Theory of uncertainty in illness in patients with cancer of unknown primary origin: Structure providers as antecedents of uncertainty in a population of cancer patients with an unknown primary diagnosis

Uncertainty has been found to be a major component of the cancer experience and can dramatically affect psychosocial adaptation and outcomes of a patient's disease state (McCormick, 2002). Patients with a diagnosis of Carcinoma of Unknown Primary (CUP) may experience higher levels of uncertainty due to the unpredictability of current and future symptoms, limited treatment options and an undetermined life expectancy. To date, only one study has touched upon uncertainty and its' effects on those with CUP but no information exists concerning the effects of uncertainty regarding diagnosis and treatment on the distress level and psychosocial adjustment of this population (Parker & Lenzi, 2003). ^ Mishel's Uncertainty in Illness Theory (1984) proposes that uncertainty is preceded by three variables, one of which being Structure Providers. Structure Providers include credible authority, the degree of trust and confidence the patient has with their doctor, education and social support. It was the goal of this study to examine the relationship between uncertainty and Structure Providers to support the following hypotheses: (1) There will be a negative association between credible authority and uncertainty, (2) There will be a negative association between education level and uncertainty, and (3) There will be a negative association between social support and uncertainty. ^ This cross-sectional analysis utilized data from 219 patients following their initial consultation with their oncologist. Data included the Mishel Uncertainty in Illness Scale (MUIS) which was used to determine patients' uncertainty levels, the Medical Outcomes Study-Social Support Scale (MOSS-SSS) to assess patients, levels of social support, the Patient Satisfaction Questionnaire (PSQ-18) and the Cancer Diagnostic Interview Scale (CDIS) to measure credible authority and general demographic information to assess age, education, marital status and ethnicity. ^ In this study we found that uncertainty levels were generally higher in this sample as compared to other types of cancer populations. And while our results seemed to support most of our hypothesis, we were only able to show significant associations between two. The analyses indicated that credible authority measured by both the CDIS and the PSQ was a significant predictor of uncertainty as was social support measured by the MOSS-SS. Education has shown to have an inconsistent pattern of effect in relation to uncertainty and in the current study there was not enough data to significantly support our hypothesis. ^ The results of this study generally support Mishel's Theory of Uncertainty in Illness and highlight the importance of taking into consideration patients, psychosocial factors as well as employing proper communication practices between physicians and their patients.^

It's your game, keep it real. Sexual education study

Purpose: This study translated and adapted the It's Your Game, Keep It Real study currently being implemented with middle school youth in Southeast Texas for a middle school population in rural western Honduras. The study tested the effects of a sexual health education program focused on human immunodeficiency virus, sexually transmitted infections, and pregnancy prevention. We hypothesized that the number of adolescents in the intervention group who initiate sexual activity will reduce in comparison to the control group and there will be an increase consistent condom use in sexually active adolescents in the intervention group. ^ Methods: The target population included Spanish-speaking Hispanic middle school students from a small, semi-urban city in western Honduras. One school was randomly selected to receive the intervention and one to the comparison condition. The intervention curriculum consisted of 10 seventh-grade lessons that included individual and group classroom-based activities and personal journaling. Follow-up surveys were completed three months after the last lesson with 146 students (79.3% of the defined cohort). ^ Results: In the comparison condition, 21.4% of students initiated sex by the post-test follow-up three months after the intervention compared to 7.8% in the intervention condition. ^ Conclusions: A multi-component, curriculum-based program that is theory driven and culturally relevant can increase knowledge about STIs and HIV, increase self-confidence amongst middle school students, and develop communication skills amongst friends and partners. Further research must be conducted to assess delay in sexual initiation and the generalizability of these results.^

Something real: A social marketing approach to smoking prevention among Montevideo youth

