995 resultados para General position
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FRAX(®) is a fracture risk assessment algorithm developed by the World Health Organization in cooperation with other medical organizations and societies. Using easily available clinical information and femoral neck bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA), when available, FRAX(®) is used to predict the 10-year probability of hip fracture and major osteoporotic fracture. These values may be included in country specific guidelines to aid clinicians in determining when fracture risk is sufficiently high that the patient is likely to benefit from pharmacological therapy to reduce that risk. Since the introduction of FRAX(®) into clinical practice, many practical clinical questions have arisen regarding its use. To address such questions, the International Society for Clinical Densitometry (ISCD) and International Osteoporosis Foundations (IOF) assigned task forces to review the best available medical evidence and make recommendations for optimal use of FRAX(®) in clinical practice. Questions were identified and divided into three general categories. A task force was assigned to investigating the medical evidence in each category and developing clinically useful recommendations. The BMD Task Force addressed issues that included the potential use of skeletal sites other than the femoral neck, the use of technologies other than DXA, and the deletion or addition of clinical data for FRAX(®) input. The evidence and recommendations were presented to a panel of experts at the ISCD-IOF FRAX(®) Position Development Conference, resulting in the development of ISCD-IOF Official Positions addressing FRAX(®)-related issues.
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OBJECTIVES: Inequalities and inequities in health are an important public health concern. In Switzerland, mortality in the general population varies according to the socio-economic position (SEP) of neighbourhoods. We examined the influence of neighbourhood SEP on presentation and outcomes in HIV-positive individuals in the era of combination antiretroviral therapy (cART). METHODS: The neighbourhood SEP of patients followed in the Swiss HIV Cohort Study (SHCS) 2000-2013 was obtained on the basis of 2000 census data on the 50 nearest households (education and occupation of household head, rent, mean number of persons per room). We used Cox and logistic regression models to examine the probability of late presentation, virologic response to cART, loss to follow-up and death across quintiles of neighbourhood SEP. RESULTS: A total of 4489 SHCS participants were included. Presentation with advanced disease [CD4 cell count <200 cells/μl or AIDS] and with AIDS was less common in neighbourhoods of higher SEP: the age and sex-adjusted odds ratio (OR) comparing the highest with the lowest quintile of SEP was 0.71 [95% confidence interval (95% CI) 0.58-0.87] and 0.59 (95% CI 0.45-0.77), respectively. An undetectable viral load at 6 months of cART was more common in the highest than in the lowest quintile (OR 1.52; 95% CI 1.14-2.04). Loss to follow-up, mortality and causes of death were not associated with neighbourhood SEP. CONCLUSION: Late presentation was more common and virologic response to cART less common in HIV-positive individuals living in neighbourhoods of lower SEP, but in contrast to the general population, there was no clear trend for mortality.
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Position sensitive particle detectors are needed in high energy physics research. This thesis describes the development of fabrication processes and characterization techniques of silicon microstrip detectors used in the work for searching elementary particles in the European center for nuclear research, CERN. The detectors give an electrical signal along the particles trajectory after a collision in the particle accelerator. The trajectories give information about the nature of the particle in the struggle to reveal the structure of the matter and the universe. Detectors made of semiconductors have a better position resolution than conventional wire chamber detectors. Silicon semiconductor is overwhelmingly used as a detector material because of its cheapness and standard usage in integrated circuit industry. After a short spread sheet analysis of the basic building block of radiation detectors, the pn junction, the operation of a silicon radiation detector is discussed in general. The microstrip detector is then introduced and the detailed structure of a double-sided ac-coupled strip detector revealed. The fabrication aspects of strip detectors are discussedstarting from the process development and general principles ending up to the description of the double-sided ac-coupled strip detector process. Recombination and generation lifetime measurements in radiation detectors are discussed shortly. The results of electrical tests, ie. measuring the leakage currents and bias resistors, are displayed. The beam test setups and the results, the signal to noise ratio and the position accuracy, are then described. It was found out in earlier research that a heavy irradiation changes the properties of radiation detectors dramatically. A scanning electron microscope method was developed to measure the electric potential and field inside irradiated detectorsto see how a high radiation fluence changes them. The method and the most important results are discussed shortly.
