Search results for: Cognitive Therapy

Authors: Olimpia Matarazzo, Fabrizio Ferrara

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In two studies we tested the hypothesis that the appropriate linguistic formulation of a deontic rule – i.e. the formulation which clarifies the monadic nature of deontic operators - should produce more correct responses than the conditional formulation in Wason selection task. We tested this assumption by presenting a prescription rule and a prohibition rule in conditional vs. proper deontic formulation. We contrasted this hypothesis with two other hypotheses derived from social contract theory and relevance theory. According to the first theory, a deontic rule expressed in terms of cost-benefit should elicit a cheater detection module, sensible to mental states attributions and thus able to discriminate intentional rule violations from accidental rule violations. We tested this prevision by distinguishing the two types of violations. According to relevance theory, performance in selection task should improve by increasing cognitive effect and decreasing cognitive effort. We tested this prevision by focusing experimental instructions on the rule vs. the action covered by the rule. In study 1, in which 480 undergraduates participated, we tested these predictions through a 2 x 2 x 2 x 2 (type of the rule x rule formulation x type of violation x experimental instructions) between-subjects design. In study 2 – carried out by means of a 2 x 2 (rule formulation x type of violation) between-subjects design - we retested the hypothesis of rule formulation vs. the cheaterdetection hypothesis through a new version of selection task in which intentional vs. accidental rule violations were better discriminated. 240 undergraduates participated in this study. Results corroborate our hypothesis and challenge the contrasting assumptions. However, they show that the conditional formulation of deontic rules produces a lower performance than what is reported in literature.

Keywords: Deontic reasoning; Evolutionary, linguistic, logical, pragmatic factors; Wason selection task

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Authors: A. Faro, D. Giordano, M. Pennisi, G. Scarciofalo, C. Spampinato, F. Tramontana

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The paper proposes a methodology to process the signals coming from the Transcranial Magnetic Stimulation (TMS) in order to identify the pathology and evaluate the therapy to treat the patients affected by demency diseases. In particular, a fuzzy model is developed to identify the demency of the patients affected by Subcortical Ischemic Vascular Dementia (SIVD) and to measure the effect of a repetitive TMS on their motor performances. A tool is also presented to support the mentioned analysis.

Keywords: TMS, EMG, fuzzy logic, transcranial magnetic stimulation.

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Authors: Fawzi Irshaid, Kamal Mansi

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Thyroid dysfunction is one of the most frequently reported complications of chronic blood transfusion therapy in patients with beta-thalassemia major (BTM). However, the occurrence of thyroid dysfunction and its possible association with iron overload in BTM patients is still under debate. Therefore, this study aimed to investigate the status of thyroid functions and iron overload in adolescent and young adult patients with BTM in Jordan population. Thirty six BTM patients aged 12-28 years and matched controls were included in this study. All patients have been receiving frequent blood transfusion to maintain pretransfusion hemoglobin concentration above 10 g dl-1 and deferoxamine at a dose of 45 mg kg-1 day-1 (8 h, 5-7 days/week) by subcutaneous infusion. Blood samples were drawn from patients and controls. The status of thyroid functions and iron overload was evaluated by measurements of serum free thyroxine (FT4), triiodothyronine (FT3), thyrotropin (TSH) and serum ferritin level. A number of some hematological and biochemical parameters were also measured. It was found that hematocrit, serum ferritin, hemoglobin, FT3 and zinc, copper mean values were significantly higher in the patients than in the controls (P< 0.05). On other hand, leukocyte, FT4 and TSH mean values were similar to that of the controls. In addition, our data also indicated that all of the above examined parameters were not significantly affected by the patient-s age and gender. Deferoxamine approach for removing excess iron from our BTM patient did not normalize the values of serum ferritin, copper and zinc, suggesting poor compliance with deferoxamine chelation therapy. Thus, we recommend the use of a combination of deferoxamine and deferiprone to reduce the risk of excess of iron in our patients. Furthermore, thyroid dysfunction appears to be a rare complication, because our patients showed normal mean levels for serum TSH and FT4. However, high mean levels of serum ferritin, zinc, copper might be seen as potential risk factors for initiation and development of thyroid dysfunctions and other diseases. Therefore, further studies must be carried out at yearly intervals with large sample number, to detect subclinical thyroid dysfunction cases.