Uruguay has some of the strictest tobacco-control laws in Latin America. Despite this, youth smoking rates in Uruguay are amongst the highest in South America. Thus, it is important to identify strategies to prevent youth smoking in Uruguay. The current qualitative research study sought to identify intrapersonal and socioenvironmental factors that are associated with smoking among middle school youth in Uruguay. It also sought to develop potential prevention strategies and media messages that would resonate with youth for a social media campaign. The study was grounded in social cognitive theory and the theory of reasoned action/planned behavior, among other behavioral science theories; anthropological perspectives were also considered. To achieve these goals, 29 group and individual structured interviews were conducted in two private middle schools catering to lower and higher SES youth in Montevideo, Uruguay during the summer of 2012. One hundred and three study participants, including students, parents, and teachers, were interviewed. The structured interviews were recorded, transcribed, translated, back translated, coded and analyzed. The study findings show that positive attitudes towards smoking (i.e. to be seen, to increase status, to ensure women's equality, to looking old, and to service as a rite of passage), delinquent behavior (i.e. transgression/deviant behavior), social norms that support smoking (i.e. peer pressure and modeling, group membership/sense of belonging, parental modeling, and family support), easy access and availability to tobacco (i.e. retails stores) were factors associated with youth smoking. Potential protective factors may include parental support, negative attitudes towards smoking, sports/music, and smoke-free environments. Because study participants are accustomed to government-sponsored strong countermarketing graphic imaging, study participants selected even stronger images and messages as the preferred way to receive tobacco prevention messages. Something Real ("Algo Real") was a theme that resonated with the participants and chosen as the name for the proposed campaign. This campaign was designed as a multiple component intervention that included mass, school base, and family based strategies to prevent tobacco use. Some intervention materials specific to these intervention components were developed to target relevant intrapersonal and socioenvironmental factors identified above. These materials will be tested in future pilot studies and larger scale evaluation with this population, outside the scope of this dissertation. ^

La unción real en el Sacramentario de Ratoldus : cooperación y significado en la liturgia medieval

El propósito de este trabajo es sondear las coincidencias y, por tanto, la cooperación que es posible encontrar entre textos de diversas procedencias y dataciones, acerca de los aspectos más representativos de la figura y de la función real. En primer lugar, se describe el proceso por el cual la inauguración del poder real es rodeado progresivamente de ritos litúrgicos. Luego, se señalan los elementos más significativos que contribuyeron a la construcción del ritual de la unción real. Finalmente, se analiza la oración de consagración real del Sacramentario de Ratoldus (s. X), rastreándose en ella los elementos que permiten reconstruir algunos aspectos centrales de la teoría política que alimentó a la sociedad altomedieval. Si tenemos en cuenta de que, en ese periodo histórico, no se produjeron tratados específicos sobre el tema, el recurso a los textos litúrgicos posibilita el acceso a una fuente de documentación válida y de particular interés para los estudios del pensamiento medieval.

Skilled emigration and exchange rate : theory and empirics

In this paper we build a theoretical model on the wage effect of skilled emigration to the fluctuations in real exchange rate through the relative prices of nontradables. Our theoretical model predicts that skilled emigration is associated with an increase in the prices of nontradable, which in turn appreciates the exchange rate. We provide robust empirical support to a higher skilled emigration associated with higher prices in nontradables and appreciation of the real effective exchange rate. Based on two samples of countries with 51 and 67 observations, in 1990 and 2000 respectively, we find robust empirical support to a higher skilled emigration associated with higher prices in nontradables and appreciation of the REER. In addition, the support for the remittance-channel of the Dutch disease is also significant; overall, our findings corroborate the remittance-based Dutch disease phenomenon by providing an additional channel through which the labor mobility across borders affects the real exchange rate volatility.

Some past decision theory models for euro construction model codes and for road drainage in Spain, and modest hints with multi-criteria methods for agro and environmental assurance

