A review of the published literature on interventions to increase compliance with follow-up outpatient medical appointments in primary care practice

Effective strategies for patient follow-up compliance in family practice are essential for the prevention and early detection of disease with the consequences of decreasing morbidity and mortality. With effective appointment reminder systems in place, physicians can better manage the overall health of their patients by providing preventive care as well. This literature review examines intervention strategies used by the authors, the compliance rate of appointment adherence using these techniques, as well as theories relating to study outcomes. The findings of this study may be used as an educational tool by practices to suggest which intervention strategies might be the most effective for their clinic.^

Physician's adherence to CDC standards for physical activity counseling of older women in a cardiology practice in Texas---An exploratory study

Physical activity is an important health-promoting behavior to prevent and control chronic disease. Interventions to increase physical activity are vitally needed. Women are not meeting the recommended goals for physical activity - a behavior that has been shown to effectively reduce the incidence of chronic disease and the medical costs associated with treating it. Among many factors predicting physical activity and the different forms of interventions that have been applied, physician counseling is one potentially cost-effective approach that may produce at least modest effects on women's behavior. The Centers for Disease Control and Prevention has published standards for physician counseling of patients regarding physical activity. This study used a short questionnaire to assess the degree to which a group practice of cardiology physicians in Texas queried and discussed physical activity recommendations to older women that they treat and whether they are meeting the physical activity counseling goals of the Centers for Disease Control and Prevention. The majority of this group of physicians counseled patients without benefit of exploring patient behavior. Although these physicians "agreed" that physical activity delayed or prevented disease, the outcome suggests that low self-efficacy hampered efforts to counsel older women on this. Physicians' perceptions that counseling may be ineffective could explain the lower rate of physical activity counseling that does not meet the goals of the Centers for Disease Control and Prevention. ^

Secret and power in social life

Secret and power constitute two fundamental instances of the social world. Secret takes care of the concealment of things and of social processes. Secret is also a power device. Power is the social capacity to do, create, not doing and stop from doing. Secret and power get mutual feedback. Power uses the secret to protect his potential, be it what may, to increment its operative strength. Secret uses the power to achieve its aims and proposals. Social sciences seem to ignore the huge explanatory capacity of these two interrelated concepts, and even more, their powerful intervention in societies.

Secret and power in social life

Secret and power constitute two fundamental instances of the social world. Secret takes care of the concealment of things and of social processes. Secret is also a power device. Power is the social capacity to do, create, not doing and stop from doing. Secret and power get mutual feedback. Power uses the secret to protect his potential, be it what may, to increment its operative strength. Secret uses the power to achieve its aims and proposals. Social sciences seem to ignore the huge explanatory capacity of these two interrelated concepts, and even more, their powerful intervention in societies.

Secret and power in social life

Secret and power constitute two fundamental instances of the social world. Secret takes care of the concealment of things and of social processes. Secret is also a power device. Power is the social capacity to do, create, not doing and stop from doing. Secret and power get mutual feedback. Power uses the secret to protect his potential, be it what may, to increment its operative strength. Secret uses the power to achieve its aims and proposals. Social sciences seem to ignore the huge explanatory capacity of these two interrelated concepts, and even more, their powerful intervention in societies.

Haemolymph inorganic ion composition, physiology and behaviour dependent on temperature and ambient magnesium concentration in early life history stages of Paralomis granulosa (Decapoda, Anomura, Lithodidae)

