829 resultados para How to be


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Venous thromboembolism (VTE) is a major cause of mortality during Western women's fertile life. Although half of thromboembolic events occur during times of low-risk situations, almost all our knowledge is focused on medical thromboprophylaxis during high-risk situations. Thus, since we only use medical thromboprophylaxis at high-risk periods, lifestyle advice could be an attractive complement both during high- and low-risk situations. The knowledge of how lifestyle factors affect VTE risk has grown in recent years, and women at high risk are often highly motivated to make changes in order to reduce their risk. This review is focused on modifiable risk factors for VTE and advice that may be given to women at increased risk of VTE.

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Overdiagnosis is the diagnosis of an abnormality that is not associated with a substantial health hazard and that patients have no benefit to be aware of. It is neither a misdiagnosis (diagnostic error), nor a false positive result (positive test in the absence of a real abnormality). It mainly results from screening, use of increasingly sensitive diagnostic tests, incidental findings on routine examinations, and widening diagnostic criteria to define a condition requiring an intervention. The blurring boundaries between risk and disease, physicians' fear of missing a diagnosis and patients' need for reassurance are further causes of overdiagnosis. Overdiagnosis often implies procedures to confirm or exclude the presence of the condition and is by definition associated with useless treatments and interventions, generating harm and costs without any benefit. Overdiagnosis also diverts healthcare professionals from caring about other health issues. Preventing overdiagnosis requires increasing awareness of healthcare professionals and patients about its occurrence, the avoidance of unnecessary and untargeted diagnostic tests, and the avoidance of screening without demonstrated benefits. Furthermore, accounting systematically for the harms and benefits of screening and diagnostic tests and determining risk factor thresholds based on the expected absolute risk reduction would also help prevent overdiagnosis.

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BACKGROUND: Despite long-standing calls to disseminate evidence-based treatments for generalized anxiety (GAD), modest progress has been made in the study of how such treatments should be implemented. The primary objective of this study was to test three competing strategies on how to implement a cognitive behavioral treatment (CBT) for out-patients with GAD (i.e., comparison of one compensation vs. two capitalization models). METHODS: For our three-arm, single-blinded, randomized controlled trial (implementation of CBT for GAD [IMPLEMENT]), we recruited adults with GAD using advertisements in high-circulation newspapers to participate in a 14-session cognitive behavioral treatment (Mastery of your Anxiety and Worry, MAW-packet). We randomly assigned eligible patients using a full randomization procedure (1:1:1) to three different conditions of implementation: adherence priming (compensation model), which had a systematized focus on patients' individual GAD symptoms and how to compensate for these symptoms within the MAW-packet, and resource priming and supportive resource priming (capitalization model), which had systematized focuses on patients' strengths and abilities and how these strengths can be capitalized within the same packet. In the intention-to-treat population an outcome composite of primary and secondary symptoms-related self-report questionnaires was analyzed based on a hierarchical linear growth model from intake to 6-month follow-up assessment. This trial is registered at ClinicalTrials.gov (identifier: NCT02039193) and is closed to new participants. FINDINGS: From June 2012 to Nov. 2014, from 411 participants that were screened, 57 eligible participants were recruited and randomly assigned to three conditions. Forty-nine patients (86%) provided outcome data at post-assessment (14% dropout rate). All three conditions showed a highly significant reduction of symptoms over time. However, compared with the adherence priming condition, both resource priming conditions indicated faster symptom reduction. The observer ratings of a sub-sample of recorded videos (n = 100) showed that the therapists in the resource priming conditions conducted more strength-oriented interventions in comparison with the adherence priming condition. No patients died or attempted suicide. INTERPRETATION: To our knowledge, this is the first trial that focuses on capitalization and compensation models during the implementation of one prescriptive treatment packet for GAD. We have shown that GAD related symptoms were significantly faster reduced by the resource priming conditions, although the limitations of our study included a well-educated population. If replicated, our results suggest that therapists who implement a mental health treatment for GAD might profit from a systematized focus on capitalization models. FUNDING: Swiss Science National Foundation (SNSF-Nr. PZ00P1_136937/1) awarded to CF. KEYWORDS: Cognitive behavioral therapy; Evidence-based treatment; Implementation strategies; Randomized controlled trial

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What some view as overly-generous funding of the Scottish parliament results from Scotland.s credible threat to secede from the United Kingdom. Scotland is shown to benefit from a second mover advantage in a non-cooperative sequential game over the allocation of public funds. Various reform proposals are criticized for not recognizing that reform of Scottish government finances must be consistent with Scotland.s credible threat. Fiscal autonomy -- in which the Scottish parliament finances a much greater proportion of its spending from Scottish-sourced taxes, is demonstrated to be a viable reform within the existing political context and, in some circumstances, could remove Scotland.s second mover advantage. We also use a cooperative bargaining game model to demonstrate that an Australian style grants commission would not be a viable reform in the British context.