The authors are from UPM and are relatively grouped, and all have intervened in different academic or real cases on the subject, at different times as being of different age. With precedent from E. Torroja and A. Páez in Madrid Spain Safety Probabilistic models for concrete about 1957, now in ICOSSAR conferences, author J.M. Antón involved since autumn 1967 for euro-steel construction in CECM produced a math model for independent load superposition reductions, and using it a load coefficient pattern for codes in Rome Feb. 1969, practically adopted for European constructions, giving in JCSS Lisbon Feb. 1974 suggestion of union for concrete-steel-al.. That model uses model for loads like Gumbel type I, for 50 years for one type of load, reduced to 1 year to be added to other independent loads, the sum set in Gumbel theories to 50 years return period, there are parallel models. A complete reliability system was produced, including non linear effects as from buckling, phenomena considered somehow in actual Construction Eurocodes produced from Model Codes. The system was considered by author in CEB in presence of Hydraulic effects from rivers, floods, sea, in reference with actual practice. When redacting a Road Drainage Norm in MOPU Spain an optimization model was realized by authors giving a way to determine the figure of Return Period, 10 to 50 years, for the cases of hydraulic flows to be considered in road drainage. Satisfactory examples were a stream in SE of Spain with Gumbel Type I model and a paper of Ven Te Chow with Mississippi in Keokuk using Gumbel type II, and the model can be modernized with more varied extreme laws. In fact in the MOPU drainage norm the redacting commission acted also as expert to set a table of return periods for elements of road drainage, in fact as a multi-criteria complex decision system. These precedent ideas were used e.g. in wide Codes, indicated in symposia or meetings, but not published in journals in English, and a condensate of contributions of authors is presented. The authors are somehow involved in optimization for hydraulic and agro planning, and give modest hints of intended applications in presence of agro and environment planning as a selection of the criteria and utility functions involved in bayesian, multi-criteria or mixed decision systems. Modest consideration is made of changing in climate, and on the production and commercial systems, and on others as social and financial.

Data Fusion based on Game Theory for Speaker Diarization

A novel algorithm based on bimatrix game theory has been developed to improve the accuracy and reliability of a speaker diarization system. This algorithm fuses the output data of two open-source speaker diarization programs, LIUM and SHoUT, taking advantage of the best properties of each one. The performance of this new system has been tested by means of audio streams from several movies. From preliminary results on fragments of five movies, improvements of 63% in false alarms and missed speech mistakes have been achieved with respect to LIUM and SHoUT systems working alone. Moreover, we also improve in a 20% the number of recognized speakers, getting close to the real number of speakers in the audio stream

Theory of intermittency applied to classical pathological cases

The classical theory of intermittency developed for return maps assumes uniform density of points reinjected from the chaotic to laminar region. Though it works fine in some model systems, there exist a number of so-called pathological cases characterized by a significant deviation of main characteristics from the values predicted on the basis of the uniform distribution. Recently, we reported on how the reinjection probability density (RPD) can be generalized. Here, we extend this methodology and apply it to different dynamical systems exhibiting anomalous type-II and type-III intermittencies. Estimation of the universal RPD is based on fitting a linear function to experimental data and requires no a priori knowledge on the dynamical model behind. We provide special fitting procedure that enables robust estimation of the RPD from relatively short data sets (dozens of points). Thus, the method is applicable for a wide variety of data sets including numerical simulations and real-life experiments. Estimated RPD enables analytic evaluation of the length of the laminar phase of intermittent behaviors. We show that the method copes well with dynamical systems exhibiting significantly different statistics reported in the literature. We also derive and classify characteristic relations between the mean laminar length and main controlling parameter in perfect agreement with data provided by numerical simulations

Cooperative Multi-robot Patrolling: A study of distributed approaches based on mathematical models of game theory to protect infrastructures

