Description of the risk factors for relapse in patients diagnosed with severe mental disorders

Objective: The objective of this paper is to describe the population served in mental health institutionsfor mental illness relapse, and the process of identifying risk factors in relapsing patientsdiagnosed with severe mental illness. To this end a descriptive exploratory multicenter, multistageepidemiological study was carried out in mental health institutions of the Order of San Juan deDios Hospital (OHSJD) with hospitalized relapsing patients with a diagnosis of severe mentaldisorder. This study comes from a working network of Psychology professionals in the OHSJDnationwide. Materials and methods: The population sample was of 1005 patients diagnosed withsevere mental disorders, who had presented relapse during the last year. First, the characterizationof the general population was conducted; then, it was narrowed down to the centers, taking intoaccount similarities and differences found according to the clinical and demographic variables.Results: Major risk factors for relapse found in patients diagnosed with severe mental disorderswere: having between 38 and 58 years of age, being female, single, graduates, unemployed, witha prevalence of bipolar affective disorder diagnosis, number of hospitalizations between 2 and10, number of drugs at the time of leaving hospital 2 to 6, with severe difficulties relating withothers and difficulties in adherence to treatment. The need for a caregiver was also found, as wellas a limited number of received psychological interventions. How the system of beliefs affects thedisease and the poor adherence to treatment was identified. Conclusions: These results indicatethe requirement of a design of team intervention strategies, ranging from the assessment team(home), definition of therapeutic action plans (for) and the posthospitalizacion (egress) following.There is a poor support network and limited adherence to comprehensive treatment.

Description and analysis of pulmonary rehabilitation care programs current state in four cities of Colombia

Purpose: there are many studies reporting the benefits of pulmonary rehabilitation, but few of them exhibit the behavior and activities of these services. This article presents the characteristics of services, parts management and training level of team members, in addition to the variables or instruments used to measure the effectiveness and impact in these programs. Method: it was made a cross sectional convenience sample which included seven pulmonary rehabilitation services in four Colombian cities (Bogotá, Medellín, Manizales and Cali), selected by the coverage, for having at least one year of experience and for being formally established and recognized nationwide. The interdisciplinary team of each service answered a survey that was validated through a pilot test and expert consensus. Participation was voluntary. Results: labor onset pulmonary rehabilitation services correspond to an average of a decade, with COPD and asthma pathologies of attention. The programs are characterized by an outpatient treatment with an average duration of eight to twelve weeks, with a frequency of an hour three times a week. Also, the director of the service is regularly a pulmonologist and the coordinator a physiotherapist (57.14%). The posgradual training of these professionals is notable, and they report to have procedural, administrative and communicative skills, but qualify regular there research skills. The physical and technological resources are well tested. 71.42% have done impact studies, but only 28.57% have been published. All have in common training in upper limbs, lower limbs, respiratory muscles, counseling, functional assessment and quality of life. The effectiveness and impact of programs is measured by the walking test, quality of life questionnaires and activities of daily living.

Tipos de lógica utilizadas en la toma de decisiones estratégicas de marketing

Para el administrador el proceso de la toma de decisiones es uno de sus mayores retos y responsabilidades, ya que en su desarrollo se debe definir el camino más acertado en un sin número de alternativas, teniendo en cuenta los obstáculos sociales, políticos y económicos del entorno empresarial. Para llegar a la decisión adecuada no hay que perder de vista los objetivos y metas propuestas, además de tener presente el proceso lógico, detectando, analizando y demostrando el porqué de esa elección. Consecuentemente el análisis que propone esta investigación aportara conocimientos sobre los tipos de lógica utilizados en la toma de decisiones estratégicas al administrador para satisfacer las demandas asociadas con el mercadeo para que de esta manera se pueda generar y ampliar eficientemente las competencia idóneas del administrador en la inserción internacional de un mercado laboral cada vez mayor (Valero, 2011). A lo largo de la investigación se pretende desarrollar un estudio teórico para explicar la relación entre la lógica y la toma de decisiones estratégicas de marketing y como estos conceptos se combinan para llegar a un resultado final. Esto se llevara a cabo por medio de un análisis de planes de marketing, iniciando por conceptos básicos como marketing, lógica, decisiones estratégicas, dirección de marketing seguido de los principios lógicos y contradicciones que se pueden llegar a generar entre la fundamentación teórica

A description of characteristics of very young children referred for speech and language evaluation at Central Institute for the Deaf

This paper discusses the early identification and assessment of children younger than six who were referred to the Central Institute for the Deaf Speech and Hearing Clinic.