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The Prostate Cancer Programme of the European School of Oncology developed the concept of specialised interdisciplinary and multiprofessional prostate cancer care to be formalized in Prostate Cancer Units (PCU). After the publication in 2011 of the collaborative article "The Requirements of a Specialist Prostate Cancer Unit: A Discussion Paper from the European School of Oncology", in 2012 the PCU Initiative in Europe was launched. A multiprofessional Task Force of internationally recognized opinion leaders, among whom representatives of scientific societies, and patient advocates gathered to set standards for quality comprehensive prostate cancer care and designate care pathways in PCUs. The result was a consensus on 40 mandatory and recommended standards and items, covering several macro-areas, from general requirements to personnel to organization and case management. This position paper describes the relevant, feasible and applicable core criteria for defining PCUs in most European countries delivered by PCU Initiative in Europe Task Force.
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Understanding nanomaterial interactions within cells is of increasing importance for assessing their toxicity and cellular transport. Here, we developed nanovesicles containing bioactive cationic lysine-based amphiphiles, and assessed whether these cationic compounds increase the likelihood of intracellular delivery and modulate toxicity. We found different cytotoxic responses among the formulations, depending on surfactant, cell line and endpoint assayed. The induction of mitochondrial dysfunction, oxidative stress and apoptosis were the general mechanisms underlying cytotoxicity. Fluorescence microscopy analysis demonstrated that nanovesicles were internalized by HeLa cells, and evidenced that their ability to release endocytosed materials into cell cytoplasm depends on the structural parameters of amphiphiles. The cationic charge position and hydrophobicity of surfactants determine the nanovesicle interactions within the cell and, thus, the resulting toxicity and intracellular behavior after cell uptake of the nanomaterial. The insights into some toxicity mechanisms of these new nanomaterials contribute to reducing the uncertainty surrounding their potential health hazards.
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Synchronous machines with an AC converter are used mainly in large drives, for example in ship propulsion drives as well as in rolling mill drives in steel industry. These motors are used because of their high efficiency, high overload capacity and good performance in the field weakening area. Present day drives for electrically excited synchronous motors are equipped with position sensors. Most drives for electrically excited synchronous motors will be equipped with position sensors also in future. This kind of drives with good dynamics are mainly used in metal industry. Drives without a position sensor can be used e.g. in ship propulsion and in large pump and blower drives. Nowadays, these drives are equipped with a position sensor, too. The tendency is to avoid a position sensor if possible, since a sensor reduces the reliability of the drive and increases costs (latter is not very significant for large drives). A new control technique for a synchronous motor drive is a combination of the Direct Flux Linkage Control (DFLC) based on a voltage model and a supervising method (e.g. current model). This combination is called Direct Torque Control method (DTC). In the case of the position sensorless drive, the DTC can be implemented by using other supervising methods that keep the stator flux linkage origin centered. In this thesis, a method for the observation of the drift of the real stator flux linkage in the DTC drive is introduced. It is also shown how this method can be used as a supervising method that keeps the stator flux linkage origin centered in the case of the DTC. In the position sensorless case, a synchronous motor can be started up with the DTC control, when a method for the determination of the initial rotor position presented in this thesis is used. The load characteristics of such a drive are not very good at low rotational speeds. Furthermore, continuous operation at a zero speed and at a low rotational speed is not possible, which is partly due to the problems related to the flux linkage estimate. For operation in a low speed area, a stator current control method based on the DFLC modulator (DMCQ is presented. With the DMCC, it is possible to start up and operate a synchronous motor at a zero speed and at low rotational speeds in general. The DMCC is necessary in situations where high torque (e.g. nominal torque) is required at the starting moment, or if the motor runs several seconds at a zero speed or at a low speed range (up to 2 Hz). The behaviour of the described methods is shown with test results. The test results are presented for the direct flux linkage and torque controlled test drive system with a 14.5 kVA, four pole salient pole synchronous motor with a damper winding and electric excitation. The static accuracy of the drive is verified by measuring the torque in a static load operation, and the dynamics of the drive is proven in load transient tests. The performance of the drive concept presented in this work is sufficient e.g. for ship propulsion and for large pump drives. Furthermore, the developed methods are almost independent of the machine parameters.
