Treatment of acute renal failure in the intensive care unit: lower costs by intermittent dialysis than continuous venovenous hemodiafiltration

Intermittent and continuous renal replacement therapies (RRTs) are available for the treatment of acute renal failure (ARF) in the intensive care unit (ICU). Although at present there are no adequately powered survival studies, available data suggest that both methods are equal with respect to patient outcome. Therefore, cost comparison between techniques is important for selecting the modality. Expenditures were prospectively assessed as a secondary end point during a controlled, randomized trial comparing intermittent hemodialysis (IHD) with continuous venovenous hemodiafiltration (CVVHDF). The outcome of the primary end points of this trial, that is, ICU and in-hospital mortality, has been previously published. One hundred twenty-five patients from a Swiss university hospital ICU were randomized either to CVVHDF or IHD. Out of these, 42 (CVVHDF) and 34 (IHD) were available for cost analysis. Patients' characteristics, delivered dialysis dose, duration of stay in the ICU or hospital, mortality rates, and recovery of renal function were not different between the two groups. Detailed 24-h time and material consumption protocols were available for 369 (CVVHDF) and 195 (IHD) treatment days. The mean daily duration of CVVHDF was 19.5 +/- 3.2 h/day, resulting in total expenditures of Euro 436 +/- 21 (21% for human resources and 79% for technical devices). For IHD (mean 3.0 +/- 0.4 h/treatment), the costs were lower (Euro 268 +/- 26), with a larger proportion for human resources (45%). Nursing time spent for CVVHDF was 113 +/- 50 min, and 198 +/- 63 min per IHD treatment. Total costs for RRT in ICU patients with ARF were lower when treated with IHD than with CVVHDF, and have to be taken into account for the selection of the method of RRT in ARF on the ICU.

Thoracolumbar spine fractures in patients who have sustained severe trauma: depiction with multi-detector row CT

PURPOSE: To determine if multi–detector row computed tomography (CT) can replace conventional radiography and be performed alone in severe trauma patients for the depiction of thoracolumbar spine fractures. MATERIALS AND METHODS: One hundred consecutive severe trauma patients who underwent conventional radiography of the thoracolumbar spine as well as thoracoabdominal multi–detector row CT were prospectively identified. Conventional radiographs were reviewed independently by three radiologists and two orthopedic surgeons; CT images were reviewed by three radiologists. Reviewers were blinded both to one another’s reviews and to the results of initial evaluation. Presence, location, and stability of fractures, as well as quality of reviewed images, were assessed. Statistical analysis was performed to determine sensitivity and interobserver agreement for each procedure, with results of clinical and radiologic follow-up as the standard of reference. The time to perform each examination and the radiation dose involved were evaluated. A resource cost analysis was performed. RESULTS: Sixty-seven fractured vertebrae were diagnosed in 26 patients. Twelve patients had unstable spine fractures. Mean sensitivity and interobserver agreement, respectively, for detection of unstable fractures were 97.2% and 0.951 for multi–detector row CT and 33.3% and 0.368 for conventional radiography. The median times to perform a conventional radiographic and a multi–detector row CT examination, respectively, were 33 and 40 minutes. Effective radiation doses at conventional radiography of the spine and thoracoabdominal multi–detector row CT, respectively, were 6.36 mSv and 19.42 mSv. Multi–detector row CT enabled identification of 146 associated traumatic lesions. The costs of conventional radiography and multi–detector row CT, respectively, were $145 and $880 per patient. CONCLUSION: Multi–detector row CT is a better examination for depicting spine fractures than conventional radiography. It can replace conventional radiography and be performed alone in patients who have sustained severe trauma.