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Global linear instability theory is concerned with the temporal or spatial development of small-amplitude perturbations superposed upon laminar steady or time-periodic threedimensional flows, which are inhomogeneous in two (and periodic in one) or all three spatial directions.1 The theory addresses flows developing in complex geometries, in which the parallel or weakly nonparallel basic flow approximation invoked by classic linear stability theory does not hold. As such, global linear theory is called to fill the gap in research into stability and transition in flows over or through complex geometries. Historically, global linear instability has been (and still is) concerned with solution of multi-dimensional eigenvalue problems; the maturing of non-modal linear instability ideas in simple parallel flows during the last decade of last century2–4 has given rise to investigation of transient growth scenarios in an ever increasing variety of complex flows. After a brief exposition of the theory, connections are sought with established approaches for structure identification in flows, such as the proper orthogonal decomposition and topology theory in the laminar regime and the open areas for future research, mainly concerning turbulent and three-dimensional flows, are highlighted. Recent results obtained in our group are reported in both the time-stepping and the matrix-forming approaches to global linear theory. In the first context, progress has been made in implementing a Jacobian-Free Newton Krylov method into a standard finite-volume aerodynamic code, such that global linear instability results may now be obtained in compressible flows of aeronautical interest. In the second context a new stable very high-order finite difference method is implemented for the spatial discretization of the operators describing the spatial BiGlobal EVP, PSE-3D and the TriGlobal EVP; combined with sparse matrix treatment, all these problems may now be solved on standard desktop computers.

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Over the last decade, Grid computing paved the way for a new level of large scale distributed systems. This infrastructure made it possible to securely and reliably take advantage of widely separated computational resources that are part of several different organizations. Resources can be incorporated to the Grid, building a theoretical virtual supercomputer. In time, cloud computing emerged as a new type of large scale distributed system, inheriting and expanding the expertise and knowledge that have been obtained so far. Some of the main characteristics of Grids naturally evolved into clouds, others were modified and adapted and others were simply discarded or postponed. Regardless of these technical specifics, both Grids and clouds together can be considered as one of the most important advances in large scale distributed computing of the past ten years; however, this step in distributed computing has came along with a completely new level of complexity. Grid and cloud management mechanisms play a key role, and correct analysis and understanding of the system behavior are needed. Large scale distributed systems must be able to self-manage, incorporating autonomic features capable of controlling and optimizing all resources and services. Traditional distributed computing management mechanisms analyze each resource separately and adjust specific parameters of each one of them. When trying to adapt the same procedures to Grid and cloud computing, the vast complexity of these systems can make this task extremely complicated. But large scale distributed systems complexity could only be a matter of perspective. It could be possible to understand the Grid or cloud behavior as a single entity, instead of a set of resources. This abstraction could provide a different understanding of the system, describing large scale behavior and global events that probably would not be detected analyzing each resource separately. In this work we define a theoretical framework that combines both ideas, multiple resources and single entity, to develop large scale distributed systems management techniques aimed at system performance optimization, increased dependability and Quality of Service (QoS). The resulting synergy could be the key 350 J. Montes et al. to address the most important difficulties of Grid and cloud management.

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The idea that a building and consequently its structure is for a lifetime has stopped being a reference. CTE establishes that the life utility of a normal construction structure should be of 50years. If the time variable is introduced in the calculation of actions on structures, seems evident thatdifferent values can be used for a standard building, for a provisional structure with ≤ 10 years of life utility or for a monumental building with a life utility of 100 years. The present presentation follows at all moment, the directives and formulations given in the different structural Eurocodes, till the moment not included in the CTE. Finally the values of the actions that must be used to extend the life utility of a building until. 100 years will be deduced, also it suitability and e conomic feasibility will be discuss.

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Following recent accounting and ethical scandals within the Telecom Industry like Gowex case, old cards are laid on the table: what kind of management and control are we doing on our businesses and what use do we give to the specific tools we have at our disposition? There are indicators, that on a very specific, concise and accurate manner, aside from brief, allow us to analyze and capture the complexity of a business and also they constitute an important support when making optimal decisions. These instruments or indicators show, a priori, all relevant data from a purely economic perspective, while there also exist, the possibility of including factors that are not of this nature strictly. For instance, there are indicators that take into account the customer?s satisfaction, the corporate reputation among others. Both kind of performance indicators form, together, an integral dashboard while the pure economic side of it could be considered as a basic dashboard. Based on DuPont?s methodology, we will be able to calculate the ROI (Return on Investment) of a company from the disaggregation of very useful and much needed indicators like the ROE (Return on Equity) or the ROA (Return on Assets); thereby, we will be able to get to know, to control and, hence, to optimize the company?s leverage level, its liquidity ratio or its solvency ratio, among others; as well as the yield we will be able to obtain if our decisions and management are optimal related to the bodies of assets. Bear in mind and make the most of the abovementioned management tools and indicators that we have at our disposition, allow us to act knowing our path and taking full responsibility, as well as, to obtain the maximum planned benefits, instead of leaving them to be casual. We will be able to avoid errors that can lead the company to an unfortunate and non-desirable situation and, of course, we will detect, way in advance, the actual needs of the business in terms of accounting and financial sanitation before irreversible situations are reached.