El principio de Teoría de Juegos permite desarrollar modelos estocásticos de patrullaje multi-robot para proteger infraestructuras criticas. La protección de infraestructuras criticas representa un gran reto para los países al rededor del mundo, principalmente después de los ataques terroristas llevados a cabo la década pasada. En este documento el termino infraestructura hace referencia a aeropuertos, plantas nucleares u otros instalaciones. El problema de patrullaje se define como la actividad de patrullar un entorno determinado para monitorear cualquier actividad o sensar algunas variables ambientales. En esta actividad, un grupo de robots debe visitar un conjunto de puntos de interés definidos en un entorno en intervalos de tiempo irregulares con propósitos de seguridad. Los modelos de partullaje multi-robot son utilizados para resolver este problema. Hasta el momento existen trabajos que resuelven este problema utilizando diversos principios matemáticos. Los modelos de patrullaje multi-robot desarrollados en esos trabajos representan un gran avance en este campo de investigación. Sin embargo, los modelos con los mejores resultados no son viables para aplicaciones de seguridad debido a su naturaleza centralizada y determinista. Esta tesis presenta cinco modelos de patrullaje multi-robot distribuidos e impredecibles basados en modelos matemáticos de aprendizaje de Teoría de Juegos. El objetivo del desarrollo de estos modelos está en resolver los inconvenientes presentes en trabajos preliminares. Con esta finalidad, el problema de patrullaje multi-robot se formuló utilizando conceptos de Teoría de Grafos, en la cual se definieron varios juegos en cada vértice de un grafo. Los modelos de patrullaje multi-robot desarrollados en este trabajo de investigación se han validado y comparado con los mejores modelos disponibles en la literatura. Para llevar a cabo tanto la validación como la comparación se ha utilizado un simulador de patrullaje y un grupo de robots reales. Los resultados experimentales muestran que los modelos de patrullaje desarrollados en este trabajo de investigación trabajan mejor que modelos de trabajos previos en el 80% de 150 casos de estudio. Además de esto, estos modelos cuentan con varias características importantes tales como distribución, robustez, escalabilidad y dinamismo. Los avances logrados con este trabajo de investigación dan evidencia del potencial de Teoría de Juegos para desarrollar modelos de patrullaje útiles para proteger infraestructuras. ABSTRACT Game theory principle allows to developing stochastic multi-robot patrolling models to protect critical infrastructures. Critical infrastructures protection is a great concern for countries around the world, mainly due to terrorist attacks in the last decade. In this document, the term infrastructures includes airports, nuclear power plants, and many other facilities. The patrolling problem is defined as the activity of traversing a given environment to monitoring any activity or sensing some environmental variables If this activity were performed by a fleet of robots, they would have to visit some places of interest of an environment at irregular intervals of time for security purposes. This problem is solved using multi-robot patrolling models. To date, literature works have been solved this problem applying various mathematical principles.The multi-robot patrolling models developed in those works represent great advances in this field. However, the models that obtain the best results are unfeasible for security applications due to their centralized and predictable nature. This thesis presents five distributed and unpredictable multi-robot patrolling models based on mathematical learning models derived from Game Theory. These multi-robot patrolling models aim at overcoming the disadvantages of previous work. To this end, the multi-robot patrolling problem was formulated using concepts of Graph Theory to represent the environment. Several normal-form games were defined at each vertex of a graph in this formulation. The multi-robot patrolling models developed in this research work have been validated and compared with best ranked multi-robot patrolling models in the literature. Both validation and comparison were preformed by using both a patrolling simulator and real robots. Experimental results show that the multirobot patrolling models developed in this research work improve previous ones in as many as 80% of 150 cases of study. Moreover, these multi-robot patrolling models rely on several features to highlight in security applications such as distribution, robustness, scalability, and dynamism. The achievements obtained in this research work validate the potential of Game Theory to develop patrolling models to protect infrastructures.