Costs and quality of medication reconciliation practice in primary care clinics

Medication reconciliation, with the aim to resolve medication discrepancy, is one of the Joint Commission patient safety goals. Medication errors and adverse drug events that could result from medication discrepancy affect a large population. At least 1.5 million adverse drug events and $3.5 billion of financial burden yearly associated with medication errors could be prevented by interventions such as medication reconciliation. This research was conducted to answer the following research questions: (1a) What are the frequency range and type of measures used to report outpatient medication discrepancy? (1b) Which effective and efficient strategies for medication reconciliation in the outpatient setting have been reported? (2) What are the costs associated with medication reconciliation practice in primary care clinics? (3) What is the quality of medication reconciliation practice in primary care clinics? (4) Is medication reconciliation practice in primary care clinics cost-effective from the clinic perspective? Study designs used to answer these questions included a systematic review, cost analysis, quality assessments, and cost-effectiveness analysis. Data sources were published articles in the medical literature and data from a prospective workflow study, which included 150 patients and 1,238 medications. The systematic review confirmed that the prevalence of medication discrepancy was high in ambulatory care and higher in primary care settings. Effective strategies for medication reconciliation included the use of pharmacists, letters, a standardized practice approach, and partnership between providers and patients. Our cost analysis showed that costs associated with medication reconciliation practice were not substantially different between primary care clinics using or not using electronic medical records (EMR) ($0.95 per patient per medication in EMR clinics vs. $0.96 per patient per medication in non-EMR clinics, p=0.78). Even though medication reconciliation was frequently practiced (97-98%), the quality of such practice was poor (0-33% of process completeness measured by concordance of medication numbers and 29-33% of accuracy measured by concordance of medication names) and negatively (though not significantly) associated with medication regimen complexity. The incremental cost-effectiveness ratios for concordance of medication number per patient per medication and concordance of medication names per patient per medication were both 0.08, favoring EMR. Future studies including potential cost-savings from medication features of the EMR and potential benefits to minimize severity of harm to patients from medication discrepancy are warranted. ^

Long-term impact of a weight management summer camp on obese children

Background: interventions that focus on improving eating habits, increasing physical activity, and reducing sedentary behaviors on weight status and body mass index percentile and z-scores in youths have not been well documented. This study aimed to determine the short and long term effects of a 2-week residential weight management summer camp program for youths on weight, BMI, BMI percentile, and BMI z-score. ^ Methods: A sample of 73 obese multiethnic 10-14 years old youths (11.9 ± 1.4) attended a weight management camp called Kamp K'aana for two weeks and completed a 12-month follow-up on height and weight. As part of Kamp K'aana, participants received a series of nutrition, physical activity and behavioral lessons and were on an 1800 kcal per day meal plan. Anthropometric measurements of height and weight were taken to calculate participants' BMI percentiles and z-scores. Paired t-tests, chi square test and ANCOVA, adjusting for age, gender, and ethnicity were used to assess changes in body weight, BMI, BMI percentiles and BMI z-scores pre to two-weeks post-camp and 12 months post-camp. ^ Results: Significant reductions in body weight of 3.6 ± 1.4 (P = 0.0000), BMI of 1.4 ± 0.54 (P = 0.0000), BMI percentile of 0.45 ± 0.06 (P = 0.0000), and BMI z-score of 0.1 ± 0.06 (P = 0.0000) were observed at the end of the camp. Significant reductions in BMI z-scores (P < 0.001) and BMI percentile (P < 0.001) were observed at the 12-month reunion when compared to pre- and two-weeks post camp data. There was a significant increase in weight and BMI (P = 0.0000) at the 12-month reunion when compared to pre and post camp measurements. ^ Conclusion: Kamp K'aana has consistently shown short-term reductions in weight, BMI, BMI percentile, and BMI z-score. Results from analysis of long-term data suggest that this intervention had beneficial effects on body composition in an ethnically diverse population of obese children. Further research which includes a control group, larger sample size, and cost-analysis should be conducted.^

A simplified energy consumption model for fiber-based Next Generation Access Networks

ICTs account nowadays for 2% of total carbon emissions. However, in a time when strict measures to reduce energyconsumption in all the industrial and services sectors are required, the ICT sector faces an increase in services and bandwidth demand. The deployment of NextGenerationNetworks (NGN) will be the answer to this new demand and specifically, the NextGenerationAccessNetworks (NGANs) will provide higher bandwidth access to users. Several policy and cost analysis are being carried out to understand the risks and opportunities of new deployments, though the question of which is the role of energyconsumption in NGANs seems off the table. Thus, this paper proposes amodel to analyze the energyconsumption of the main fiber-based NGAN architectures, i.e. Fiber To The House (FTTH) in both Passive Optical Network (PON) and Point-to-Point (PtP) variations, and FTTx/VDSL. The aim of this analysis is to provide deeper insight on the impact of new deployments on the energyconsumption of the ICT sector and the effects of energyconsumption on the life-cycle cost of NGANs. The paper presents also an energyconsumption comparison of the presented architectures, particularized in the specific geographic and demographic distribution of users of Spain, but easily extendable to other countries.