Marine brachyuran and anomuran crustaceans are completely absent from the extremely cold (-1.8 °C) Antarctic continental shelf, but caridean shrimps are abundant. This has at least partly been attributed to low capacities for magnesium excretion in brachyuran and anomuran lithodid crabs ([Mg2+]HL = 20-50 mmol/L) compared to caridean shrimp species ([Mg2+]HL = 5-12 mmol/L). Magnesium has an anaesthetizing effect and reduces cold tolerance and activity of adult brachyuran crabs. We investigated whether the capacity for magnesium regulation is a factor that influences temperature-dependent activity of early ontogenetic stages of the Sub-Antarctic lithodid crab Paralomis granulosa. Ion composition (Na+, Mg2+, Ca2+, Cl-, [SO4]2-) was measured in haemolymph withdrawn from larval stages, the first and second juvenile instars (crabs I and II) and adult males and females. Magnesium excretion improved during ontogeny, but haemolymph sulphate concentration was lowest in the zoeal stages. Neither haemolymph magnesium concentrations nor Ca2+:Mg2+ ratios paralleled activity levels of the life stages. Long-term (3 week) cold exposure of crab I to 1 °C caused a significant rise of haemolymph sulphate concentration and a decrease in magnesium and calcium concentrations compared to control temperature (9 °C). Spontaneous swimming activity of the zoeal stages was determined at 1, 4 and 9 °C in natural sea water (NSW, [Mg2+] = 51 mmol/L) and in sea water enriched with magnesium (NSW + Mg2+, [Mg2+] = 97 mmol/L). It declined significantly with temperature but only insignificantly with increased magnesium concentration. Spontaneous velocities were low, reflecting the demersal life style of the zoeae. Heart rate, scaphognathite beat rate and forced swimming activity (maxilliped beat rate, zoea I) or antennule beat rate (crab I) were investigated in response to acute temperature change (9, 6, 3, 1, -1 °C) in NSW or NSW + Mg2+. High magnesium concentration reduced heart rates in both stages. The temperature-frequency curve of the maxilliped beat (maximum: 9.6 beats/s at 6.6 °C in NSW) of zoea I was depressed and shifted towards warmer temperatures by 2 °C in NSW + Mg2+, but antennule beat rate of crab I was not affected. Magnesium may therefore influence cold tolerance of highly active larvae, but it remains questionable whether the slow-moving lithodid crabs with demersal larvae would benefit from an enhanced magnesium excretion in nature.

Ocean Acidification Affects Redox-Balance and Ion-Homeostasis in the Life-Cycle Stages of Emiliania huxleyi

Ocean Acidification (OA) has been shown to affect photosynthesis and calcification in the coccolithophore Emiliania huxleyi, a cosmopolitan calcifier that significantly contributes to the regulation of the biological carbon pumps. Its non-calcifying, haploid life-cycle stage was found to be relatively unaffected by OA with respect to biomass production. Deeper insights into physiological key processes and their dependence on environmental factors are lacking, but are required to understand and possibly estimate the dynamics of carbon cycling in present and future oceans. Therefore, calcifying diploid and non-calcifying haploid cells were acclimated to present and future CO2 partial pressures (pCO2; 38.5 Pa vs. 101.3 Pa CO2) under low and high light (50 vs. 300 µmol photons/m**2 /s). Comparative microarray-based transcriptome profiling was used to screen for the underlying cellular processes and allowed to follow up interpretations derived from physiological data. In the diplont, the observed increases in biomass production under OA are likely caused by stimulated production of glycoconjugates and lipids. The observed lowered calcification under OA can be attributed to impaired signal-transduction and ion-transport. The haplont utilizes distinct genes and metabolic pathways, reflecting the stage-specific usage of certain portions of the genome. With respect to functionality and energy-dependence, however, the transcriptomic OA-responses resemble those of the diplont. In both life-cycle stages, OA affects the cellular redox-state as a master regulator and thereby causes a metabolic shift from oxidative towards reductive pathways, which involves a reconstellation of carbon flux networks within and across compartments. Whereas signal transduction and ion-homeostasis appear equally OA-sensitive under both light intensities, the effects on carbon metabolism and light physiology are clearly modulated by light availability. These interactive effects can be attributed to the influence of OA and light on the redox equilibria of NAD and NADP, which function as major sensors for energization and stress. This generic mode of action of OA may therefore provoke similar cell-physiological responses in other protists.