Keywords: beta-thalassemia major, deferoxamine, iron overload, triiodothyronine, zinc.

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Authors: Dante J. Dorantes-González, Aldrin Balsa-Yepes

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Existing learning techniques such as problem-based learning, project-based learning, or case study learning are learning techniques that focus mainly on technical details, but give no specific guidelines on learner’s experience and emotional learning aspects such as arousal salience and valence, being emotional states important factors affecting engagement and retention. Some approaches involving emotion in educational settings, such as social and emotional learning, lack neuroscientific rigorousness and use of specific neurobiological mechanisms. On the other hand, neurobiology approaches lack educational applicability. And educational approaches mainly focus on cognitive aspects and disregard conditioning learning. First, authors start explaining the reasons why it is hard to learn thoughtfully, then they use the method of neurobiological mapping to track the main limbic system functions, such as the reward circuit, and its relations with perception, memories, motivations, sympathetic and parasympathetic reactions, and sensations, as well as the brain cortex. The authors conclude explaining the major finding: The mechanisms of nonconscious learning and the triggers that guarantee long-term memory potentiation. Afterward, the educational framework for practical application and the instructors’ guidelines are established. An implementation example in engineering education is given, namely, the study of tuned-mass dampers for earthquake oscillations attenuation in skyscrapers. This work represents an original learning technique based on nonconscious learning mechanisms to enhance long-term memories that complement existing cognitive learning methods.

Keywords: Emotion, emotion-enhanced memory, learning technique, STEM.

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Authors: Dmitriy Yu. Korulkin, Raissa A. Muzychkina

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The article represents the results of clinical researches of composite herbal medicinal product based on essential oils of Sedum plants growing in Kazakhstan in commercial reserves at the territory of Kazakhstan. The results of comparative analysis are represented in obstetric-gynecologic practice during combined therapy for postnatal complications, inflammatory infiltrates in the area of surgical wounds including wounds after caesarean section.

Keywords: Anti-inflammatory, bioactive substances, essential oils, isolation, Sedum L., wound healing.

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Authors: Gioacchino Lavanco, Viviana Catania, Anna Milio, Floriana Romano

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The cyberspace is an instrument through which internet users could get new experiences. It could contribute to foster one-s own growth, widening cognitive, creative and communicative abilities and promoting relationships. In the cyberspace, in fact, it is possible to create virtual learning communities where internet users improve their interpersonal sphere, knowledge and skills. The main element of e-learning is the establishment of online relationships, that are often collaborative.

Keywords: Internet addiction, learner support, virtual relationships.

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Authors: Raghavi Janaswamy, Saraswathi K. Vasudev

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Music is ubiquitous in human lives. Ever since the foetus hears the sound inside the mother’s womb and later upon birth the baby experiences alluring sounds, the curiosity of learning emanates and evokes exploration. Music is an education than a mere entertainment. The intricate balance between music, education and entertainment has well been recognized by the scientific community and is being explored as a viable tool to understand and improve the human cognition. There are seven basic swaras (notes) Sa, Ri, Ga, Ma, Pa, Da and Ni in the Carnatic music system that are analogous to C, D, E, F, G, A and B of the western system. The Carnatic music builds on the conscious use of microtones, gamakams (oscillation) and rendering styles that evolved over centuries and established its stance. The complex but erudite raga system has been designed with elaborate experiments on srutis (musical sounds) and human perception abilities. In parallel, ‘rasa’- the emotions evoked by certain srutis and hence the ragas been solidified along with the power of language in combination with the musical sounds. The Carnatic music branches out as Kalpita sangeetam (pre-composed music) and Manodharma sangeetam (improvised music). This article explores the Manodharma sangeetam and its subdivisions such as raga alapana, swara kalpana, neraval and ragam-tanam-pallavi (RTP). The intrinsic mathematical strategies in its practice methods toward improvising the music have been discussed in detail with concert examples. The techniques on swara weaving for swara kalpana rendering and methods on the alapana development are also discussed at length with an emphasis on the impact on the human cognitive abilities. The articulation of the outlined conscious practice methods not only helps to leave a long-lasting melodic impression on the listeners but also onsets cognitive developments.