Clean Coal Technologies Scenario and Evaluation of Present CO2 Dwindling Initiatives to Approach Zero Emission Power Stations By Coal Combustion. Deployment Situation and Evaluation Study

In the present uncertain global context of reaching an equal social stability and steady thriving economy, power demand expected to grow and global electricity generation could nearly double from 2005 to 2030. Fossil fuels will remain a significant contribution on this energy mix up to 2050, with an expected part of around 70% of global and ca. 60% of European electricity generation. Coal will remain a key player. Hence, a direct effect on the considered CO2 emissions business-as-usual scenario is expected, forecasting three times the present CO2 concentration values up to 1,200ppm by the end of this century. Kyoto protocol was the first approach to take global responsibility onto CO2 emissions monitoring and cap targets by 2012 with reference to 1990. Some of principal CO2emitters did not ratify the reduction targets. Although USA and China spur are taking its own actions and parallel reduction measures. More efficient combustion processes comprising less fuel consuming, a significant contribution from the electricity generation sector to a CO2 dwindling concentration levels, might not be sufficient. Carbon Capture and Storage (CCS) technologies have started to gain more importance from the beginning of the decade, with research and funds coming out to drive its come in useful. After first researching projects and initial scale testing, three principal capture processes came out available today with first figures showing up to 90% CO2 removal by its standard applications in coal fired power stations. Regarding last part of CO2 reduction chain, two options could be considered worthy, reusing (EOR & EGR) and storage. The study evaluates the state of the CO2 capture technology development, availability and investment cost of the different technologies, with few operation cost analysis possible at the time. Main findings and the abatement potential for coal applications are presented. DOE, NETL, MIT, European universities and research institutions, key technology enterprises and utilities, and key technology suppliers are the main sources of this study. A vision of the technology deployment is presented.

Parallelizing irregular and pointer-based computations automatically: perspectives from logic and constraint programming

Irregular computations pose sorne of the most interesting and challenging problems in automatic parallelization. Irregularity appears in certain kinds of numerical problems and is pervasive in symbolic applications. Such computations often use dynamic data structures, which make heavy use of pointers. This complicates all the steps of a parallelizing compiler, from independence detection to task partitioning and placement. Starting in the mid 80s there has been significant progress in the development of parallelizing compilers for logic pro­gramming (and more recently, constraint programming) resulting in quite capable paralle­lizers. The typical applications of these paradigms frequently involve irregular computations, and make heavy use of dynamic data structures with pointers, since logical variables represent in practice a well-behaved form of pointers. This arguably makes the techniques used in these compilers potentially interesting. In this paper, we introduce in a tutoríal way, sorne of the problems faced by parallelizing compilers for logic and constraint programs and provide pointers to sorne of the significant progress made in the area. In particular, this work has resulted in a series of achievements in the areas of inter-procedural pointer aliasing analysis for independence detection, cost models and cost analysis, cactus-stack memory management, techniques for managing speculative and irregular computations through task granularity control and dynamic task allocation such as work-stealing schedulers), etc.

Abstract interpretation-based code certification for pervasive systems: Preliminary experiments