Quantitative evaluation of artifact removal in real magnetoencephalogram signals with blind source separation

The magnetoencephalogram (MEG) is contaminated with undesired signals, which are called artifacts. Some of the most important ones are the cardiac and the ocular artifacts (CA and OA, respectively), and the power line noise (PLN). Blind source separation (BSS) has been used to reduce the influence of the artifacts in the data. There is a plethora of BSS-based artifact removal approaches, but few comparative analyses. In this study, MEG background activity from 26 subjects was processed with five widespread BSS (AMUSE, SOBI, JADE, extended Infomax, and FastICA) and one constrained BSS (cBSS) techniques. Then, the ability of several combinations of BSS algorithm, epoch length, and artifact detection metric to automatically reduce the CA, OA, and PLN were quantified with objective criteria. The results pinpointed to cBSS as a very suitable approach to remove the CA. Additionally, a combination of AMUSE or SOBI and artifact detection metrics based on entropy or power criteria decreased the OA. Finally, the PLN was reduced by means of a spectral metric. These findings confirm the utility of BSS to help in the artifact removal for MEG background activity.

Aspectos de la medición dinámica instantánea de emisiones de motores. Aplicación al desarrollo de un equipo portátil y una metodología para estudios de contaminación de vehículos en tráfico real.

Esta Tesis Doctoral se encuadra en el ámbito de la medida de emisiones contaminantes y de consumo de combustible en motores de combustión interna alternativos cuando se utilizan como plantas de potencia para propulsión de vehículos ligeros de carretera, y más concretamente en las medidas dinámicas con el vehículo circulando en tráfico real. En este ámbito, el objetivo principal de la Tesis es estudiar los problemas asociados a la medición en tiempo real con equipos embarcados de variables medioambientales, energéticas y de actividad, de vehículos ligeros propulsados por motores térmicos en tráfico real. Y como consecuencia, desarrollar un equipo y una metodología apropiada para este objetivo, con el fin de realizar consiguientemente un estudio sobre los diferentes factores que influyen sobre las emisiones y el consumo de combustible de vehículos turismo en tráfico real. La Tesis se comienza realizando un estudio prospectivo sobre los trabajos de otros autores relativos al desarrollo de equipos portátiles de medida de emisiones (Portable Emission Measurement Systems – PEMS), problemas asociados a la medición dinámica de emisiones y estudios de aplicación en tráfico real utilizando este tipo de equipos. Como resultado de este estudio se plantea la necesidad de disponer de un equipo específicamente diseñado para ser embarcado en un vehículo que sea capaz de medir en tiempo real las concentraciones de emisiones y el caudal de gases de escape, al mismo tiempo que se registran variables del motor, del vehículo y del entorno como son la pendiente y los datos meteorológicos. De esta forma se establecen las especificaciones y condiciones de diseño del equipo PEMS. Aunque al inicio de esta Tesis ya existían en el mercado algunos sistemas portátiles de medida de emisiones (PEMS: Portable Emissions Measurement Systems), en esta Tesis se investiga, diseña y construye un nuevo sistema propio, denominado MIVECO – PEMS. Se exponen, discuten y justifican todas las soluciones técnicas incorporadas en el sistema que incluyen los subsistema de análisis de gases, subsistemas de toma de muestra incluyendo caudalímetro de gases de escape, el subsistema de medida de variables del entorno y actividad del vehículo y el conjunto de sistemas auxiliares. El diseño final responde a las hipótesis y necesidades planteadas y se valida en uso real, en banco de rodillos y en comparación con otro equipos de medida de emisiones estacionarios y portátiles. En esta Tesis se presenta también toda la investigación que ha conducido a establecer la metodología de tratamiento de las señales registradas en tiempo real que incluye la sincronización, cálculos y propagación de errores. La metodología de selección y caracterización de los recorridos y circuitos y de las pautas de conducción, preparación del vehículo y calibración de los equipos forma también parte del legado de esta Tesis. Para demostrar la capacidad de medida del equipo y el tipo de resultados que pueden obtenerse y que son útiles para la comunidad científica, y las autoridades medioambientales en la parte final de esta Tesis se plantean y se presentan los resultados de varios estudios de variables endógenas y exógenas que afectan a las emisiones instantáneas y a los factores de emisión y consumo (g/km) como: el estilo de conducción, la infraestructura vial, el nivel de congestión del tráfico, tráfico urbano o extraurbano, el