The Hamburg-Model of Integrated Care for Patients with Psychosis: Part 2

Objective: Since the beginning of the integrated care model for severely ill patients with psychotic disorders ("Hamburg model") in 2007 different clinical parameters have been consecutively assessed within a naturalistic, observational, prospective study.Methods: Clinical outcome of the 2-year and 4-year follow-ups of n = 158 patients.Results: A significant and ongoing improvement of psychopathology, severity of illness, functional outcome, quality of life and satisfaction with care in this sample of severely ill and merely chronic patients with psychosis was shown. Moreover, medication adherence improved and quality and quantity of outpatient treatment increased.Conclusion: The ongoing psychosocial stabilisation of the patients most likely result from a combination of various factors: continuity of care, multimodal and individualized care, therapeutic specialisation and the multidisciplinary ACT team. Results provide clinical and scientific evidence for future implementations of the integrated care model "Hamburg Model" for the treatment of psychosis.

The Basement of the Deccan Traps and Its Madagascar Connection: Constraints from Xenoliths

Paleogeographic reconstructions of India and Madagascar before their late Cretaceous rifting juxtapose the Antongil Block of Madagascar against the Deccan Traps of India, indicating that the Western Dharwar Craton extends below the Deccan lavas. Some recent studies have suggested that the South Maharashtra Shear Zone along the northern Konkan coast of India limits the northern extent of the Western Dharwar Craton, implying that the craton does not extend below the Deccan Traps, raising a question mark on paleogeographic reconstructions of India and Madagascar. The continuity of the Western Dharwar Craton north of the South Maharashtra Shear Zone below the Deccan Traps—or its lack thereof—is critical for validating tectonic models correlating Madagascar with India. In this study, zircons in tonalitic basement xenoliths hosted in Deccan Trap dykes were dated in situ, using the U-Pb isotope system. The data furnish U-Pb ages that define three populations at 2527 ± 6, 2456 ± 6, and 2379 ± 9 Ma. The 2527 ± 6 Ma ages correspond to the igneous crystallization of the tonalites, whereas the 2456 ± 6 and 2379 ± 9 Ma ages date metamorphic overprints. The results help to establish for the first time that the basement is a part of the Neoarchean granitoid suite of the Western Dharwar Craton, which extends northward up to at least Talvade in central and Kihim beach in the western Deccan. By implication, the South Maharashtra Shear Zone cannot be the northern limit of the Western Dharwar Craton. The granitoids are correlated with the Neoarchean felsic intrusions (2.57–2.49) of the Masaola suite in the Antongil Block of Madagascar, supporting the existence of a Neoarchean Greater Dharwar Craton comprising the Western Dharwar Craton and the Antongil-Masora Block.

Coercive, Normative, and Mimetic Influences on the Assimilation of BCM in Outsourcing Relationships

Today many business processes are based on IT systems. These systems are exposed to different threats, which may lead to failures of critical business pro-cesses. Thus, enterprises prepare themselves against threats and failures of critical IT systems by means of Business Continuity Management (BCM). The phe-nomenon of outsourcing introduces a new dimension to BCM. In an outsourcing relationship the client organization is still responsible for the continuity of its processes but does not have full control over the implemented business continuity measures. In this paper we build a research model based on institutional and assimilation theories to describe and explain how and why BCM is assimilated in outsourcing relationships. In our case studies we found evidence that primarily coercive and normative pressures influence the assimilation of BCM in outsourcing relationships and support the explanation of variation across enterprises. Mimetic pressures seem to influence the assimilation but do not explain variations.

Impact of the arc length on GNSS analysis results

Homogeneously reprocessed combined GPS/GLONASS 1- and 3-day solutions from 1994 to 2013, generated by the Center for Orbit Determination in Europe (CODE) in the frame of the second reprocessing campaign REPRO-2 of the International GNSS Service, as well as GPS- and GLONASS-only 1- and 3-day solutions for the years 2009 to 2011 are analyzed to assess the impact of the arc length on the estimated Earth Orientation Parameters (EOP, namely polar motion and length of day), on the geocenter, and on the orbits. The conventional CODE 3-day solutions assume continuity of orbits, polar motion components, and of other parameters at the day boundaries. An experimental 3-day solution, which assumes continuity of the orbits, but independence from day to day for all other parameters, as well as a non-overlapping 3-day solution, is included into our analysis. The time series of EOPs, geocenter coordinates, and orbit misclosures, are analyzed. The long-arc solutions were found to be superior to the 1-day solutions: the RMS values of EOP and geocenter series are typically reduced between 10 and 40 %, except for the polar motion rates, where RMS reductions by factors of 2–3 with respect to the 1-day solutions are achieved for the overlapping and the non-overlapping 3-day solutions. In the low-frequency part of the spectrum, the reduction is even more important. The better performance of the orbits of 3-day solutions with respect to 1-day solutions is also confirmed by the validation with satellite laser ranging.