Proof carrying code is a general methodology for certifying that the execution of an untrusted mobile code is safe, according to a predefined safety policy. The basic idea is that the code supplier attaches a certifícate (or proof) to the mobile code which, then, the consumer checks in order to ensure that the code is indeed safe. The potential benefit is that the consumer's task is reduced from the level of proving to the level of checking, a much simpler task. Recently, the abstract interpretation techniques developed in logic programming have been proposed as a basis for proof carrying code [1]. To this end, the certifícate is generated from an abstract interpretation-based proof of safety. Intuitively, the verification condition is extracted from a set of assertions guaranteeing safety and the answer table generated during the analysis. Given this information, it is relatively simple and fast to verify that the code does meet this proof and so its execution is safe. This extended abstract reports on experiments which illustrate several issues involved in abstract interpretation-based code certification. First, we describe the implementation of our system in the context of CiaoPP: the preprocessor of the Ciao multi-paradigm (constraint) logic programming system. Then, by means of some experiments, we show how code certification is aided in the implementation of the framework. Finally, we discuss the application of our method within the área of pervasive systems which may lack the necessary computing resources to verify safety on their own. We herein illustrate the relevance of the information inferred by existing cost analysis to control resource usage in this context. Moreover, since the (rather complex) analysis phase is replaced by a simpler, efficient checking process at the code consumer side, we believe that our abstract interpretation-based approach to proof-carrying code becomes practically applicable to this kind of systems.

Optimal and Long-Term Dynamic Transport Policy Design: Seeking Maximum Social Welfare through a Pricing Scheme.

This article presents an alternative approach to the decision-making process in transport strategy design. The study explores the possibility of integrating forecasting, assessment and optimization procedures in support of a decision-making process designed to reach the best achievable scenario through mobility policies. Long-term evaluation, as required by a dynamic system such as a city, is provided by a strategic Land-Use and Transport Interaction (LUTI) model. The social welfare achieved by implementing mobility LUTI model policies is measured through a cost-benefit analysis and maximized through an optimization process throughout the evaluation period. The method is tested by optimizing a pricing policy scheme in Madrid on a cordon toll in a context requiring system efficiency, social equity and environmental quality. The optimized scheme yields an appreciable increase in social surplus through a relatively low rate compared to other similar pricing toll schemes. The results highlight the different considerations regarding mobility impacts on the case study area, as well as the major contributors to social welfare surplus. This leads the authors to reconsider the cost-analysis approach, as defined in the study, as the best option for formulating sustainability measures.

Análisis de los mercados de gas mayoristas en Europa: Francia, Reino Unido, Bélgica y Holanda

Este proyecto consiste en una previa investigación descriptiva del mercado mayorista de gas en España. Para ello, se ha estudiado en profundidad el funcionamiento de los componentes que constituyen este sistema y las herramientas necesarias utilizadas para el sostenimiento del mismo. Se ha analizado las capacidades, peajes, etc. para poder extrapolar estos conocimientos al resto de los mercados europeos examinados. Una vez explorado el mercado español, se ha analizado el mercado belga, francés, inglés y holandés. En estos mercados se ha hecho un estudio de las bases necesarias que un comercializador necesita para poder introducirse en estos nuevos mercados. Por último, al tratarse de un proyecto de investigación, se ha realizado un estudio del coste económico que un estudio como este podría conllevar. 3 ABSTRACT This project is a descriptive pre-research study of the wholesale gas market in Spain. For that purpose, the system's structure, functioning and the strategies required for its sustainability have been studied extensively. Capacities, tolls, etc. have been analysed so that results can be then extrapolated to the other markets examined. Once the spanish market was explored; belgian, french, english and dutch markets were analysed. In these markets, the basis required for a potential marketer entering these markets, have been evaluated. At last, as a research study, it includes an economic cost analysis that a study like this would imply

On the economics of energy consumption in 4G networks: the case of Spain

Reducing energy consumption is one of the main challenges in most countries. For example, European Member States agreed to reduce greenhouse gas (GHG) emissions by 20% in 2020 compared to 1990 levels (EC 2008). Considering each sector separately, ICTs account nowadays for 2% of total carbon emissions. This percentage will increase as the demand of communication services and applications steps up. At the same time, the expected evolution of ICT-based developments - smart buildings, smart grids and smart transportation systems among others - could result in the creation of energy-saving opportunities leading to global emission reductions (Labouze et al. 2008), although the amount of these savings is under debate (Falch 2010). The main development required in telecommunication networks ?one of the three major blocks of energy consumption in ICTs together with data centers and consumer equipment (Sutherland 2009) ? is the evolution of existing infrastructures into ultra-broadband networks, the so-called Next Generation Networks (NGN). Fourth generation (4G) mobile communications are the technology of choice to complete -or supplement- the ubiquitous deployment of NGN. The risk and opportunities involved in NGN roll-out are currently in the forefront of the economic and policy debate. However, the issue of which is the role of energy consumption in 4G networks seems absent, despite the fact that the economic impact of energy consumption arises as a key element in the cost analysis of this type of networks. Precisely, the aim of this research is to provide deeper insight on the energy consumption involved in the usage of a 4G network, its relationship with network main design features, and the general economic impact this would have in the capital and operational expenditures related with network deployment and usage.