Keywords: Carnatic, Manodharmam, music cognition, Alapana.

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Authors: Helyane Bronoski Borges, Júlio Cesar Nievola

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The most important subtype of non-Hodgkin-s lymphoma is the Diffuse Large B-Cell Lymphoma. Approximately 40% of the patients suffering from it respond well to therapy, whereas the remainder needs a more aggressive treatment, in order to better their chances of survival. Data Mining techniques have helped to identify the class of the lymphoma in an efficient manner. Despite that, thousands of genes should be processed to obtain the results. This paper presents a comparison of the use of various attribute selection methods aiming to reduce the number of genes to be searched, looking for a more effective procedure as a whole.

Keywords: Attribute selection, data mining.

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Authors: T. Solonchak, S. Pesina

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Lexical invariants, being a sort of stereotypes within the frames of ordinary consciousness, are created by the members of a language community as a result of uniform division of reality. The invariant meaning is formed in person’s mind gradually in the course of different actualizations of secondary meanings in various contexts. We understand lexical the invariant as abstract language essence containing a set of semantic components. In one of its configurations it is the basis or all or a number of the meanings making up the semantic structure of the word.

Keywords: Lexical invariant, invariant theories, polysemantic word, cognitive linguistics.

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Authors: Ekaterina Y. Lukianova-Hleb, Dmitri O. Lapotko

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Cell processing techniques for gene and cell therapies use several separate procedures for gene transfer and cell separation or elimination, because no current technology can offer simultaneous multi-functional processing of specific cell sub-sets in heterogeneous cell systems. Using our novel on-demand nonstationary intracellular events instead of permanent materials, plasmonic nanobubbles, generated with a short laser pulse only in target cells, we achieved simultaneous multifunctional cell-specific processing with the rate up to 50 million cells per minute.

Keywords: Delivery, cell separation, graft, laser, plasmonic nanobubble, cell therapy, gold nanoparticle.

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Authors: Е. V. Kutsina, S. A. Tarasova

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In this article we present a methodology which enables preschool and primary school unlanguaged children to remember words, phrases and texts with the help of graphic signs - letters, syllables and words. Reading for a child becomes a support for speech development. Teaching is based on the principle "from simple to complex", "a letter - a syllable - a word - a proposal - a text." Availability of multi-level texts allows using this methodology for working with children who have different levels of speech development.

Keywords: Alalia, analytic-synthetic method, development of coherent speech, formation of vocabulary, learning to read, , sentence formation, three-level stories, unlanguaged children.

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Authors: Dmitry K. Shaytan, Georgy D. Laptev

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In our research we aimed to test a managerial approach for the fuzzy front end (FFE) of innovation by creating controlled experiment/ business case in a breakthrough innovation development. The experiment was in the sport industry and covered all aspects of the customer discovery stage from ideation to prototyping followed by patent application. In the paper we describe and analyze mile stones, tasks, management challenges, decisions made to create the break through innovation, evaluate overall managerial efficiency that was at the considered FFE stage. We set managerial outcome of the FFE stage as a valid product concept in hand. In our paper we introduce hypothetical construct “Q-factor” that helps us in the experiment to distinguish quality of FFE outcomes. The experiment simulated for entrepreneur the FFE of innovation and put on his shoulders responsibility for the outcome of valid product concept. While developing managerial approach to reach the outcome there was a decision to look on product concept from the cognitive psychology and cognitive science point of view. This view helped us to develop the profile of a person whose projection (mental representation) of a new product could optimize for a manager or entrepreneur FFE activities. In the experiment this profile was tested to develop breakthrough innovation for swimmers. Following the managerial approach the product concept was created to help swimmers to feel/sense water. The working prototype was developed to estimate the product concept validity and value added effect for customers. Based on feedback from coachers and swimmers there were strong positive effect that gave high value for customers, and for the experiment – the valid product concept being developed by proposed managerial approach for the FFE. In conclusions there is a suggestion of managerial approach that was derived from experiment.