Identifying characteristics of mentally ill homeless individuals who are successfully linked to health and social services post-incarceration via the jail inreach project

Healthcare for the Homeless—Houston (HHH) received a research grant from The Medallion Foundation, Inc. in March 2006 to pilot The Jail Inreach Project, an intensive “inreach” initiative to assess the impact of providing continuity of mental and primary health care services for homeless individuals who suffer from mental illness and/or substance abuse being released from jail. This pilot project was initiated by HHH, in collaboration with the Harris County Sheriff’s Office and the Mental Health Mental Retardation Authority of Harris County (MHMRA). Those who are flagged as “frequent flyers” and who are diagnosed with a mental illness are referred to the Jail Inreach Project. In order to maximize the effectiveness of the discharge plan, case managers offer the option of meeting the client at the time of release and bring them to the HHH clinic located four blocks from the jail. Participation in both the program and the option for direct release to the care of a case manager are voluntary.^ The purpose of this study is to determine the outcomes of the Jail Inreach Project and addresses the following objectives: (1) to evaluate the characteristics of inmates that chose to be released from jail to the direct care of an HHH case manager versus those who opt for self release and (2) to determine the number and percent of inmates that are linked to services and relationship with type of release (direct versus indirect), (3) to determine if there is a relationship between outcomes and characteristics and (4) to determine what outcomes are a function of release, controlling for characteristics. Statistical analysis, including frequencies, cross tabulations, chi-square and logistical regression, found that those who opt for self release are six times less likely to be successfully linked to services and that gender is the most significant predictor of choosing self release. Men are far more likely to opt for self release than women engaged in this program. These findings help inform policy and program design and development that addresses the difference in service utilization and successful linkage to services post-incarceration. Successful linkage to services, thus continuity of and access to care, further impact the effects of the revolving door phenomenon of mentally ill homeless individuals cycling between the streets, jails and hospital emergency centers.^

Patient satisfaction in government health facilities in the state of Qatar

This study provides data which can contribute to improving services and delivering quality health care in government health facilities in the state of Qatar. To measure the satisfaction with current care of selected patients who receive care in Hamad General Hospital and the Khalifa Town Health Center in the city of Doha, a cross-sectional survey and a self-administered questionnaire were used.^ Analysis was performed on data from 444 patients on eight dimensions of patient satisfaction with medical care. These include: general satisfaction, availability of services, convenience of services, facilities, humaneness of doctors, quality of care, continuity of care, and aspects of the last visit. Patient satisfaction parameters were compared for males vs. females, for citizens vs. non-citizens, and for patients seen in the hospital vs. those seen in the health center.^ Results indicate that patients seen in the hospital were more satisfied with care than patients seen in the health center, that non-citizens were more satisfied than citizens, and that males were slightly more satisfied than females with medical services. ^

Summary of physical properties on cores used for petrofabric analyses triaxial experiments at DSDP Leg 67 Holes

Deformation features within the cores are studied with a view towards elucidating the structure of the Middle America Trench along the transect drilled during Leg 67. Where possible, inferences are made as to the physical environment of deformation. Extensional tectonics prevails in the area of the seaward slope and trench. Fracturing and one well-preserved normal fault are found mostly within the lower Miocene chalks, at the base of the sedimentary section. These chalks have high porosities (40%-60%) and water content (30%-190%, based on % dry wt.). Experimental triaxial compression tests conducted on both dry and water-saturated samples of chalk from Holes 495 and 499B show that only in the saturated samples is more brittle behavior observed. Brittle failure of the chalks is greatly facilitated by pore fluid pressures that lead to low effective pressures. Additional embrittlement (weakening) can take place as a result of the imposed extensional stress resulting from bending of a subducting elastic oceanic plate. The chalks exhibit, in a landward direction, an increase in density and mechanical strength and a decrease in water content. These changes are attributed to mechanical compaction that may have resulted from tectonic horizontal compression. The structure of the landward slope is not well understood because the slope sites had to be abandoned due to the presence of gas hydrate. The relationship of the chaotic, brittle deformation (observed in the cores from Hole 494A) at the base of the landward slope to tectonic processes remains unclear. The deformation observed on the slope sites (Holes 496 and 497) is mostly fracturing and near-vertical sigmoidal veinlets. These are interpreted as being the result of gas/fluid overpressurization due to the decomposition of the gas hydrate, and not due to tectonic loading of accreted sediments. Aside from four small displacement (less than 1cm) reverse faults observed in the lower Miocene chalks (which may be the product of soft-sediment deformation), there is a noticeable absence of structures reflecting a dominance of horizontal (tectonic) compression along the transect drilled. The absence of such features, the lack of continuity of sediment types across the trench-landward slope, and the normal stratigraphic sequence in Hole 494A do not support any known accretionary model.