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Entre los problemas medioambientales más trascendentales para la sociedad, se encuentra el del cambio climático así como el de la calidad del aire en nuestras áreas metropolitanas. El transporte por carretera es uno de los principales causantes, y como tal, las administraciones públicas se enfrentan a estos problemas desde varios ángulos: Cambios a modos de transporte más limpios, nuevas tecnologías y combustibles en los vehículos, gestión de la demanda y el uso de tecnologías de la información y la comunicación (ICT) aplicadas al transporte. En esta tesis doctoral se plantea como primer objetivo el profundizar en la comprensión de cómo ciertas medidas ICT afectan al tráfico, las emisiones y la propia dinámica de los vehículos. El estudio se basa en una campaña de recogida de datos con vehículos flotantes para evaluar los impactos de cuatro medidas concretas: Control de velocidad por tramo, límites variables de velocidad, limitador de velocidad (control de crucero) y conducción eficiente (eco‐driving). Como segundo objetivo, el estudio se centra en la conducción eficiente, ya que es una de las medidas que más ahorros de combustible presenta a nivel individual. Aunque estas reducciones están suficientemente documentadas en la literatura, muy pocos estudios se centran en estudiar el efecto que los conductores eficientes pueden tener en el flujo de tráfico, y cuál sería el impacto si se fuera aumentando el porcentaje de este tipo de conductores. A través de una herramienta de microsimulación de tráfico, se han construido cuatro modelos de vías urbanas que se corresponden con una autopista urbana, una arteria, un colector y una vía local. Gracias a los datos recogidos en la campaña de vehículos flotantes, se ha calibrado el modelo, tanto el escenario base como el ajuste de parámetros de conducción para simular la conducción eficiente. En total se han simulado 72 escenarios, variando el tipo de vía, la demanda de tráfico y el porcentaje de conductores eficientes. A continuación se han calculado las emisiones de CO2 and NOx mediante un modelo de emisiones a nivel microscópico. Los resultados muestran que en escenarios con alto porcentaje de conductores eficientes y altas demandas de tráfico las emisiones aumentan. Esto se debe a que las mayores distancias de seguridad y las aceleraciones y frenadas suaves hacen que aumente la congestión, produciendo así mayores emisiones a nivel global. Climate change and the reduced air quality in our metropolitan areas are two of the main environmental problems that the society is addressing currently. Being road transportation one of the main contributors, public administrations are facing these problems from different points of view: shift to cleaner modes, new fuels and vehicle technologies, demand management and the use of information and communication technologies (ICT) applied to transportation. The first objective of this thesis is to understand how certain ICT measures affect traffic, emissions and vehicle dynamics. The study is based on a data collection campaign with floating vehicles to evaluate the impact of four specific measures: section speed control, variable speed limits, cruise control and eco‐driving. The second objective of the study focuses on eco‐driving, as it is one of the measures that present the largest fuel savings at an individual level. Although these savings are well documented in the literature, few studies focus on how ecodrivers affect the surrounding vehicles and the traffic, and what would be the impact in case of different eco‐drivers percentage. Using a traffic micro‐simulation tool, four models in urban context have been built, corresponding to urban motorway, urban arterial, urban collector and a local street. Both the base‐case and the parameters setting to simulate eco‐driving have been calibrated with the data collected through floating vehicles. In total 72 scenarios were simulated, varying the type of road, traffic demand and the percentage of eco‐drivers. Then, the CO2 and NOx emissions have been estimated through the use of an emission model at microscopic level. The results show that in scenarios with high percentage of co‐drivers and high traffic demand the emissions rise. Higher headways and smooth acceleration and decelerations increase congestion, producing higher emissions globally.

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Companies are looking for workers trained in soft skills, and we want to help in the learning process. How? Through three courses (Building trust through values, soft skills and entrepreneurship) and historical aces, characters who joined strong values, intellectual and social capabilities and an entrepreneurial spirit, to leave a legacy. CompasLab.org = Values + Skills + Action.

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This paper will focus on Leon Tebbetts’ time in the United States Army Air Corps as an artist for Special Services. It will demonstrate how a combination of personal associations and psychological factors, including Hartley’s death, contributed to Tebbetts’ decision to abandon painting, with the result that this World War II muralist has been almost entirely forgotten.

