Plataforma automatizada de detección de malware

Es descriu el disseny i posterior implementació de la nova plataforma d’automatització del servei ofert per Internet Security Auditors, S.L. destinada a l’anàlisi de dominis d’Internet amb la finalitat de detectar possibles infeccions que afectin a usuaris de la web. El sistema actual conté algunes deficiències, de manera que aquest text presenta una nova versió, la qual aporta millores molt significatives com ara una gestió més òptima, o un disseny renovat i escalable de la informació i els diferents processos. Així mateix es dota al sistema d’un control d’errors centralitzat, amb enviament d’alàrmes en temps real, i una agrupació i centralització dels resultats.

Colonoscopy is the preferred colorectal cancer screening method in a population-based program.

BACKGROUND AND STUDY AIMS: Various screening methods for colorectal cancer (CRC) are promoted by professional societies; however, few data are available about the factors that determine patient participation in screening, which is crucial to the success of population-based programs. This study aimed (i) to identify factors that determine acceptance of screening and preference of screening method, and (ii) to evaluate procedure success, detection of colorectal neoplasia, and patient satisfaction with screening colonoscopy. PATIENTS AND METHODS: Following a public awareness campaign, the population aged 50 - 80 years was offered CRC screening in the form of annual fecal occult blood tests, flexible sigmoidoscopy, a combination of both, or colonoscopy. RESULTS: 2731 asymptomatic persons (12.0 % of the target population) registered with and were eligible to take part in the screening program. Access to information and a positive attitude to screening were major determinants of participation. Colonoscopy was the method preferred by 74.8 % of participants. Advanced colorectal neoplasia was present in 8.5 %; its prevalence was higher in males and increased with age. Significant complications occurred in 0.5 % of those undergoing colonoscopy and were associated with polypectomy or sedation. Most patients were satisfied with colonoscopy and over 90 % would choose it again for CRC screening. CONCLUSIONS: In this population-based study, only a small proportion of the target population underwent CRC screening despite an extensive information campaign. Colonoscopy was the preferred method and was safe. The determinants of participation in screening and preference of screening method, together with the distribution of colorectal neoplasia in different demographic categories, provide a rationale for improving screening procedures.

Ambulatory measurement of ankle kinetics for clinical applications.

This study aimed to design and validate the measurement of ankle kinetics (force, moment, and power) during consecutive gait cycles and in the field using an ambulatory system. An ambulatory system consisting of plantar pressure insole and inertial sensors (3D gyroscopes and 3D accelerometers) on foot and shank was used. To test this system, 12 patients and 10 healthy elderly subjects wore shoes embedding this system and walked many times across a gait lab including a force-plate surrounded by seven cameras considered as the reference system. Then, the participants walked two 50-meter trials where only the ambulatory system was used. Ankle force components and sagittal moment of ankle measured by ambulatory system showed correlation coefficient (R) and normalized RMS error (NRMSE) of more than 0.94 and less than 13% in comparison with the references system for both patients and healthy subjects. Transverse moment of ankle and ankle power showed R>0.85 and NRMSE<23%. These parameters also showed high repeatability (CMC>0.7). In contrast, the ankle coronal moment of ankle demonstrated high error and lower repeatability. Except for ankle coronal moment, the kinetic features obtained by the ambulatory system could distinguish the patients with ankle osteoarthritis from healthy subjects when measured in 50-meter trials. The proposed ambulatory system can be easily accessible in most clinics and could assess main ankle kinetics quantities with acceptable error and repeatability for clinical evaluations. This system is therefore suggested for field measurement in clinical applications.

Caracterización de materiales en banda W

Para medir los coeficientes de transmisión y reflexión, S21 y S11, de diferentes materiales o muestras planas, se usa un sistema de toma de medidas en espacio libre operando banda W (75 – 110 GHz). Usando estos parámetros, S21 y S11, podemos calcular la permitividad dieléctrica relativa compleja (Er ) y la permeabilidad magnética relativa compleja (μr) mediante un proceso llamado NRW (Nicolson-Ross-Weir). El sistema para medir consiste en dos antenas de bocina, una transmisora y otra receptora, dos espejos con los que obtenemos una onda plana para medir las propiedades del material y un ordenador o dispositivo que calcula los resultados. Este dispositivo requiere de calibración para la obtención de resultados óptimos. Dicho sistema se puede simular de manera ideal con un software llamado ADS (Assistance Design System) para el estudio y comparación de grosores, permitividades dieléctricas relativas y permeabilidades magnéticas relativas de los materiales en función de la frecuencia.