Método para el análisis independiente de problemas

habilidades de comprensión y resolución de problemas. Tanto es así que se puede afirmar con rotundidad que no existe el método perfecto para cada una de las etapas de desarrollo y tampoco existe el modelo de ciclo de vida perfecto: cada nuevo problema que se plantea es diferente a los anteriores en algún aspecto y esto hace que técnicas que funcionaron en proyectos anteriores fracasen en los proyectos nuevos. Por ello actualmente se realiza un planteamiento integrador que pretende utilizar en cada caso las técnicas, métodos y herramientas más acordes con las características del problema planteado al ingeniero. Bajo este punto de vista se plantean nuevos problemas. En primer lugar está la selección de enfoques de desarrollo. Si no existe el mejor enfoque, ¿cómo se hace para elegir el más adecuado de entre el conjunto de los existentes? Un segundo problema estriba en la relación entre las etapas de análisis y diseño. En este sentido existen dos grandes riesgos. Por un lado, se puede hacer un análisis del problema demasiado superficial, con lo que se produce una excesiva distancia entre el análisis y el diseño que muchas veces imposibilita el paso de uno a otro. Por otro lado, se puede optar por un análisis en términos del diseño que provoca que no cumpla su objetivo de centrarse en el problema, sino que se convierte en una primera versión de la solución, lo que se conoce como diseño preliminar. Como consecuencia de lo anterior surge el dilema del análisis, que puede plantearse como sigue: para cada problema planteado hay que elegir las técnicas más adecuadas, lo que requiere que se conozcan las características del problema. Para ello, a su vez, se debe analizar el problema, eligiendo una técnica antes de conocerlo. Si la técnica utiliza términos de diseño entonces se ha precondicionado el paradigma de solución y es posible que no sea el más adecuado para resolver el problema. En último lugar están las barreras pragmáticas que frenan la expansión del uso de métodos con base formal, dificultando su aplicación en la práctica cotidiana. Teniendo en cuenta todos los problemas planteados, se requieren métodos de análisis del problema que cumplan una serie de objetivos, el primero de los cuales es la necesidad de una base formal, con el fin de evitar la ambigüedad y permitir verificar la corrección de los modelos generados. Un segundo objetivo es la independencia de diseño: se deben utilizar términos que no tengan reflejo directo en el diseño, para que permitan centrarse en las características del problema. Además los métodos deben permitir analizar problemas de cualquier tipo: algorítmicos, de soporte a la decisión o basados en el conocimiento, entre otros. En siguiente lugar están los objetivos relacionados con aspectos pragmáticos. Por un lado deben incorporar una notación textual formal pero no matemática, de forma que se facilite su validación y comprensión por personas sin conocimientos matemáticos profundos pero al mismo tiempo sea lo suficientemente rigurosa para facilitar su verificación. Por otro lado, se requiere una notación gráfica complementaria para representar los modelos, de forma que puedan ser comprendidos y validados cómodamente por parte de los clientes y usuarios. Esta tesis doctoral presenta SETCM, un método de análisis que cumple estos objetivos. Para ello se han definido todos los elementos que forman los modelos de análisis usando una terminología independiente de paradigmas de diseño y se han formalizado dichas definiciones usando los elementos fundamentales de la teoría de conjuntos: elementos, conjuntos y relaciones entre conjuntos. Por otro lado se ha definido un lenguaje formal para representar los elementos de los modelos de análisis – evitando en lo posible el uso de notaciones matemáticas – complementado con una notación gráfica que permite representar de forma visual las partes más relevantes de los modelos. El método propuesto ha sido sometido a una intensa fase de experimentación, durante la que fue aplicado a 13 casos de estudio, todos ellos proyectos reales que han concluido en productos transferidos a entidades públicas o privadas. Durante la experimentación se ha evaluado la adecuación de SETCM para el análisis de problemas de distinto tamaño y en sistemas cuyo diseño final usaba paradigmas diferentes e incluso paradigmas mixtos. También se ha evaluado su uso por analistas con distinto nivel de experiencia – noveles, intermedios o expertos – analizando en todos los casos la curva de aprendizaje, con el fin de averiguar si es fácil de aprender su uso, independientemente de si se conoce o no alguna otra técnica de análisis. Por otro lado se ha estudiado la capacidad de ampliación de modelos generados con SETCM, para comprobar si permite abordar proyectos realizados en varias fases, en los que el análisis de una fase consista en ampliar el análisis de la fase anterior. En resumidas cuentas, se ha tratado de evaluar la capacidad de integración de SETCM en una organización como la técnica de análisis preferida para el desarrollo de software. Los resultados obtenidos tras esta experimentación han sido muy positivos, habiéndose alcanzado un alto grado de cumplimiento de todos los objetivos planteados al definir el método.---ABSTRACT---Software development is an inherently complex activity, which requires specific abilities of problem comprehension and solving. It is so difficult that it can even be said that there is no perfect method for each of the development stages and that there is no perfect life cycle model: each new problem is different to the precedent ones in some respect and the techniques that worked in other problems can fail in the new ones. Given that situation, the current trend is to integrate different methods, tools and techniques, using the best suited for each situation. This trend, however, raises some new problems. The first one is the selection of development approaches. If there is no a manifestly single best approach, how does one go about choosing an approach from the array of available options? The second problem has to do with the relationship between the analysis and design phases. This relation can lead to two major risks. On one hand, the analysis could be too shallow and far away from the design, making it very difficult to perform the transition between them. On the other hand, the analysis could be expressed using design terminology, thus becoming more a kind of preliminary design than a model of the problem to be solved. In third place there is the analysis dilemma, which can be expressed as follows. The developer has to choose the most adequate techniques for each problem, and to make this decision it is necessary to know the most relevant properties of the problem. This implies that the developer has to analyse the problem, choosing an analysis method before really knowing the problem. If the chosen technique uses design terminology then the solution paradigm has been preconditioned and it is possible that, once the problem is well known, that paradigm wouldn’t be the chosen one. The last problem consists of some pragmatic barriers that limit the applicability of formal based methods, making it difficult to use them in current practice. In order to solve these problems there is a need for analysis methods that fulfil several goals. The first one is the need of a formal base, which prevents ambiguity and allows the verification of the analysis models. The second goal is design-independence: the analysis should use a terminology different from the design, to facilitate a real comprehension of the problem under study. In third place the analysis method should allow the developer to study different kinds of problems: algorithmic, decision-support, knowledge based, etc. Next there are two goals related to pragmatic aspects. Firstly, the methods should have a non mathematical but formal textual notation. This notation will allow people without deep mathematical knowledge to understand and validate the resulting models, without losing the needed rigour for verification. Secondly, the methods should have a complementary graphical notation to make more natural the understanding and validation of the relevant parts of the analysis. This Thesis proposes such a method, called SETCM. The elements conforming the analysis models have been defined using a terminology that is independent from design paradigms. Those terms have been then formalised using the main concepts of the set theory: elements, sets and correspondences between sets. In addition, a formal language has been created, which avoids the use of mathematical notations. Finally, a graphical notation has been defined, which can visually represent the most relevant elements of the models. The proposed method has been thoroughly tested during the experimentation phase. It has been used to perform the analysis of 13 actual projects, all of them resulting in transferred products. This experimentation allowed evaluating the adequacy of SETCM for the analysis of problems of varying size, whose final design used different paradigms and even mixed ones. The use of the method by people with different levels of expertise was also evaluated, along with the corresponding learning curve, in order to assess if the method is easy to learn, independently of previous knowledge on other analysis techniques. In addition, the expandability of the analysis models was evaluated, assessing if the technique was adequate for projects organised in incremental steps, in which the analysis of one step grows from the precedent models. The final goal was to assess if SETCM can be used inside an organisation as the preferred analysis method for software development. The obtained results have been very positive, as SETCM has obtained a high degree of fulfilment of the goals stated for the method.