Pliocene stable oxygen and carbon isotope record of benthic foraminifera from ODP Site 138-846 in the eastern equatorial Pacific

Oxygen and carbon isotope ratios were measured in benthic foraminifers from the entire Pliocene and latest Miocene sections of Site 846, a 180-m section, at a sampling interval of 10 cm. This provides a temporal resolution of about 2500 yr. The documented continuity of the record is excellent. Using the time scale that was developed on the basis of orbital tuning of GRAPE density records, we observed a fairly constant phase relationship between delta18O and variations in the obliquity of Earth's rotational axis. A new numbering scheme for Pliocene isotope stages is proposed. This high-resolution delta18O record clarifies several interesting aspects of late Neogene climatic evolution, including a "glacial" event that may have caused the final Messinian desiccation of the Mediterranean Sea; one or more "interglacial" events that might have caused refilling of the Mediterranean; a well-resolved couplet of glacial events at about the age of the Sidujfall Subchron; interglacial extremes in the early part of the Gauss that could have resulted from either significant deglaciation on Antarctica or from warming of deep water; and a gradual ramp of increasingly extreme "glacial" events, starting at about the Kaena Subchron and culminating with delta18O stage 100 in the earliest Matuyama.

Distribution of foraminifera and other components in ODP Leg 188 sites

During Leg 188 of the Ocean Drilling Program (ODP), employing JOIDES Resolution, we drilled holes at three sites in the southern Indian Ocean in and near Prydz Bay, East Antarctica, between 28 January and 29 February 2000. The objectives of the voyage were to: - Core through sediments deposited when Antarctica underwent the transition from "greenhouse" to the modern "icehouse" state late in the Eocene or early in the Oligocene, at sites obtaining their sediment from the currently subglacial Gamburtsev Mountains that probably were the site of nucleation of the ice sheet (principally Site 1166); - Obtain a sediment record from times at which major changes in the ice sheet volume and characteristics took place as judged from oxygen isotope records, especially at ~23.7 Ma (Oligocene/Miocene boundary), 12-16 Ma (middle Miocene), and 2.7 Ma (late Pliocene) (mainly Site 1165); and - Sample through the upper Pliocene and Quaternary in an attempt to document fluctuations in the extent of the ice sheet over the continental shelf during the Quaternary (especially Site 1167). Paleogene foraminifer-bearing marine sections were not intersected, and thus discussion of marine sections is restricted to the Neogene. Foraminifers are not major contributors to Leg 188 chronostratigraphy but contribute to paleoenvironmental interpretation, to issues such as carbonate compensation depth (CCD) effects and source and history of sediment, and provide a basis for Sr and d18O studies. Chronostratigraphy for the various sections was compiled from diatoms, radiolarians, and paleomagnetism (Shipboard Scientific Party, 2001, doi:10.2973/odp.proc.ir.188.101.2001). Foraminifers were sporadic rather than continuous except in short intervals; however, the Neogene foraminifers from the region are very poorly known and the new records proved to be of significant value in paleoenvironmental interpretation. Only at Site 1167 did drilling intersect a section that yielded foraminifers virtually throughout. Other than for the very young section at each site, there is virtually no continuity of assemblages between sites and thus each section is treated here as separate and unrelated.