Morteros acumuladores con parafinas microencapsuladas para el aprovechamiento de la energía solar en suelos radiantes

Esta Tesis plantea la pregunta de si el uso de morteros con parafinas microencapsuladas combinado con colectores solares térmicos puede reducir el consumo de energías convencionales, en un sistema tradicional de suelo radiante. Se pretende contribuir al conocimiento acerca del efecto que produce en el edificio, el calor latente acumulado en suelos radiantes, utilizando morteros de cemento Portland con material de cambio de fase (PCM), en conjunto con la energía solar. Para cumplir con este propósito, la investigación se desarrolla considerando diversos aspectos. En primer lugar, se revisa y analiza la documentación disponible en la actualidad, de almacenamiento de energía mediante calor latente en la construcción, y en particular la aplicación de microcápsulas de PCM en morteros y suelos radiantes. También se revisa la documentación relacionada con la aplicación de la energía solar térmica y en suelo radiante. Se analiza la normativa vigente respecto al material, a los colectores solares y al suelo radiante. Se verifica que no hay normativa relacionada con mortero-PCM, debido a esto se aplica en la investigación una adaptación de la existente. La fase experimental desarrollada esta principalmente dirigida a la cuantificación, caracterización y evaluación de las propiedades físicas, mecánicas y térmicas del mortero de cemento Portland con parafinas microencapsuladas. Los resultados obtenidos y su análisis, permiten conocer el comportamiento de este tipo de morteros, con las diferentes variables aplicadas en la investigación. Además, permite disponer de la información necesaria, para crear una metodología para el diseño de morteros con parafina microencapsulada, tanto del punto de vista de su resistencia a la compresión y contenido de PCM, como de su comportamiento térmico como acumulador de calor. Esto se logra procesando la información obtenida y generando modelos matemáticos, para dosificar mezclas, y predecir la acumulación de calor en función de su composición. Se determinan los tipos y cantidades de PCM, y el cemento más adecuado. Se obtienen importantes conclusiones respecto a los aspectos constructivos a considerar en la aplicación de morteros con PCM, en suelo radiante. Se analiza y evalúa la demanda térmica que se puede cubrir con el suelo radiante, utilizando morteros con parafina microencapsulada, a través de la acumulación de energía solar producida por colectores solares, para condiciones climáticas, técnicas y tipologías constructivas específicas. Se determina que cuando los paneles cubren más de 60 % de la demanda por calefacción, se puede almacenar en los morteros con PCM, el excedente generado durante el día. Se puede cubrir la demanda de acumulación de energía con los morteros con PCM, en la mayoría de los casos analizados. Con esto, se determina que el uso de morteros con PCM, aporta a la eficiencia energética de los edificios, disminuyendo el consumo de energías convencionales, reemplazándola por energía solar térmica. En esta investigación, el énfasis está en las propiedades del material mortero de cemento-PCM y en poder generar metodologías que faciliten su uso. Se aborda el uso de la energía solar, para verificar que es posible su acumulación en morteros con PCM aplicados en suelo radiante, posibilitando el reemplazo de energías convencionales. Quedan algunos aspectos de la aplicación de energía solar a suelo radiante con morteros con PCM, que no han sido tratados con la profundidad que requieren, y que resultan interesantes de evaluar en este tipo de aplicaciones constructivas, como entre otros, los relacionados con la cuantificación de los ahorros de energía en las diferentes