contenido de biocarburante, tipo de motor (diesel y encendido provocado), etc. Las principales conclusiones de esta Tesis son que es posible medir emisiones másicas y consumo de motores de vehículos en uso real y que los resultados permiten establecer políticas de reducción de impacto medio ambiental y de eficiencia energética, pero, se deben establecer unas metodologías precisas y se debe tener mucho cuidado en todo el proceso de calibración, medida y postratamientos de los datos. Abstract This doctoral thesis is in the field of emissions and fuel consumption measurement of reciprocating internal combustion engines when are used as power-trains for light-duty road vehicles, and especially in the real-time dynamic measurements procedures when the vehicle is being driven in real traffic. In this context, the main objective of this thesis is to study the problems associated with on-board real-time measuring systems of environmental, energy and activity variables of light vehicles powered by internal combustion engines in real traffic, and as a result, to develop an instrument and an appropriate methodology for this purpose, and consequently to make a study of the different factors which influence the emissions and the fuel consumption of passenger cars in real traffic. The thesis begins developing a prospective study on other authors’ works about development of Portable Emission Measurement Systems (PEMS), problems associated with dynamic emission measurements and application studies on actual traffic using PEMS. As a result of this study, it was shown that a measuring system specifically designed for being on-board on a vehicle, which can measure in real time emission concentrations and exhaust flow, and at the same time to record motor vehicle and environment variables as the slope and atmospheric data, is needed; and the specifications and design parameters of the equipment are proposed. Although at the beginning of this research work there were already on the market some PEMS, in this Thesis a new system is researched, designed and built, called MIVECO – PEMS, in order to meet such measurements needs. Following that, there are presented, discussed and justify all technical solutions incorporated in the system, including the gas analysis subsystem, sampling and exhaust gas flowmeter subsystem, the subsystem for measurement of environment variables and of the vehicle activity and the set of auxiliary subsystems. The final design meets the needs and hypotheses proposed, and is validated in real-life use and chassis dynamometer testing and is also compared with other stationary and on-board systems. This thesis also presents all the research that has led to the methodology of processing the set of signals recorded in real time including signal timing, calculations and error propagation. The methodology to select and characterize of the routes and circuits, the driving patterns, and the vehicle preparation and calibration of the instruments and sensors are part of the legacy of this thesis. To demonstrate the measurement capabilities of the system and the type of results that can be obtained and that are useful for the scientific community and the environmental authorities, at the end of this Thesis is presented the results of several studies of endogenous and exogenous variables that affect the instantaneous and averaged emissions and consumption factors (g/km), as: driving style, road infrastructure, the level of traffic congestion, urban and extra-urban traffic, biofuels content, type of engine (diesel or spark ignition) etc. The main conclusions of this thesis are that it is possible to measure mass emissions and consumption of vehicle engines in actual use and that the results allow us to establish policies to reduce environmental impact and improve energy efficiency, but, to establish precise methodologies and to be very careful in the entire process of calibration, measurement and data post-treatment is necessary.

Quantity of CO2 Emissions in the Life Cycle of a Highway Infrastructure

There is strong evidence to indicate that carbon dioxide and other greenhouse gases are accumulating at unprecedented concentrations in out atmosphere contributing to global climate change. Evidence is equally strong that human activities, mainly the burning of fossil fuels, are driving force in this process (IPCC 2007). While different industries contribute varying amounts to total anthropogenic greenhouse gases, it is incumbent upon each to understand its contribution and search for sensible ways to reduce overall greenhouse gas production. The aim of this paper is the development of a methodology to determine the amount of CO2 emissions of a highway, allowing providing solutions that can improve the energy footprint and reduce its emissions

Quantity of CO2 Emissions in the Life Cycle of a Highway Infrastructure.