Reliability issues related to the usage of Cloud Computing in Critical Infrastructures

The use of cloud computing is extending to all kind of systems, including the ones that are part of Critical Infrastructures, and measuring the reliability is becoming more difficult. Computing is becoming the 5th utility, in part thanks to the use of cloud services. Cloud computing is used now by all types of systems and organizations, including critical infrastructure, creating hidden inter-dependencies on both public and private cloud models. This paper investigates the use of cloud computing by critical infrastructure systems, the reliability and continuity of services risks associated with their use by critical systems. Some examples are presented of their use by different critical industries, and even when the use of cloud computing by such systems is not widely extended, there is a future risk that this paper presents. The concepts of macro and micro dependability and the model we introduce are useful for inter-dependency definition and for analyzing the resilience of systems that depend on other systems, specifically in the cloud model.

Space-time Measurements of Oceanic Sea States

Stereo video techniques are effective for estimating the space–time wave dynamics over an area of the ocean. Indeed, a stereo camera view allows retrieval of both spatial and temporal data whose statistical content is richer than that of time series data retrieved from point wave probes. We present an application of the Wave Acquisition Stereo System (WASS) for the analysis of offshore video measurements of gravity waves in the Northern Adriatic Sea and near the southern seashore of the Crimean peninsula, in the Black Sea. We use classical epipolar techniques to reconstruct the sea surface from the stereo pairs sequentially in time, viz. a sequence of spatial snapshots. We also present a variational approach that exploits the entire data image set providing a global space–time imaging of the sea surface, viz. simultaneous reconstruction of several spatial snapshots of the surface in order to guarantee continuity of the sea surface both in space and time. Analysis of the WASS measurements show that the sea surface can be accurately estimated in space and time together, yielding associated directional spectra and wave statistics at a point in time that agrees well with probabilistic models. In particular, WASS stereo imaging is able to capture typical features of the wave surface, especially the crest-to-trough asymmetry due to second order nonlinearities, and the observed shape of large waves are fairly described by theoretical models based on the theory of quasi-determinism (Boccotti, 2000). Further, we investigate space–time extremes of the observed stationary sea states, viz. the largest surface wave heights expected over a given area during the sea state duration. The WASS analysis provides the first experimental proof that a space–time extreme is generally larger than that observed in time via point measurements, in agreement with the predictions based on stochastic theories for global maxima of Gaussian fields.

The Phase Space as a New Representation of the Dynamical Behaviour of Temperature and Enthalpy in a Reefer monitored with a Multidistributed Sensors Network

The study of temperature gradients in cold stores and containers is a critical issue in the food industry for the quality assurance of products during transport, as well as forminimizing losses. The objective of this work is to develop a new methodology of data analysis based on phase space graphs of temperature and enthalpy, collected by means of multidistributed, low cost and autonomous wireless sensors and loggers. A transoceanic refrigerated transport of lemons in a reefer container ship from Montevideo (Uruguay) to Cartagena (Spain) was monitored with a network of 39 semi-passive TurboTag RFID loggers and 13 i-button loggers. Transport included intermodal transit from transoceanic to short shipping vessels and a truck trip. Data analysis is carried out using qualitative phase diagrams computed on the basis of Takens?Ruelle reconstruction of attractors. Fruit stress is quantified in terms of the phase diagram area which characterizes the cyclic behaviour of temperature. Areas within the enthalpy phase diagram computed for the short sea shipping transport were 5 times higher than those computed for the long sea shipping, with coefficients of variation above 100% for both periods. This new methodology for data analysis highlights the significant heterogeneity of thermohygrometric conditions at different locations in the container.

Subjective study of adaptive streaming strategies for 3DTV

Although the delivery of 3D video services to households is nowadays a reality thanks to frame-compatible formats, many efforts are being made to obtain efficient methods to transmit 3D content offering a high quality of experience to the end users. In this paper, a stereoscopic video streaming scenario is considered and the perceptual impact of various strategies applicable to adaptive streaming situations are compared. Specifically, the mechanisms are based on switching between copies of the content with different coding qualities, on discarding frames of the sequence, on switching from 3D to 2D and on using asymmetric coding of the stereo views. In addition, when video freezes happen, the possibility of keeping the end-to-end latency or maintaining the continuity of the video are considered. These aspects were evaluated carrying out a subjective assessment test considering also visual discomfort issues using a methodology designed to keep as far as possible domestic viewing conditions.

