the urban-rural continuum. The study was cross-sectional in design whereby a random sample of 279 households was interviewed using structured questionnaire. Data were analysed using Statistical Package for Social Sciences (SPSS) Version 20 software. It was revealed that the proportion of households relying on less preferred and quality foods, eating fewer meals per day, undertaking work for food or money, performing farm and off-farm activities, and selling fall back assets was higher in rural settings compared to urban and peri-urban areas. Similarly, more households in urban and peri-urban areas cope with food access insecurity by having strict food budgets compared to those in rural households (p ≤ 0.001). The study concludes that food insecurity coping strategies vary significantly from one spatial entity to another. It is thereby recommended that poor, particularly rural households should be supported to diversify their income-generating activities not only for food security purposes during times of food shortage but also as businesses aimed at increasing their household incomes.

Keywords: Food coping strategies, household food insecurity, medium-sized towns, urban-rural continuum.

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Authors: Wenhsuan Lee, Yachi Chang, Yingyih Shih

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In clinical practices, it is common that while facing the unknown progress of their disease, palliative care patients may easily feel anxious and depressed. These types of reactions are a cause of psychosomatic diseases and may also influence treatment results. However, the purpose of palliative care is to provide relief from all kinds of pains. Therefore, how to make patients more comfortable is an issue worth studying. This study adopted the “bio-psycho-social model” proposed by Engel and applied spontaneous breathing training, in the hope of seeing patients’ psychological state changes caused by their physiological state changes, improvements in their anxious conditions, corresponding adjustments of their cognitive functions, and further enhancement of their social functions and the social support system. This study will be a one-year study. Palliative care outpatients will be recruited and assigned to the experimental group or the control group for six outpatient visits (once a month), with 80 patients in each group. The patients of both groups agreed that this study can collect their physiological quantitative data using an HRV device before the first outpatient visit. They also agreed to answer the “Beck Anxiety Inventory (BAI)”, the “Taiwanese version of the WHOQOL-BREF questionnaire” before the first outpatient visit, to fill a self-report questionnaire after each outpatient visit, and to answer the “Beck Anxiety Inventory (BAI)”, the “Taiwanese version of the WHOQOL-BREF questionnaire” after the last outpatient visit. The patients of the experimental group agreed to receive the breathing training under HRV monitoring during the first outpatient visit of this study. Before each of the following three outpatient visits, they were required to fill a self-report questionnaire regarding their breathing practices after going home. After the outpatient visits, they were taught how to practice breathing through an HRV device and asked to practice it after going home. Later, based on the results from the HRV data analyses and the pre-tests and post-tests of the “Beck Anxiety Inventory (BAI)”, the “Taiwanese version of the WHOQOL-BREF questionnaire”, the influence of the breathing training in the bio, psycho, and social aspects were evaluated. The data collected through the self-report questionnaires of the patients of both groups were used to explore the possible interfering factors among the bio, psycho, and social changes. It is expected that this study will support the “bio-psycho-social model” proposed by Engel, meaning that bio, psycho, and social supports are closely related, and that breathing training helps to transform palliative care patients’ psychological feelings of anxiety and depression, to facilitate their positive interactions with others, and to improve the quality medical care for them.

Keywords: Palliative care, breathing training, bio-psycho-social Model, heart rate variability.

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Authors: Volker Lange, Stephanie Moede, Christiane Auffermann

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From an economic standpoint the current and future road traffic situation in urban areas is a cost factor. Traffic jams and congestion prolong journey times and tie up resources in trucks and personnel. Many discussions about imposing charges or tolls for cities in Europe in order to reduce traffic congestion are currently in progress. Both of these effects lead – directly or indirectly - to additional costs for the urban distribution systems in retail companies. One approach towards improving the efficiency of retail distribution systems, and thus towards avoiding negative environmental factors in urban areas, is horizontal collaboration for deliveries to retail outlets – Urban Retail Logistics. This paper presents a classification system to help reveal where cooperation between retail companies is possible and makes sense for deliveries to retail outlets in urban areas.

Keywords: City Logistics, Horizontal Collaboration, Urban Freight Transport, Urban Retail Logistics.

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Authors: D. Triantakonstantis, D. Stathakis

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Urban areas have been expanded throughout the globe. Monitoring and modelling urban growth have become a necessity for a sustainable urban planning and decision making. Urban prediction models are important tools for analyzing the causes and consequences of urban land use dynamics. The objective of this research paper is to analyze and model the urban change, which has been occurred from 1990 to 2000 using CORINE land cover maps. The model was developed using drivers of urban changes (such as road distance, slope, etc.) under an Artificial Neural Network modelling approach. Validation was achieved using a prediction map for 2006 which was compared with a real map of Urban Atlas of 2006. The accuracy produced a Kappa index of agreement of 0,639 and a value of Cramer's V of 0,648. These encouraging results indicate the importance of the developed urban growth prediction model which using a set of available common biophysical drivers could serve as a management tool for the assessment of urban change.

Keywords: Artificial Neural Networks, CORINE, Urban Atlas, Urban Growth Prediction.