Environmental Wireless Sensor Network Deployment in Food Industry: from Theory to Practice

The difficulty behind Wireless Sensor Network deployments in industrial environments not only resides in the number of nodes or the communication protocols but also in the real location of the sensor nodes and the parameters to be monitored. Sensor soiling, high humidity and unreachable locations, among others, make real deployments a very difficult task to plan. Even though it is possible to find myriad approaches for floor planners and deployment tools in the state of the art, most of these problems are very difficult to model and foresee before actually deploying the network in the final scenario. This work shows two real deployments in food factories and how their problems are found and overcome.

Saint Mathew Law and Bonini Paradox in Textual Theory of Complex Models

The mathematical models of the complex reality are texts belonging to a certain literature that is written in a semi-formal language, denominated L(MT) by the authors whose laws linguistic mathematics have been previously defined. This text possesses linguistic entropy that is the reflection of the physical entropy of the processes of real world that said text describes. Through the temperature of information defined by Mandelbrot, the authors begin a text-reality thermodynamic theory that drives to the existence of information attractors, or highly structured point, settling down a heterogeneity of the space text, the same one that of ontologic space, completing the well-known law of Saint Mathew, of the General Theory of Systems and formulated by Margalef saying: “To the one that has more he will be given, and to the one that doesn't have he will even be removed it little that it possesses.

Proof theory for lattice-ordered groups

Proof-theoretic methods are developed and exploited to establish properties of the variety of lattice-ordered groups. In particular, a hypersequent calculus with a cut rule is used to provide an alternative syntactic proof of the generation of the variety by the lattice-ordered group of automorphisms of the real number chain. Completeness is also established for an analytic (cut-free) hypersequent calculus using cut elimination and it is proved that the equational theory of the variety is co-NP complete.

A note on Atrubin's real-time iterative multiplier /

"UIUCDCS-R-74-640"

A treatise on the theory and management of ulcers : with a dissertation on white swellings of the joints. To which is prefixed an essay on the chirurgical treatment of inflammation and its consequences /

Mode of access: Internet.