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In this paper I am concerned with the problem of applying the notion of rigidity to general terms. In Naming and Necessity, Kripke has clearly suggested that we should include some general terms among the rigid ones, namely, those common nouns semantically correlated with natural substances, species and phenomena, in general, natural kinds -'water', 'tiger', 'heat'- and some adjectives -'red', 'hot', 'loud'. However, the notion of rigidity has been defined for singular terms; after all, the notion that Kripke has provided us with is the notion of a rigid designator. But general terms do not designate single individuals: rather, they apply to many of them. In sum, the original concept of rigidity cannot be straightforwardly applied to general terms: it has to be somehow redefined in order to make it cover them. As is known, two main positions have been put forward to accomplish that task: the identity of designation conception, according to which a rigid general term is one that designates the same property or kind in all possible worlds, and the essentialist conception, which conceives of a rigid general term as an essentialist one, namely, a term that expresses an essential property of an object. My purpose in the present paper is to defend a particular version of the identity of designation conception: on the proposed approach, a rigid general term will be one that expresses the same property in all possible worlds and names the property it expresses. In my opinion, the position can be established on the basis of an inference to the best explanation of our intuitive interpretation and evaluation, relative to counterfactual circumstances, of statements containing different kinds of general terms, which is strictly analogous to our intuitive interpretation and evaluation, relative to such circumstances, of statements containing different kinds of singular ones. I will argue that it is possible to offer a new solution to the trivialization problem that is thought to threaten all versions of the identity of designation conception of rigidity. Finally, I will also sketch a solution to the so-called 'over-generalization and under-generalization problems', both closely related to the above-mentioned one.
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Colley Lyons Lucas Foster (1778-1843) was a militia officer who served in England, Ireland, Jamaica and Upper Canada. He served as aide-de-camp to Lieutenant-General Gordon Drummond in Ireland, and in 1813 accompanied Drummond to his new post in Upper Canada. In February of 1814, Foster was appointed Adjutant General of the Upper Canadian militia. After the war, Foster resigned from his position and moved to Quebec. In 1816, he became Assistant Adjutant General to the regular forces in Upper Canada and remained in this position until his death in 1843. During the rebellion in Upper Canada in 1837, Foster was instrumental in organizing a guard composed of citizens of Toronto. When Sir Francis Bond Head, Lieutenant-Governor of Upper Canada, resigned his post in January 1838, Foster commanded both the militia and regular forces in Upper Canada until the arrival of Major-General Sir George Arthur in March of 1838.
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Copy of a report of a Committee of the Honorable and Executive Council dated May 6, 1859 approved by His Excellency the Governor General in Council. This is in regard to charges made by Joshua Manly of Port Colborne against Mr. Woodruff, the superintendent and other persons connected with the Welland Canal. The accusations have been substantiated by the committee. This is accompanied by a petition accusing Mr. Woodruff of gross corruption and jobbery [the practice of using a public office or position of trust for one's own advantage]. This was signed by a number of petitioners on July 2, 1858 (2 pages, handwritten), 1859.
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La energía eléctrica y los bienes o activos eléctricos (de acuerdo con la definición técnica) con que se lleva a cabo su prestación, goza de una particular regulación y normatividad, explicables por la importancia capital de este servicio público, sumado al diseño institucional traído por la constitución de 1991, lo que la hace especialmente compleja, dinámica y abierta a precisiones. Es ese sentido, se parte de un entendimiento inicial de todos los activos que conforman una red de generación, transmisión y distribución eléctrica, para de esa forma comenzar a esbozar el régimen jurídico de los mismos, dependiendo de su posición dentro de la cadena de suministro eléctrico. Una vez concluido este acercamiento, se abordan los principales problemas previsibles desde una perspectiva puramente académica, como por ejemplo el relacionado con el alcance de los conceptos de la CREG y su valor normativo, la presunta inembargabilidad de los bienes destinados a la prestación de servicios públicos en cabeza de comunidades organizadas y el problema de la propiedad de particulares sobre activos conformantes de la red de suministro eléctrico y la salida normativa a ese conflicto (pues no debe olvidarse que los propietarios de activos de uso general, de acuerdo con la CREG, deben ser prestadores de servicios públicos domiciliarios) de modo tal que se respeten los derechos de propiedad. De cada uno de estos interrogantes surgen soluciones que lejos de zanjar las discusiones al respecto, buscan abrir el debate sobre un tema de tan capital importancia.