Exact solution for the conjugate fluid-fluid problem in the thermal entrance region of laminar counterflow heat exchangers

A generalized Lévêque solution is presented for the conjugate fluid–fluid problem that arises in the thermal entrance region of laminar counterflow heat exchangers. The analysis, carried out for constant property fluids, assumes that the Prandtl and Peclet numbers are both large compared to unity, and neglects axial conduction both in the fluids and in the plate, assumed to be thermally thin. Under these conditions, the thermal entrance region admits an asymptotic self-similar description where the temperature varies as a power ϳ of the axial distance, with the particularity that the self-similarity exponent must be determined as an eigenvalue by solving a transcendental equation arising from the requirement of continuity of heat fluxes at the heat conducting wall. Specifically, the analysis reveals that j depends only on the lumped parameter ƙ = (A2/A1)1/3 (α1/α2)1/3(k2/k1), defined in terms of the ratios of the wall velocity gradients, A, thermal diffusivities, α i, and thermal conductivities,k i, of the fluids entering, 1, and exiting, 2, the heat exchanger. Moreover, it is shown that for large (small) values of K solution reduces to the classical first (second) Lévêque solution. Closed-form analytical expressions for the asymptotic temperature distributions and local heat-transfer rate in the thermal entrance region are given and compared with numerical results in the counterflow parallel-plate configuration, showing very good agreement in all cases.