Keywords: Concept development, concept testing, customer discovery, entrepreneurship, entrepreneurial management, idea generation, idea screening, startup management.

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Authors: Chi-Fang Huang, Xi-Zhang Lin, Yi-Ru Yang

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Aiming the application of localized hyperthermia, a magnetic induction system with new approaches is proposed. The techniques in this system for improving the effectiveness of localized hyperthermia are that using magnetic circuit and the multiple-coil array instead of a giant coil for generating magnetic field. Specially, amorphous metal is adopted as the material of magnetic circuit. Detail design parameters of hardware are well described. Simulation tool is employed for this work and experiment result is reported as well.

Keywords: cancer therapy, hyperthermia, Helmholtz coil, induction heating, magnetic circuit.

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Authors: Mohamed Bendahmane, Brahim Elfalaki, Mohammed Benattou

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One of the major sources of learners' professional difficulties is their heterogeneity. Whether on cognitive, social, cultural or emotional level, learners being part of the same group have many differences. These differences do not allow to apply the same learning process at all learners. Thus, an optimal learning path for one, is not necessarily the same for the other. We present in this paper a model-oriented service to offer to each learner a personalized learning path to acquire the targeted skills.

Keywords: Service-oriented architecture, learning path, web service, personalization, trace analysis.

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Authors: Gioacchino Lavanco, Floriana Romano, Anna Milio

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Terrorism represents an unexpected and unwanted change which challenges one-s social identity. We carried out a study to explore the demographic variables- role on the perception of personal and national threat, and to investigate the effects of perceived terrorist threat on people-s ways of life, moods, opinions and hopes. 313 residents of Palermo (Italy) were interviewed. The results pointed out that the fear of terrorism affects three areas: the cognitive, the emotional and the behavioural one.

Keywords: Disaster, national threat, personal threat, terrorism.

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Authors: M. Das Gupta, S. Banerjee

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Content Based Image Retrieval (CBIR) coupled with Case Based Reasoning (CBR) is a paradigm that is becoming increasingly popular in the diagnosis and therapy planning of medical ailments utilizing the digital content of medical images. This paper presents a survey of some of the promising approaches used in the detection of abnormalities in retina images as well in mammographic screening and detection of regions of interest in MRI scans of the brain. We also describe our proposed algorithm to detect hard exudates in fundus images of the retina of Diabetic Retinopathy patients.

Keywords: Case based reasoning, Exudates, Retina image, Similarity based retrieval.

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Authors: M. Hoxha, V. Capra, C. Buccellati, A. Sala, C. Cena, R. Fruttero, M. Bertinaria, G. E. Rovati

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Today COXIBs are used in the treatment of arthritis and many other painful conditions in selected patients with high gastrointestinal risk and low cardiovascular (CV) risk. Previously, we have identified an unexpected mechanism of action of a traditional non-steroidal anti-inflammatory drug (NSAID) (diclofenac) and a specific inhibitor of cyclooxygenase-2 (COXIB) (lumiracoxib) demonstrating that they possess weak competitive antagonism at the thromboxane receptor (TP). We hypothesize that modifying the structure of a known COXIB so that it becomes also a more potent TP antagonist will preserve the anti-inflammatory and gastrointestinal safety typical of COXIBs and prevent the CV risk associated with long term therapy.

Keywords: Cyclooxygenase, inflammation, lumiracoxib, thromboxane A2.