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This paper considers an overlapping generations model in which capital investment is financed in a credit market with adverse selection. Lenders’ inability to commit ex-ante not to bailout ex-post, together with a wealthy position of entrepreneurs gives rise to the soft budget constraint syndrome, i.e. the absence of liquidation of poor performing firms on a regular basis. This problem arises endogenously as a result of the interaction between the economic behavior of agents, without relying on political economy explanations. We found the problem more binding along the business cycle, providing an explanation to creditors leniency during booms in some LatinAmerican countries in the late seventies and early nineties.
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Resumen basado en el de la publicaci??n
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This is the second half of a two-part paper dealing with the social theoretic assumptions underlying system dynamics. In the first half it was concluded that analysing system dynamics using traditional, paradigm-based social theories is highly problematic. An innovative and potentially fruitful resolution is now proposed to these problems. In the first section it is argued that in order to find an appropriate social theoretic home for system dynamics it is necessary to look to a key exchange in contemporary social science: the agency/structure debate. This debate aims to move beyond both the theories based only on the actions of individual human agents, and those theories that emphasise only structural influences. Emerging from this debate are various theories that instead aim to unite the human agent view of the social realm with views that concentrate solely on system structure. It is argued that system dynamics is best viewed as being implicitly grounded in such theories. The main conclusion is therefore that system dynamics can contribute to an important part of social thinking by providing a formal approach for explicating social mechanisms. This conclusion is of general significance for system dynamics. However, the over-arching aim of the two-part paper is to increase the understanding of system dynamics in related disciplines. Four suggestions are therefore offered for how the system dynamics method might be extended further into the social sciences. It is argued that, presented in the right way, the formal yet contingent feedback causality thinking of system dynamics should diffuse widely in the social sciences and make a distinctive and important contribution to them. Felix qui potuit rerum cognoscere causas Happy is he who comes to know the causes of things Virgil - Georgics, Book II, line 490. 29 BCE
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Background Epidemiological studies indicate that the prevalence of psychological problems in patients attending primary care services may be as high as 25%. Aim To identify factors that influence the detection of psychological difficulties in adolescent patients receiving primary care in the UK. Design of study A prospective study of 13-16 year olds consecutively attending general practices. Setting General practices, Norfolk, UK. Method Information was obtained from adolescents and parents using the validated Strengths and Difficulties Questionnaire (SDQ) and from GF`s using the consultation assessment form. Results Ninety-eight adolescents were recruited by 13 GPs in Norfolk (mean age = 14.4 years, SD = 1.08; 38 males, 60 females). The study identified psychological difficulties in almost one-third of adolescents (31/98, 31.6%). Three factors significant to the detection of psychological disorders in adolescents were identified: adolescents' perceptions of difficulties according to the self-report SDQ, the severity of their problems as indicated by the self-report SDQ, and whether psychological issues were discussed in the consultation. GPs did not always explore psychological problems with adolescents, even if GPs perceived these to be present. Nineteen of 31 adolescents with psychological difficulties were identified by GPs (sensitivity = 61.2%, specificity = 85.1%). A management plan or follow-up was made for only seven of 19 adolescents identified, suggesting that ongoing psychological difficulties in many patients are not being addressed. Conclusions GPs are in a good position to identify psychological issues in adolescents, but GPs and adolescents seem reluctant to explore these openly. Open discussion of psychological issues in GP consultations was found to be the most important factor in determining whether psychological difficulties in adolescents are detected by GPs.
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This paper describes the successful introduction of a kaizen scheme in a General Motors factory plant in Gliwice, Poland. Employee value systems changed, despite the presence of strong, pre-existing values that might have inhibited this process. These findings are drawn on to examine the concept of ‘resistance to change’ and replace it with a notion of ‘functional persistence’. Our case study illustrates how assuming this position can aid the development of new work attitudes, as opposed to constraining the old ones.