Dynamic analysis of payloads and structures with intermediate modal density

La necesidad de desarrollar técnicas para predecir la respuesta vibroacústica de estructuras espaciales lia ido ganando importancia en los últimos años. Las técnicas numéricas existentes en la actualidad son capaces de predecir de forma fiable el comportamiento vibroacústico de sistemas con altas o bajas densidades modales. Sin embargo, ambos rangos no siempre solapan lo que hace que sea necesario el desarrollo de métodos específicos para este rango, conocido como densidad modal media. Es en este rango, conocido también como media frecuencia, donde se centra la presente Tesis doctoral, debido a la carencia de métodos específicos para el cálculo de la respuesta vibroacústica. Para las estructuras estudiadas en este trabajo, los mencionados rangos de baja y alta densidad modal se corresponden, en general, con los rangos de baja y alta frecuencia, respectivamente. Los métodos numéricos que permiten obtener la respuesta vibroacústica para estos rangos de frecuencia están bien especificados. Para el rango de baja frecuencia se emplean técnicas deterministas, como el método de los Elementos Finitos, mientras que, para el rango de alta frecuencia las técnicas estadísticas son más utilizadas, como el Análisis Estadístico de la Energía. En el rango de medias frecuencias ninguno de estos métodos numéricos puede ser usado con suficiente precisión y, como consecuencia -a falta de propuestas más específicas- se han desarrollado métodos híbridos que combinan el uso de métodos de baja y alta frecuencia, intentando que cada uno supla las deficiencias del otro en este rango medio. Este trabajo propone dos soluciones diferentes para resolver el problema de la media frecuencia. El primero de ellos, denominado SHFL (del inglés Subsystem based High Frequency Limit procedure), propone un procedimiento multihíbrido en el cuál cada subestructura del sistema completo se modela empleando una técnica numérica diferente, dependiendo del rango de frecuencias de estudio. Con este propósito se introduce el concepto de límite de alta frecuencia de una subestructura, que marca el límite a partir del cual dicha subestructura tiene una densidad modal lo suficientemente alta como para ser modelada utilizando Análisis Estadístico de la Energía. Si la frecuencia de análisis es menor que el límite de alta frecuencia de la subestructura, ésta se modela utilizando Elementos Finitos. Mediante este método, el rango de media frecuencia se puede definir de una forma precisa, estando comprendido entre el menor y el mayor de los límites de alta frecuencia de las subestructuras que componen el sistema completo. Los resultados obtenidos mediante la aplicación de este método evidencian una mejora en la continuidad de la respuesta vibroacústica, mostrando una transición suave entre los rangos de baja y alta frecuencia. El segundo método propuesto se denomina HS-CMS (del inglés Hybrid Substructuring method based on Component Mode Synthesis). Este método se basa en la clasificación de la base modal de las subestructuras en conjuntos de modos globales (que afectan a todo o a varias partes del sistema) o locales (que afectan a una única subestructura), utilizando un método de Síntesis Modal de Componentes. De este modo es posible situar espacialmente los modos del sistema completo y estudiar el comportamiento del mismo desde el punto de vista de las subestructuras. De nuevo se emplea el concepto de límite de alta frecuencia de una subestructura para realizar la clasificación global/local de los modos en la misma. Mediante dicha clasificación se derivan las ecuaciones globales del movimiento, gobernadas por los modos globales, y en las que la influencia del conjunto de modos locales se introduce mediante modificaciones en las mismas (en su matriz dinámica de rigidez y en el vector de fuerzas). Las ecuaciones locales se resuelven empleando Análisis Estadístico de Energías. Sin embargo, este último será un modelo híbrido, en el cual se introduce la potencia adicional aportada por la presencia de los modos globales. El método ha sido probado para el cálculo de la respuesta de estructuras sometidas tanto a cargas estructurales como acústicas. Ambos métodos han sido probados inicialmente en estructuras sencillas para establecer las bases e hipótesis de aplicación. Posteriormente, se han aplicado a estructuras espaciales, como satélites y reflectores de antenas, mostrando buenos resultados, como se concluye de la comparación de las simulaciones y los datos experimentales medidos en ensayos, tanto estructurales como acústicos. Este trabajo abre un amplio campo de investigación a partir del cual es posible obtener metodologías precisas y eficientes para reproducir el comportamiento vibroacústico de sistemas en el rango de la media frecuencia. ABSTRACT Over the last years an increasing need of novel prediction techniques for vibroacoustic analysis of space structures has arisen. Current numerical techniques arc able to predict with enough accuracy the vibro-acoustic behaviour of systems with low and high modal densities. However, space structures are, in general, very complex and they present a range of frequencies in which a mixed behaviour exist. In such cases, the full system is composed of some sub-structures which has low modal density, while others present high modal density. This frequency range is known as the mid-frequency range and to develop methods for accurately describe the vibro-acoustic response in this frequency range is the scope of this dissertation. For the structures under study, the aforementioned low and high modal densities correspond with the low and high frequency ranges, respectively. For the low frequency range, deterministic techniques as the Finite Element Method (FEM) are used while, for the high frequency range statistical techniques, as the Statistical Energy Analysis (SEA), arc considered as more appropriate. In the mid-frequency range, where a mixed vibro-acoustic behaviour is expected, any of these numerical method can not be used with enough confidence level. As a consequence, it is usual to obtain an undetermined gap between low and high frequencies in the vibro-acoustic response function. This dissertation proposes two different solutions to the mid-frequency range problem. The first one, named as The Subsystem based High Frequency Limit (SHFL) procedure, proposes a multi-hybrid procedure in which each sub-structure of the full system is modelled with the appropriate modelling technique, depending on the frequency of study. With this purpose, the concept of high frequency limit of a sub-structure is introduced, marking out the limit above which a substructure has enough modal density to be modelled by SEA. For a certain analysis frequency, if it is lower than the high frequency limit of the sub-structure, the sub-structure is modelled through FEM and, if the frequency of analysis is higher than the high frequency limit, the sub-structure is modelled by SEA. The procedure leads to a number of hybrid models required to cover the medium frequency range, which is defined as the frequency range between the lowest substructure high frequency limit and the highest one. Using this procedure, the mid-frequency range can be define specifically so that, as a consequence, an improvement in the continuity of the vibro-acoustic response function is achieved, closing the undetermined gap between the low and high frequency ranges. The second proposed mid-frequency solution is the Hybrid Sub-structuring method based on Component Mode Synthesis (HS-CMS). The method adopts a partition scheme based on classifying the system modal basis into global and local sets of modes. This classification is performed by using a Component Mode Synthesis, in particular a Craig-Bampton transformation, in order to express the system modal base into the modal bases associated with each sub-structure. Then, each sub-structure modal base is classified into global and local set, fist ones associated with the long wavelength motion and second ones with the short wavelength motion. The high frequency limit of each sub-structure is used as frequency frontier between both sets of modes. From this classification, the equations of motion associated with global modes are derived, which include the interaction of local modes by means of corrections in the dynamic stiffness matrix and the force vector of the global problem. The local equations of motion are solved through SEA, where again interactions with global modes arc included through the inclusion of an additional input power into the SEA model. The method has been tested for the calculation of the response function of structures subjected to structural and acoustic loads. Both methods have been firstly tested in simple structures to establish their basis and main characteristics. Methods are also verified in space structures, as satellites and antenna reflectors, providing good results as it is concluded from the comparison with experimental results obtained in both, acoustic and structural load tests. This dissertation opens a wide field of research through which further studies could be performed to obtain efficient and accurate methodologies to appropriately reproduce the vibro-acoustic behaviour of complex systems in the mid-frequency range.