A description of the FAMOUS (version XDBUA) climate model and control run

FAMOUS is an ocean-atmosphere general circulation model of low resolution, capable of simulating approximately 120 years of model climate per wallclock day using current high performance computing facilities. It uses most of the same code as HadCM3, a widely used climate model of higher resolution and computational cost, and has been tuned to reproduce the same climate reasonably well. FAMOUS is useful for climate simulations where the computational cost makes the application of HadCM3 unfeasible, either because of the length of simulation or the size of the ensemble desired. We document a number of scientific and technical improvements to the original version of FAMOUS. These improvements include changes to the parameterisations of ozone and sea-ice which alleviate a significant cold bias from high northern latitudes and the upper troposphere, and the elimination of volume-averaged drifts in ocean tracers. A simple model of the marine carbon cycle has also been included. A particular goal of FAMOUS is to conduct millennial-scale paleoclimate simulations of Quaternary ice ages; to this end, a number of useful changes to the model infrastructure have been made.

U.K. HiGEM: The New U.K. High-Resolution Global Environment Model—Model Description and Basic Evaluation

This article describes the development and evaluation of the U.K.’s new High-Resolution Global Environmental Model (HiGEM), which is based on the latest climate configuration of the Met Office Unified Model, known as the Hadley Centre Global Environmental Model, version 1 (HadGEM1). In HiGEM, the horizontal resolution has been increased to 0.83° latitude × 1.25° longitude for the atmosphere, and 1/3° × 1/3° globally for the ocean. Multidecadal integrations of HiGEM, and the lower-resolution HadGEM, are used to explore the impact of resolution on the fidelity of climate simulations. Generally, SST errors are reduced in HiGEM. Cold SST errors associated with the path of the North Atlantic drift improve, and warm SST errors are reduced in upwelling stratocumulus regions where the simulation of low-level cloud is better at higher resolution. The ocean model in HiGEM allows ocean eddies to be partially resolved, which dramatically improves the representation of sea surface height variability. In the Southern Ocean, most of the heat transports in HiGEM is achieved by resolved eddy motions, which replaces the parameterized eddy heat transport in the lower-resolution model. HiGEM is also able to more realistically simulate small-scale features in the wind stress curl around islands and oceanic SST fronts, which may have implications for oceanic upwelling and ocean biology. Higher resolution in both the atmosphere and the ocean allows coupling to occur on small spatial scales. In particular, the small-scale interaction recently seen in satellite imagery between the atmosphere and tropical instability waves in the tropical Pacific Ocean is realistically captured in HiGEM. Tropical instability waves play a role in improving the simulation of the mean state of the tropical Pacific, which has important implications for climate variability. In particular, all aspects of the simulation of ENSO (spatial patterns, the time scales at which ENSO occurs, and global teleconnections) are much improved in HiGEM.

A simple model for predicting soil temperature in snow-covered and seasonally frozen soil: model description and testing

Microbial processes in soil are moisture, nutrient and temperature dependent and, consequently, accurate calculation of soil temperature is important for modelling nitrogen processes. Microbial activity in soil occurs even at sub-zero temperatures so that, in northern latitudes, a method to calculate soil temperature under snow cover and in frozen soils is required. This paper describes a new and simple model to calculate daily values for soil temperature at various depths in both frozen and unfrozen soils. The model requires four parameters average soil thermal conductivity, specific beat capacity of soil, specific heat capacity due to freezing and thawing and an empirical snow parameter. Precipitation, air temperature and snow depth (measured or calculated) are needed as input variables. The proposed model was applied to five sites in different parts of Finland representing different climates and soil types. Observed soil temperatures at depths of 20 and 50 cm (September 1981-August 1990) were used for model calibration. The calibrated model was then tested using observed soil temperatures from September 1990 to August 2001. R-2-values of the calibration period varied between 0.87 and 0.96 at a depth of 20 cm and between 0.78 and 0.97 at 50 cm. R-2 -values of the testing period were between 0.87 and 0.94 at a depth of 20cm. and between 0.80 and 0.98 at 50cm. Thus, despite the simplifications made, the model was able to simulate soil temperature at these study sites. This simple model simulates soil temperature well in the uppermost soil layers where most of the nitrogen processes occur. The small number of parameters required means, that the model is suitable for addition to catchment scale models.