estaciones del año, de la estabilización de temperaturas internas, su análisis de costo y la optimización de este tipo de sistemas para utilización en verano, los que dan pie para otras Tesis o proyectos de investigación. ABSTRACT This Thesis proposes the question of whether the use of mortars with microencapsulated paraffin combined with solar thermal collectors can reduce conventional energy consumption in a traditional heating floor system. It aims to contribute to knowledge about the effect that it has on the building, the latent heat accumulated in heating floor, using Portland cement mortars with phase change material (PCM), in conjunction with solar energy. To fulfill this purpose, the research develops it considering various aspects. First, it reviews and analyzes the documentation available today, about energy storage by latent heat in the building, and in particular the application of PCM microcapsules in mortars and heating floors. It also reviews the documentation related to the application of solar thermal energy and heating floor. Additionally, it analyzes the current regulations regarding to material, solar collectors and heating floors. It verifies that there aren’t regulations related to PCM mortar, due to this, it applies an adaptation in the investigation. The experimental phase is aimed to the quantification, mainly, characterization and evaluation of physical, mechanical and thermal properties of Portland cement mortar with microencapsulated paraffin. The results and analysis, which allow us to know the behavior of this type of mortars with different variables applied in research. It also allows having the information necessary to create a methodology for designing mortars with microencapsulated paraffin, both from the standpoint of its resistance to compression and PCM content, and its thermal performance as a heat accumulator. This accomplishes by processing the information obtained, and generating mathematical models for dosing mixtures, and predicting heat accumulation depending on their composition. The research determines the kinds and amounts of PCM, and the most suitable cement. Relevant conclusions obtain it regarding constructive aspects to consider in the implementation of PCM mortars in heating floor. Also, it analyzes and evaluates the thermal demand that it can be covered in heating floor using microencapsulated paraffin mortars, through the accumulation of solar energy produced by solar collectors to weather conditions, technical and specific building typologies. It determines that if the panels cover more than 60% of the demand for heating, the surplus generated during the day can be stored in PCM mortars. It meets the demand of energy storage with PCM mortars, in most of the cases analyzed. With this, it determines that the use of PCM mortars contributes to building energy efficiency, reducing consumption of conventional energy, replacing it with solar thermal energy. In this research approaches the use of solar energy to determine that it’s possible to verify its accumulation in PCM mortars applied in heating floor, enabling the replacement of conventional energy. The emphasis is on material properties of PCM mortar and, in order to generate methodologies to facilitate their use. There are some aspects of solar energy application in PCM mortars in heating floor, which have not been discussed with the depth required, and that they are relevant to evaluate in this kind of construction applications, including among others: the applications related to the energy savings quantification in different seasons of the year, the stabilizing internal temperatures, its cost analysis and optimization of these systems for use in summer, which can give ideas for other thesis or research projects.