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Authors: Emilia Nercissians

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The paper attempts to contribute to the largely neglected social and anthropological discussion of technology development on the one hand, and to redirecting the emphasis in anthropology from primitive and exotic societies to problems of high relevance in contemporary era and how technology is used in everyday life. It draws upon multidimensional models of intelligence and ideal type formation. It is argued that the predominance of computational and cognitive cosmovisions have led to technology alienation. Injection of communicative competence in artificially intelligent systems and identity technologies in the coming information society are analyzed

Keywords: convergence, nomadic computing, solidarity, status.

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Authors: A. Breda, C. Cruz

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The Japanese art of origami provides a rich context for designing exploratory mathematical activities for children and young people. By folding a simple sheet of paper, fascinating and surprising planar and spatial configurations emerge. Equally surprising is the unfolding process, which also produces striking patterns. The procedure of folding, unfolding, and folding again allows the exploration of interesting geometric patterns. When adequately and systematically done, we may deduce some of the mathematical rules ruling origami. As the child/youth folds the sheet of paper repeatedly, he can physically observe how the forms he obtains are transformed and how they relate to the pattern of the corresponding unfolding, creating space for the understanding/discovery of mathematical principles regulating the folding-unfolding process. As part of a 2023 Summer Academy organized by a Portuguese university, a session entitled “Folding, Thinking and Generalizing” took place. 23 students attended the session, all enrolled in the 2nd cycle of Portuguese Basic Education and aged between 10 and 12 years old. The main focus of this session was to foster the development of critical cognitive and socio-emotional skills among these young learners, using origami. These skills included creativity, critical analysis, mathematical reasoning, collaboration, and communication. Employing a qualitative, descriptive, and interpretative analysis of data, collected during the session through field notes and students’ written productions, our findings reveal that structured origami-based activities not only promote student engagement with mathematical concepts in a playful and interactive but also facilitate the development of socio-emotional skills, which include collaboration and effective communication between participants. This research highlights the value of integrating origami into educational practices, highlighting its role in supporting comprehensive cognitive and emotional learning experiences.

Keywords: Active learning, hands-on activities, origami, creativity, critical thinking.

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Authors: Martin Rozanek, Karel Roubik

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The study deals with the modelling of the gas flow during heliox therapy. A special model has been developed to study the effect of the helium upon the gas flow in the airways during the spontaneous breathing. Lower density of helium compared with air decreases the Reynolds number and it allows improving the flow during the spontaneous breathing. In the cases, where the flow becomes turbulent while the patient inspires air the flow is still laminar when the patient inspires heliox. The use of heliox decreases the work of breathing and improves ventilation. It allows in some cases to prevent the intubation of the patients.

Keywords: Gas flow, heliox, Reynolds number, turbulent flow.

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Authors: Rusu Ligia, Cosma Germina, Lica Eliana, Marin Mihnea, Cernăianu Sorina, Copilusi Petre Cristian, Rusu Petre Florinel

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The aim of this paper is to present the role of myotonometry in assessment muscle viscoelasticity by measurement of force index (IF) and stiffness (S) at thigh muscle groups. The results are used for improve the muscle training. The method is based on mechanic impulse on the muscle group, that involve a muscle response like acceleration, speed and amplitude curves. From these we have information about elasticity, stiffness beginning from mechanic oscillations of muscle tissue. Using this method offer the possibility for monitoring the muscle capacity for produce mechanic energy, that allows a efficiency of movement with a minimal tissue deformation.

Keywords: assessment, infraspinatus syndrome, kinetic therapy, rehabilitation

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Authors: Touahria Mohamed, Khababa Abdallah, Frécon Louis

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This paper proposes a declarative language for knowledge representation (Ibn Rochd), and its environment of exploitation (DeGSE). This DeGSE system was designed and developed to facilitate Ibn Rochd writing applications. The system was tested on several knowledge bases by ascending complexity, culminating in a system for recognition of a plant or a tree, and advisors to purchase a car, for pedagogical and academic guidance, or for bank savings and credit. Finally, the limits of the language and research perspectives are stated.

Keywords: Knowledge representation, declarative language, IbnRochd, DeGSE, facets, cognitive approach.