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Authors: Zulkefli bin Ibrahim, Ainin Sulaiman, Tengku M. Faziharudean

Abstract:

Malaysia is aggressive in promoting the usage of ICT to its mass population through the support by the government policies and programs targeting the general population. However, with the uneven distribution of the basic telecommunication infrastructure between the urban and rural area, cost for being “interconnected" that is considered high among the poorer rural population and the lack of local contents that suit the rural population needs or lifestyles, it is still a challenge for Malaysia to achieve its Vision 2020 Agenda moving the nation towards an information society by the year 2020. Among the existing programs that have been carried out by the government to encourage the usage of ICT by the rural population is “Kedaikom", a community telecenter with the general aim is to engage the community to get exposed and to use the ICT, encouraging the diffusion of the ICT technology to the rural population. The research investigated by using a questionnaire survey of how Kedaikom, as a community telecenter could play a role in encouraging the rural or underserved community to use the ICT. The result from the survey has proven that the community telecenter could bridge the digital divide between the underserved rural population and the well-accessed urban population in Malaysia. More of the rural population, especially from the younger generation and those with higher educational background are using the community telecenter to be connected to the ICT.

Keywords: Digital divide, ICT, telecenters.

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Authors: N. Utaberta, N. Sharifi, M. Surat, A. I. Che-Ani, N.M. Tawil

Abstract:

Iran has diverse climates and each have established distinct properties in their area. The extent and intensity of climatic factors effects on the lives of people living in various regions of Iran is so great that it cannot be simply ignored. In a large part of Iran known as the Central Plateau there is no precipitation for more than half of the year and dry weather and scarcity of fresh water pose an ever present problem for the people of these regions while in north of Iran upon the southern shores of the Caspian Sea the people face 80% humidity caused by the sea and 2 meters of annual precipitation. This article tries to review the past experiences of local architecture of Iran-s various regions so that they can be used to reshape and redirect the urban areas and structure of Iran-s current cities to provide environmental comfort by minimum use of fossil fuels.

Keywords: Urban Passage, Architecture in Iran, Urban Structure, Climatic Comfort

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Authors: U. Bottigli, R.Chiarucci, B. Golosio, G.L. Masala, P. Oliva, S.Stumbo, D.Cascio, F. Fauci, M. Glorioso, M. Iacomi, R. Magro, G. Raso

Abstract:

Purpose of this work is to develop an automatic classification system that could be useful for radiologists in the breast cancer investigation. The software has been designed in the framework of the MAGIC-5 collaboration. In an automatic classification system the suspicious regions with high probability to include a lesion are extracted from the image as regions of interest (ROIs). Each ROI is characterized by some features based generally on morphological lesion differences. A study in the space features representation is made and some classifiers are tested to distinguish the pathological regions from the healthy ones. The results provided in terms of sensitivity and specificity will be presented through the ROC (Receiver Operating Characteristic) curves. In particular the best performances are obtained with the Neural Networks in comparison with the K-Nearest Neighbours and the Support Vector Machine: The Radial Basis Function supply the best results with 0.89 ± 0.01 of area under ROC curve but similar results are obtained with the Probabilistic Neural Network and a Multi Layer Perceptron.

Keywords: Neural Networks, K-Nearest Neighbours, Support Vector Machine, Computer Aided Detection

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Authors: Hsing-Yi Kao, Der-Ming Liou

Abstract:

Transferring patient information between medical care sites is necessary to deliver better patient care and to reduce medical cost. So developing of electronic medical records is an important trend for the world.The Continuity of Care Document (CCD) is product of collaboration between CDA and CCR standards. In this study, we will develop a system to generate medical records with entry level based on CCD template module.

Keywords: Continuity Care Document, medical record, entrylevel

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Authors: N. P. Tsephe, S. D. Eyono Obono

Abstract:

Rural tourism is usually associated with rural development because it has strong linkages to rural resources; but it remains underdeveloped compared to urban tourism. This underdevelopment of rural tourism serves as a motivation for this study whose aim is to examine the factors affecting the perceived satisfaction of rural tourists. The objectives of this study are: to identify and design theories and models on rural tourism satisfaction, and to empirically validate these models and theories through a survey of tourists from the Malealea Lodge which is located in the Mafeteng District, in the Mountain Kingdom of Lesotho. Data generated by the collection of questionnaires used by this survey was analyzed quantitatively using descriptive statistics and correlations in SPSS after checking the validity and the reliability of the questionnaire. The main hypothesis behind this study is the relationship between the demographics of rural tourists, their motivation, and their satisfaction, as supported by existing literature; except that motivation is measured in this study according to three dimensions: push factors, pull factors, and perceived usefulness of ICTs in the rural tourism experience. Findings from this study indicate that among the demographics factors, continent of origin and marital status influence the satisfaction of rural tourists; and their occupation affects their perceptions on the use of ICTs in rural tourism. Moreover, only pull factors were found to influence the satisfaction of rural tourists.

Keywords: Digital world, Motivation, Rural tourism, Satisfaction.

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