The complexity of climate change and its evolution during the last few years has a positive impact on new developments and approaches to reduce the emissions of CO2. Looking for a methodology to evaluate the sustainability of a roadway, a tool has been developed. Life Cycle Assessment (LCA) is being accepted by the road industry to measure and evaluate the environmental impacts of an infrastructure, as the energy consumption and carbon footprint. This paper describes the methodology to calculate the CO2 emissions associated with the energy embodied on a roadway along its life cycle, including construction, operations and demolition. It will assist to find solutions to improve the energy footprint and reduce the amount of CO2 emissions. Details are provided of both, the methodology and the data acquisition. This paper is an application of the methodology to the Spanish highways, using a local database. Two case studies and a practical example are studied to show the model as a decision support for sustainable construction in the road industry.

Ball possession effectiveness in men's and women's elite basketball according to situational variables in different game periods

The aim of the present study was to identify the importance of floorball tactical variables to predict ball possession effectiveness, when controlling quality of opposition and game periods. The sample was composed by 1500 ball possessions, corresponding to 14 games randomly selected from the International Championships played during 2008 and 2010 (World Championship, Four nations tournament and classificatory phases for World Championship) by teams from different competition levels (HIGH, INTERMEDIATE and LOW). The effects of the predictor variables on successful ball possessions according to the three game contexts (HIGH vs. HIGH; HIGH vs. LOW; LOW vs. LOW games) were analyzed using Binomial Logistic Regressions. The results showed no interaction with the game period. In HIGH vs. HIGH games, quality of opposition showed an association with ball possession effectiveness with ending zone, offensive system, possession duration, height of shooting and defensive pressures previous to the shot. In HIGH vs. LOW games the important factors were the starting zone, possession duration, defensive pressure previous to the last pass and to the shot, technique of shooting and the number players involved in each ball possession. Finally, in LOW vs. LOW games, the results emphasized the importance of starting and ending zones, the number of passes used and the technique of shooting. In conclusion, elite floorball performance is mainly affected by quality of opposition showing different game patterns in each context that should be considered by coaches when preparing practices and competitions.

Flexible low-cost system to test batteries and ultracapacitors for electric and hybrid vehicles in real working conditions

Batteries and ultracapacitors for hybrid and electric vehicles must satisfy very demanding working conditions that are not usual in other applications. In this sense, specific tests must be performed in order to draw accurate conclusions about their behaviour. To do so, new advanced test benches are needed. These platforms must allow the study of a wide variety of energy storage systems under conditions similar to the real ones. In this paper, a flexible, low-cost and highly customizable system is presented. This system allows batteries and ultracapacitors to be tested in many and varied ways, effectively emulating the working conditions that they face in an electric vehicle. The platform was specifically designed to study energy storage systems for electric and hybrid vehicles, meaning that it is suitable to test different systems in many different working conditions, including real driving cycles. This flexibility is achieved keeping the cost of the platform low, which makes the proposed test bench a feasible alternative for the industry. As an example of the functionality of the platform, a test consisting of a 17-minute ARTEMIS urban cycle with a NiMH battery pack is presented.

A Dynamically Adaptable Image Processing Application Trading Off Between High Performance, Consumption and Dependability in Real Time

As embedded systems evolve, problems inherent to technology become important limitations. In less than ten years, chips will exceed the maximum allowed power consumption affecting performance, since, even though the resources available per chip are increasing, frequency of operation has stalled. Besides, as the level of integration is increased, it is difficult to keep defect density under control, so new fault tolerant techniques are required. In this demo work, a new dynamically adaptable virtual architecture (ARTICo3) to allow dynamic and context-aware use of resources is implemented in a high performance Wireless Sensor node (HiReCookie) to perform an image processing application.