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Authors: M. Rodionov, Z. Dedovets

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This article discusses ways to implement a differentiated approach to developing academic motivation for mathematical studies which relies on defining the primary structural characteristics of motivation. The following characteristics are considered: features of realization of cognitive activity, meaningmaking characteristics, level of generalization and consistency of knowledge acquired by personal experience. The assessment of the present level of individual student understanding of each component of academic motivation is the basis for defining the relevant educational strategy for its further development.

Keywords: Learning activity, mathematics, motivation, student.

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Authors: Toshihiko Matsuka

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One problem in evaluating recent computational models of human category learning is that there is no standardized method for systematically comparing the models' assumptions or hypotheses. In the present study, a flexible general model (called GECLE) is introduced that can be used as a framework to systematically manipulate and compare the effects and descriptive validities of a limited number of assumptions at a time. Two example simulation studies are presented to show how the GECLE framework can be useful in the field of human high-order cognition research.

Keywords: artificial intelligence, category learning, cognitive modeling, radial basis functions.

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Authors: Katie Emerson, Sara Perez-Ojalvo, Jim Komorowski, Danielle Greenberg

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The purpose of this study was to evaluate arginase activity levels in response to combinations of an inositol-stabilized arginine silicate (ASI; Nitrosigine®), L-arginine, and Inositol. Arginine acts as a vasodilator that promotes increased blood flow resulting in enhanced delivery of oxygen and nutrients to the brain and other tissues. Arginase, found in human serum, catalyzes the conversion of arginine to ornithine and urea, completing the last step in the urea cycle. Decreasing arginase levels maintains arginine and results in increased nitric oxide production. This study aimed to determine the most effective combination of ASI, L-arginine and inositol for minimizing arginase levels and therefore maximize ASI’s effect on cognition. Serum was taken from untreated healthy donors by separation from clotted factors. Arginase activity of serum in the presence or absence of test products was determined (QuantiChrom™, DARG-100, Bioassay Systems, Hayward CA). The remaining ultra-filtrated serum units were harvested and used as the source for the arginase enzyme. ASI alone or combined with varied levels of Inositol were tested as follows: ASI + inositol at 0.25 g, 0.5 g, 0.75 g, or 1.00 g. L-arginine was also tested as a positive control. All tests elicited changes in arginase activity demonstrating the efficacy of the method used. Adding L-arginine to serum from untreated subjects, with or without inositol only had a mild effect. Adding inositol at all levels reduced arginase activity. Adding 0.5 g to the standardized amount of ASI led to the lowest amount of arginase activity as compared to the 0.25 g, 0.75 g or 1.00g doses of inositol or to L-arginine alone. The outcome of this study demonstrates an interaction of the pairing of inositol with ASI on the activity of the enzyme arginase. We found that neither the maximum nor minimum amount of inositol tested in this study led to maximal arginase inhibition. Since the inhibition of arginase activity is desirable for product formulations looking to maintain arginine levels, the most effective amount of inositol was deemed preferred. Subsequent studies suggest this moderate level of inositol in combination with ASI leads to cognitive improvements including reaction time, executive function, and concentration.

Keywords: Arginine, blood flow, colorimetry, urea cycle.

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Authors: Erik Pontiskoski, Kazuhiro Asakawa

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This is a conceptual paper on the application of open innovation in three case examples of Apple, Nintendo, and Nokia. Utilizing key concepts from research into managerial and organizational cognition, we describe how each company overcame barriers to utilizing open innovation strategy in R&D and commercialization projects. We identify three levels of barriers: cognitive, behavioral, and institutional, and describe the companies balanced between internal and external resources to launch products that were instrumental in companies reinventing themselves in mature markets.

Keywords: managerial cognition, open innovation.

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Authors: Ivan Traina, Luigi Sangalli, Fabio Tognon, Angelo Lascioli

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Currently, challenges regarding preschooler children are mainly focused on a sedentary lifestyle. Also, motor activity in infancy is seen as a tool for the separate acquisition of cognitive and socio-emotional skills rather than considering neuromotor development as a tool for improving learning abilities. The paper utilized an observational research method to shed light on the results of practicing neuromotor exercises in preschool children with disability as well as provide implications for practice.