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Introducing teaching about healthy solutions in buildings and BIM has been a challenge for the University of Alicante. Teaching attached to very tighten study plans conditioned the types of methods that could be used in the past. The worldwide situation of crisis that especially reached Spain and the bursting of the housing bubble generated a lack of employment that reached universities where careers related to construction, Architecture and Architectural Technologist, suffered a huge reduction in the number of students enrolled. In the case of the University of Alicante, students’ enrolment for Architectural Technology reached an 80% reduction. The necessity of a reaction against this situation made the teachers be innovative and use the new Bologna adapted study plans to develop new teaching experiences introducing new concepts: people wellbeing in buildings and BIM. Working with healthy solutions in buildings provided new approaches for building design and construction as an alternative to sustainability. For many years sustainability was the concept that applied to housing gave buildings an added value and the possibility of having viability in a very complex scenario. But after lots of experiences, the approved methodologies for obtaining sustainable housing were ambiguous and at the end, investors, designers, constructors and purchasers cannot find real and validated criteria for obtaining an effective sustainable house. It was the moment to work with new ideas and concepts and start facing buildings from the users’ point of view. At the same time the development of new tools, BIM, has opened a wide range of opportunities, innovative and suggestive, that allows simulation and evaluation of many building factors. This paper describes the research in teaching developed by the University of Alicante to adapt the current study plans, introducing work with healthy solutions in buildings and the use of BIM, with the aim of attracting students by improving their future employability. Pilot experiences have been carried out in different subjects based on the work with projects and case studies under an international frame with the cooperation of different European partner universities. The use of BIM tools, introduced in 2014, solved the problems that appeared in some subjects, mainly building construction, and helped with the evaluation of some healthy concepts that presented difficulties until this moment as knowledge acquired by the students was hard to be evaluated. The introduction of BIM tools: Vasari, FormIt, Revit and Light Control among others, allowed the study of precise healthy concepts and provided the students a real understand of how these different parameters can condition a healthy architectural space. The analysis of the results showed a clear acceptance by the students and gave teachers the possibility of opening new research lines. At the same time, working with BIM tools to obtain healthy solutions in building has been a good option to improve students’ employability as building market in Spain is increasing the number of specialists in BIM with a wider knowledge.

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A procedure is proposed to name new chemical elements. After the discovery of a new element is established by the joint IUPAC-IUPAP Working Group, the discoverers are invited to propose a name and a symbol to the IUPAC Inorganic Chemistry Division. Elements can be named after a mythological concept, a mineral, a place or country, a property or a scientist. After examination and acceptance by the Inorganic Chemistry Division, the proposal follows the accepted IUPAC procedure and is then ratified by the Council of IUPAC. This document is a slightly amended version of the 2002 IUPAC Recommendations; the most important change is that the names of all new elements should have an ending that reflects and maintains historical and chemical consistency. This would be in general “-ium” for elements belonging to groups 1–16, i.e. including the f-block elements, “-ine” for elements of group 17 and “-on” for elements of group 18.

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A lively debate emerged on the proposed “Connected Continent” legislative package presented by the European Commission in September 2013. The package contains a proposed rule on the ‘open Internet’, which was heavily discussed in European Parliament hearings in early December. This commentary argues that while the proposed rule is in principle balanced and appealing, it is utterly impractical due to the enormous uncertainty that its application would entail. At the same time, the rule is very far from what neutrality proponents have argued for almost a decade: rather than the place for internet freedom, it would transform the Web into a place requiring constant micro-management and tutoring of user behaviour. Both arguments lead to the conclusion that the current proposal should be at once reformed and analysed under a more holistic lens. On the one hand, Europe should launch an ambitious project for the future, converged infrastructure by mobilising resources and reforming rules to encourage investment into ubiquitous, converged, ‘always on’ connectivity. On the other hand, enhanced legal certainty for broadband investment could justify a more neutrality-oriented approach to traffic management practices on the Internet. The author proposes a new approach to Internet regulation which, altogether, will lead to a more balanced and sustainable model for the future, without jeopardising user freedom.

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This report is based on discussions within the CEPS Task Force on “The Quantity and Quality of Human Capital in Higher Education: Comparing the EU, the US and China", chaired by Jan-Eric Sundgren, Senior Adviser to the CEO of Volvo, and former President of Chalmers University of Technology in Gothenburg. It aims to draw salient lessons from the successes and failures in higher education practices in the EU, the US and China by comparing key education indicators and policy trends. Against the background of the profound tectonic shifts affecting the talent distribution around the world, which is fundamentally changing the global ‘brain game’, the authors argue that it is important that the EU as a whole creates ‘virtuous circles’ of talent and innovation to sustain prosperity and growth, as well as to secure the long-term well-being and quality of life in Europe.