Optimal and Long-Term Dynamic Transport Policy Design: Seeking Maximum Social Welfare through a Pricing Scheme

This article presents an alternative approach to the decision-making process in transport strategy design. The study explores the possibility of integrating forecasting, assessment and optimization procedures in support of a decision-making process designed to reach the best achievable scenario through mobility policies. Long-term evaluation, as required by a dynamic system such as a city, is provided by a strategic Land-Use and Transport Interaction (LUTI) model. The social welfare achieved by implementing mobility LUTI model policies is measured through a cost-benefit analysis and maximized through an optimization process throughout the evaluation period. The method is tested by optimizing a pricing policy scheme in Madrid on a cordon toll in a context requiring system efficiency, social equity and environmental quality. The optimized scheme yields an appreciable increase in social surplus through a relatively low rate compared to other similar pricing toll schemes. The results highlight the different considerations regarding mobility impacts on the case study area, as well as the major contributors to social welfare surplus. This leads the authors to reconsider the cost-analysis approach, as defined in the study, as the best option for formulating sustainability measures.

Consultoría en el marco económico-financiero de la empresa

Muchas de las grandes iniciativas empresariales, se ven truncadas por falta de un adecuado análisis económico-financiero. Incluso, muchas grandes ideas no son implantadas correctamente en el primer intento por este motivo, y son otras personas las que consiguen posteriormente el éxito de esas brillantes ideas gracias a una correcta aproximación financiera. Las empresas necesitan definir sus objetivos, establecer las para lograrlos, identificar las personas responsables de su ejecución (sus roles y funciones) y elaborar un plan económico-financiero que recoja el estudio de inversiones necesarias, el análisis de costes, la previsión de ingresos, así como la estrategia financiera más adecuada para la captación de los fondos necesarios para llevar a cabo las acciones programadas. Una vez iniciado el proyecto empresarial, será imprescindible realizar un seguimiento y control de la evolución (integración), tomando las medidas que se estimen oportunas para mantener el rumbo adecuado durante todo el tiempo de actividad. En este trabajo, aplicaremos las metodologías y buenas prácticas de la gestión de proyectos, como marco estructurado que nos permita abordar las principales cuestiones económico-financieras a tener en cuenta a la hora de enfrentarnos a un proyecto empresarial, para contribuir, en la medida de lo posible, a que los emprendedores tengan en cuenta estas cuestiones, facilitando así el desarrollo de negocios, en un difícil entorno económico de crisis como el que actualmente estamos viviendo en España, y animando de esta manera a optar por la iniciativa emprendedora, tratando de minimizar el riesgo en base al contenido. ---ABSTRACT---Lack of adequate economic and financial analysis truncates many of the entrepreneurship and innovation programs. Because of that reason, many great ideas are not even correctly implemented on the first attempt, and the person who finds the proper financial approach, succeed. All the enterprises have to establish clear objectives, actions to accomplish those objectives, assign roles, responsibilities and executive functions to specific people. Elaborate funding plan that contains surveys on necessary investments, cost analysis, estimate the income, liquid assets and also financial strategy suitable for fundraising to finance programmed actions. Once the project has been executed it is essential to monitor and control the development and integration adopting measures accordingly to the needs. This thesis applies methodology and best practice of project management as structured framework for the principal economic and financial issues facing business project. It is necessary contribution to entrepreneurs understanding of business, therefore facilitates business development in such rough environment as Spain is at this moment, and at the same time encourages adopting entrepreneur’s solution as less risky one. This document aims to explore all the economic and financial issues from methodological point of view based on my own professional experience, resulting in helping to understand the importance that economy and finances have in developing adequate corporate strategy. Crisis has highlighted inadequate functionality of many companies. Most popular first symptom is lack of cash flow that deteriorates the company, and results in suspension of payments followed by closing. In other cases, difficulties appear due to poor financial management of committed resources; to be observed in lack of prevision and planning or incorrect basic functionality and operational matters on daily basis. What would be your advice to someone who have magnificent business idea however no knowledge on how to handle finances in order to succeed in initiating and executing the project? Despite of the fact that the central nucleus of this paper is at economics and finances area, all the other concepts and topics given during master will be revived; for example business strategy, consultants abilities, organization and standard processes, among others, are impregnated with knowledge of project management.

Improving brain injury cognitive rehabilitation by personalized telerehabilitation services: Guttmann neuropersonal trainer

Cognitive rehabilitation aims to remediate or alleviate the cognitive deficits appearing after an episode of acquired brain injury (ABI). The purpose of this work is to describe the telerehabilitation platform called Guttmann Neuropersonal Trainer (GNPT) which provides new strategies for cognitive rehabilitation, improving efficiency and access to treatments, and to increase knowledge generation from the process. A cognitive rehabilitation process has been modeled to design and develop the system, which allows neuropsychologists to configure and schedule rehabilitation sessions, consisting of set of personalized computerized cognitive exercises grounded on neuroscience and plasticity principles. It provides remote continuous monitoring of patient's performance, by an asynchronous communication strategy. An automatic knowledge extraction method has been used to implement a decision support system, improving treatment customization. GNPT has been implemented in 27 rehabilitation centers and in 83 patients' homes, facilitating the access to the treatment. In total, 1660 patients have been treated. Usability and cost analysis methodologies have been applied to measure the efficiency in real clinical environments. The usability evaluation reveals a system usability score higher than 70 for all target users. The cost efficiency study results show a relation of 1-20 compared to face-to-face rehabilitation. GNPT enables brain-damaged patients to continue and further extend rehabilitation beyond the hospital, improving the efficiency of the rehabilitation process. It allows customized therapeutic plans, providing information to further development of clinical practice guidelines.