Patients satisfaction in an academic walk-in centre : a new model of residents training achieved by family doctors

Introduction Walk-in centers may improve access to healthcare for some patients, due to their convenient location and extensive opening hours, with no need for appointment. Herein we describe and assess a new model of walk-in centre, characterized by care provided by residents and supervision achieved by experienced family doctors. Main aim of the study was to assess patients satisfaction about the care they received from residents and the supervision by family doctors. Secondary aim was to describe walk-in patients demographic characteristics and to identify potential associations with satisfaction. Methods The study was conducted in the walk-in centre of Lausanne. Patients who consulted between in April 2011 were automatically included and received a questionnaire in French. We used a five-point Likert scale, from "not at all satisfied" to "very satisfied", converted from 1 to 5. We focused on the satisfaction regarding residents care and supervision by a family doctor. The former was divided in three categories: "Skills", "Treatment" and "Behaviour". Mean satisfaction was calculated for each category and a multivariable logistic model was applied in order to identify associations among patients demographics. Results Response rate was 47% [184/395], Walk-in patients were more likely to be women, young, with a high education level. Patients were very satisfied with residents care, with median satisfaction between 4.5 and 5, for each category. Over than 90% of patients were "satisfied" or "very satisfied" that a family doctor was involved in the consultation. Age showed the major association of satisfaction. Discussion Patients were highly satisfied with care provided by residents and with involvement of a family doctor in the consultation. Older age showed the major association with satisfaction with a positive impact. The high satisfaction reported by walk-in patients supports this new model of walk-in centre.

A Survey of Health Service Utilisation and Health Needs of a Population of Patient with HIV/ AIDS

This study described the demographic and medical characteristics of a population of patients with HIV/AIDS attending the department of Genito-Urinary Medicine (GUM) at a major Dublin hospital. The study population's utilisation of statutory and voluntary medical and social services at primary care level, satisfaction with services received and perceived need for services examined. The information obtained was used to make recommendations concerning the provision of care to patients with HIV/AIDS. The study was carried out between February and November 1994. Data was collected from a consecutive sample of eighty inpatients using n interviewer-administered questionnaire which contained both closed and open questions. The first forty patients interviewed were reviewed six months following the initial interview to document changes in physical condition and uptake of medical services over that time period. Data for the second part of the study was obtained by review of the patients' medical case notes and interview with the individual hospital medical social worker assigned to each patient. Over ninety percent of respondents were from the Greater Dublin Area. Almost three quarters were intravenous drug users (IVDUs), and the majority of these patients came from south inner city Dublin. The methodology was biased towards sampling patients with advanced disease and 73% had CDC Stage 4 disease. Twenty percent required some assistance with the activities of daily living when first interviewed. Most were reliant on informal carers. Social and physical dependency increased substantially over the six month period of the follow-up study of forty patients. Financial difficulties were identified as a particular area of need. Only ten percent of those interviewed were in current employment and over 80% were dependent on statutory payments. There is a need for greater co-ordination between the providers of services to patients HIV/AIDS and an improved system of data collection regarding patients' uptake of services and unmet needs is required to assist in future service planning.This resource was contributed by The National Documentation Centre on Drug Use.

Aliskiren penetrates adipose and skeletal muscle tissue, and reduces Renin-Angiotensin System activity in obese hypertensive patients

Introduction: Tissue Renin-Angiotensin System activity is increased in obesity and may contribute to obesity-related hypertension and metabolic abnormalities. This open-label pilot study investigated the local effects of Aliskiren in adipose tissue and skeletal muscle.Methods: After a 1-2 week washout, 10 patients with hypertension and abdominal obesity received placebo for 2 weeks, then Aliskiren 300 mg once daily for 4 weeks, followed by a 4-week washout period and then another 4 weeks treatment period with Amlodipine 5 mg once daily. Drug concentrations and Renin-Angiotensin Systembiomarkers were measured in interstitial fluid employing the microdialysis zero-flow method, and in biopsies from abdominal subcutaneous adipose and skeletal muscle.Results: After 4 weeks treatment, microdialysate concentrations (mean±SD) of Aliskiren were 2.4±2.1 ng/ml in adipose tissue, and 7.1±4.2 ng/ml in skeletal muscle. These concentrations were similar to the mean plasma concentration of 8.4±4.4 ng/ml. Tissue concentrations (ng/g) of Aliskiren were 29.0±16.7 ng/g in adipose tissue, and 107.3±68.6 ng/g in skeletal muscle after 4 weeks treatment. Angiotensin II concentrations in microdialysates were below the lower limit of quantification in most patients, but pooled data from two patients suggested that Angiotensin II was reduced by Aliskiren and unchanged by Amlodipine. Aliskiren 300 mg significantly reduced mean plasma Renin activity by 68% and Angiotensin II by 61% (p<0.05 vs. baseline). Amlodipine 5 mg increased plasma Renin activity by 48% (p<0.05 vs. baseline), and non-significantly increased Angiotensin II by 60%. Both treatments increased plasma Renin concentration.Conclusion: Aliskiren 300 mg once daily penetrates adipose and skeletal muscle tissue at concentrations sufficient to reduce tissue Renin-Angiotensin System activity in obese patients with hypertension.