Keywords: Children with disability, learning abilities, inclusion, neuromotor development.

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Authors: A. Taqaddas

Abstract:

Purpose: This E-survey was carried out to facilitate the implementation and Education of VMAT (Volumetric Modulated Arc Therapy) in Radiotherapy-RT departments and reasons for not using IMRT (Intensity Modulated Radiotherapy). VMAT Skills in demand were also identified. Method: E-Survey was distributed to NHS hospitals across UK by email. Thirty NHS and related centres in England, 21 in Scotland, 3 in Ireland and 1 in Wales were contacted. This Survey was intended for those working in RT and Medical Physics and who were responsible for Treatment Planning and training. Results: This E-survey have indicated pathways adopted by staff to acquire VMAT skills, strategies to efficiently implement VMAT in RT departments and for obtaining VMAT Education. Conclusion: Despite poor survey response this survey has managed to highlight requirements for education and implementation of VMAT that are also applicable to IMRT. Other RT centres in world can also find these results useful.

Keywords: IMRT, Radiotherapy, Treatment Planning, VMAT.

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Authors: Muhammad Raza Ali, Tim Morris

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Human computer interaction has progressed considerably from the traditional modes of interaction. Vision based interfaces are a revolutionary technology, allowing interaction through human actions, gestures. Researchers have developed numerous accurate techniques, however, with an exception to few these techniques are not evaluated using standard HCI techniques. In this paper we present a comprehensive framework to address this issue. Our evaluation of a computer vision application shows that in addition to the accuracy, it is vital to address human factors

Keywords: Usability evaluation, cognitive walkthrough, think aloud, gesture recognition.

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Authors: Ilyas Khan. Liliane Pintelon, Harry Martin, Michael Shömig

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The increasing costs of healthcare on one hand, and the rise in aging population and associated chronic disease, on the other hand, are putting increasing burden on the current health care system in many Western countries. For instance, chronic kidney disease (CKD) is a common disease and in Europe, the cost of renal replacement therapy (RRT) is very significant to the total health care cost. However, the recent advancement in healthcare technology, provide the opportunity to treat patients at home in their own comfort. It is evident that home healthcare offers numerous advantages apparently, low costs and high patients’ quality of life. Despite these advantages, the intake of home hemodialysis (HHD) therapy is still low in particular in Germany. Many factors are accounted for the low number of HHD intake. However, this paper is focusing on patients’ safety-related factors of current HHD practices in Germany. The aim of this paper is to analyze the current HHD practices in Germany and to identify risks related factors if any exist. A case study has been conducted in a dialysis center which consists of four dialysis centers in the south of Germany. In total, these dialysis centers have 350 chronic dialysis patients, of which, four patients are on HHD. The centers have 126 staff which includes six nephrologists and 120 other staff i.e. nurses and administration. The results of the study revealed several risk-related factors. Most importantly, these centers do not offer allied health services at the pre-dialysis stage, the HHD training did not have an established curriculum; however, they have just recently developed the first version. Only a soft copy of the machine manual is offered to patients. Surprisingly, the management was not aware of any standard available for home assessment and installation. The home assessment is done by a third party (i.e. the machines and equipment provider) and they may not consider the hygienic quality of the patient’s home. The type of machine provided to patients at home is similar to the one in the center. The model may not be suitable at home because of its size and complexity. Even though portable hemodialysis machines, which are specially designed for home use, are available in the market such as the NxStage series. Besides the type of machine, no assistance is offered for space management at home in particular for placing the machine. Moreover, the centers do not offer remote assistance to patients and their carer at home. However, telephonic assistance is available. Furthermore, no alternative is offered if a carer is not available. In addition, the centers are lacking medical staff including nephrologists and renal nurses.

Keywords: Home hemodialysis, home hemodialysis practices, patients’ related risks in the current home hemodialysis practices, patient safety in home hemodialysis.

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