Effectiveness of Pregabalin as Monotherapy or Combination Therapy for Neuropathic Pain in Patients Unresponsive to Previous Treatments in a Spanish Primary Care Setting

BACKGROUND AND OBJECTIVE Patients from a previous study of neuropathic pain (NP) in the Spanish primary care setting still had symptoms despite treatment. Subsequently, patients were treated as prescribed by their physician and followed up for 3 months. Since pregabalin has been shown to be effective in NP, including refractory cases, the objective of this study was to assess the effectiveness of pregabalin therapy in patients with NP refractory to previous treatments. METHODS This was a post hoc analysis of pregabalin-naïve NP patients treated with pregabalin in a 3-month follow-up observational multicenter study to assess symptoms and satisfaction with treatment. Patients were evaluated with the Douleur Neuropathique en 4 questions (DN4), the Brief Pain Inventory (BPI) and the Treatment Satisfaction for Medication Questionnaire (SATMED-Q) overall satisfaction domain. RESULTS 1,670 patients (mean age 58 years, 59 % women), previously untreated or treated with ≥1 drug other than pregabalin, were treated with pregabalin (37 % on monotherapy). At 3 months, pain intensity and its interference with activities decreased by half (p < 0.0001), while the number of days with no or mild pain increased by a mean of 4.5 days (p < 0.0001). Treatment satisfaction increased twofold (p < 0.0001). Patients with a shorter history of pain and those with neuralgia and peripheral nerve compression syndrome (PCS) as etiologies had the highest proportion on monotherapy and showed the greatest improvements in pain-related parameters in their respective group categories. CONCLUSION Treatment with pregabalin (as monotherapy or combination therapy) provides benefits in pain and treatment satisfaction in patients with NP, including refractory cases. Shorter disease progression and neuralgia and PCS etiologies are favorable factors for pregabalin treatment response.

(Endogenous) occupational choices and job satisfaction among recent PhD recipients: evidence from Catalonia

Drawing on data from two successive cohorts of PhD graduates, this paper analyses differences in overall job satisfaction and specific job domain satisfaction among PhDs employed in different sectors four years after completing their doctorate degrees. Covariate-adjusted job satisfaction differentials suggest that, compared to faculty members, PhD holders employed outside traditional academic and research jobs are more satisfied with the pecuniary facets of their work (principally, because of higher earnings), but significantly less satisfied with the content of their job and with how well the job matches their skills (and, in the case of public sector workers, with their prospects of promotion). The evidence regarding the overall job satisfaction of the PhD holders indicates that working in the public or private sectors is associated with less work well-being, which cannot be fully compensated by the better pecuniary facets of the job. It also appears that being employed in academia or in research centres provides almost the same perceived degree of satisfaction with the job and with its four specific domains. We also take into account the endogenous sorting of PhD holders into different occupations based on latent personal traits that might be related to job satisfaction. The selectivity-corrected job satisfaction differentials reveal the importance of self-selection based on unobservable traits, and confirm the existence of a certain penalisation for working in occupations other than academia or research, which is especially marked in the case of satisfaction with job content and job-skills match. The paper presents additional interesting evidence about the determinants of occupational choice among PhD holders, highlighting the relevance of certain academic attributes (especially PhD funding and pre-and-post-doc research mobility) in affecting the likelihood of being employed in academia, in a research centre or in other public or private sector job four years after completing their doctorate programme.

Effectiveness of career counseling and the impact of the working alliance.

This study analyzes the role of the working alliance on the life satisfaction and career decision difficulties of clients participating in career counseling in Switzerland. The study also compares these career counseling clients to a group of students who did not seek counseling, to explore the overall effectiveness of a face-to-face career counseling intervention, using a pre-post design. Results indicated that the working alliance was positively associated with clients' satisfaction with the intervention and with the final level of their life satisfaction. Working alliance was also negatively associated with the final levels of career decision difficulties. Moreover, clients' career decision difficulties significantly decreased and their life satisfaction increased throughout the intervention. These findings suggest that working alliance represents an important variable to better understand career interventions' underlying mechanisms. Moreover, face-to-face career counseling is effective considering career-specific as well as broader, life-related indicators.

Protocol of the COSMIN study: consensus-based standards for the selection of health measurement instruments

Background: Choosing an adequate measurement instrument depends on the proposed use of the instrument, the concept to be measured, the measurement properties (e.g. internal consistency, reproducibility, content and construct validity, responsiveness, and interpretability), the requirements, the burden for subjects, and costs of the available instruments. As far as measurement properties are concerned, there are no sufficiently specific standards for the evaluation of measurement properties of instruments to measure health status, and also no explicit criteria for what constitutes good measurement properties. In this paper we describe the protocol for the COSMIN study, the objective of which is to develop a checklist that contains COnsensus-based Standards for the selection of health Measurement INstruments, including explicit criteria for satisfying these standards. We will focus on evaluative health related patient-reported outcomes (HR-PROs), i.e. patient-reported health measurement instruments used in a longitudinal design as an outcome measure, excluding health care related PROs, such as satisfaction with care or adherence. The COSMIN standards will be made available in the form of an easily applicable checklist.Method: An international Delphi study will be performed to reach consensus on which and how measurement properties should be assessed, and on criteria for good measurement properties. Two sources of input will be used for the Delphi study: (1) a systematic review of properties, standards and criteria of measurement properties found in systematic reviews of measurement instruments, and (2) an additional literature search of methodological articles presenting a comprehensive checklist of standards and criteria. The Delphi study will consist of four (written) Delphi rounds, with approximately 30 expert panel members with different backgrounds in clinical medicine, biostatistics, psychology, and epidemiology. The final checklist will subsequently be field-tested by assessing the inter-rater reproducibility of the checklist.Discussion: Since the study will mainly be anonymous, problems that are commonly encountered in face-to-face group meetings, such as the dominance of certain persons in the communication process, will be avoided. By performing a Delphi study and involving many experts, the likelihood that the checklist will have sufficient credibility to be accepted and implemented will increase.

Web-based Implementation of Winter Maintenance Decision Support System Using GIS and Remote Sensing, May 2005

Winter maintenance, particularly snow removal and the stress of snow removal materials on public structures, is an enormous budgetary burden on municipalities and nongovernmental maintenance organizations in cold climates. Lately, geospatial technologies such as remote sensing, geographic information systems (GIS), and decision support tools are roviding a valuable tool for planning snow removal operations. A few researchers recently used geospatial technologies to develop winter maintenance tools. However, most of these winter maintenance tools, while having the potential to address some of these information needs, are not typically placed in the hands of planners and other interested stakeholders. Most tools are not constructed with a nontechnical user in mind and lack an easyto-use, easily understood interface. A major goal of this project was to implement a web-based Winter Maintenance Decision Support System (WMDSS) that enhances the capacity of stakeholders (city/county planners, resource managers, transportation personnel, citizens, and policy makers) to evaluate different procedures for managing snow removal assets optimally. This was accomplished by integrating geospatial analytical techniques (GIS and remote sensing), the existing snow removal asset management system, and webbased spatial decision support systems. The web-based system was implemented using the ESRI ArcIMS ActiveX Connector and related web technologies, such as Active Server Pages, JavaScript, HTML, and XML. The expert knowledge on snow removal procedures is gathered and integrated into the system in the form of encoded business rules using Visual Rule Studio. The system developed not only manages the resources but also provides expert advice to assist complex decision making, such as routing, optimal resource allocation, and monitoring live weather information. This system was developed in collaboration with Black Hawk County, IA, the city of Columbia, MO, and the Iowa Department of transportation. This product was also demonstrated for these agencies to improve the usability and applicability of the system.

Improving Transition Outcomes: Promising Transition Practices

Summary of the Promising Transition Practices implemented under the Improving Transition Outcomes with Iowa Vocational Rehabilitation Services grant.

Improving Transition Outcomes: Capacity Building Forum: Dissemination of Promising Transition Practices

Information on the Promising Transition Practices shared at the September 28, 2007 Capacity Building Forum sponsored by Improving Transition Outcomes with Iowa Vocational Rehabilitation Services.

Improving Transition Outcomes: Request for Proposals

Request for Proposals under Improving Transition Outcomes with Iowa Vocational Rehabilitation Services.