A Single-blinded, Randomized Clinical Trial of How to Implement an Evidence-based Treatment for Generalized Anxiety Disorder [IMPLEMENT] — Effects of Three Different Strategies of Implementation

BACKGROUND: Despite long-standing calls to disseminate evidence-based treatments for generalized anxiety (GAD), modest progress has been made in the study of how such treatments should be implemented. The primary objective of this study was to test three competing strategies on how to implement a cognitive behavioral treatment (CBT) for out-patients with GAD (i.e., comparison of one compensation vs. two capitalization models). METHODS: For our three-arm, single-blinded, randomized controlled trial (implementation of CBT for GAD [IMPLEMENT]), we recruited adults with GAD using advertisements in high-circulation newspapers to participate in a 14-session cognitive behavioral treatment (Mastery of your Anxiety and Worry, MAW-packet). We randomly assigned eligible patients using a full randomization procedure (1:1:1) to three different conditions of implementation: adherence priming (compensation model), which had a systematized focus on patients' individual GAD symptoms and how to compensate for these symptoms within the MAW-packet, and resource priming and supportive resource priming (capitalization model), which had systematized focuses on patients' strengths and abilities and how these strengths can be capitalized within the same packet. In the intention-to-treat population an outcome composite of primary and secondary symptoms-related self-report questionnaires was analyzed based on a hierarchical linear growth model from intake to 6-month follow-up assessment. This trial is registered at ClinicalTrials.gov (identifier: NCT02039193) and is closed to new participants. FINDINGS: From June 2012 to Nov. 2014, from 411 participants that were screened, 57 eligible participants were recruited and randomly assigned to three conditions. Forty-nine patients (86%) provided outcome data at post-assessment (14% dropout rate). All three conditions showed a highly significant reduction of symptoms over time. However, compared with the adherence priming condition, both resource priming conditions indicated faster symptom reduction. The observer ratings of a sub-sample of recorded videos (n = 100) showed that the therapists in the resource priming conditions conducted more strength-oriented interventions in comparison with the adherence priming condition. No patients died or attempted suicide. INTERPRETATION: To our knowledge, this is the first trial that focuses on capitalization and compensation models during the implementation of one prescriptive treatment packet for GAD. We have shown that GAD related symptoms were significantly faster reduced by the resource priming conditions, although the limitations of our study included a well-educated population. If replicated, our results suggest that therapists who implement a mental health treatment for GAD might profit from a systematized focus on capitalization models. FUNDING: Swiss Science National Foundation (SNSF-Nr. PZ00P1_136937/1) awarded to CF. KEYWORDS: Cognitive behavioral therapy; Evidence-based treatment; Implementation strategies; Randomized controlled trial

A sorrow shared is a sorrow halved? Internet-based group therapy versus individual therapy for social anxiety disorder: A randomized controlled trial

Purpose: Social anxiety disorder is one of the most researched conditions in the field of Internet-based self-help. Various studies have shown that cognitive-behavioral treatments can be efficacious to reduce social phobic symptoms. Most of the interventions tested include some form of support, whereas the efficacy of a web-based group format has yet to be investigated. The present study aims at investigating the possible added value of therapist-guided group support in an Internet-based guided self-help treatment for SAD. Methods: A total of 150 adults with a diagnosis of SAD are randomly assigned to either a wait-list control group or one of two active treatment conditions. Participants in the two active conditions use the same Internet-based self-help program, either with individual guidance by a therapist or with the support of a therapist-guided group of 6 individuals. In the group condition, participants communicate with each other via an integrated, protected discussion forum. The primary outcome variables are symptoms of SAD and diagnostic status immediately after the intervention (12 weeks) and at 6-month follow-up. Secondary endpoints are general symptomatology, depression, quality of life and adherence to treatment. Furthermore, process variables such as group processes and the working alliance are studied. Results: Results are currently being analyzed. Results at post-treatment will be presented and discussed. Potential moderating and mediating variables of treatment success will be addressed. Conclusion: The results of this study should indicate whether therapist-guided group support could enhance the efficacy of an internet based self-help treatment for SAD. This novel treatment format, if shown efficacious, could represent a cost-effective option and could be further modified to treat other conditions.

CATCH across Texas: Building a model for the diffusion of effective school-based health promotion programs

The impact of health promotion programs is related to both program effectiveness and the extent to which the program is implemented among the target population. The purpose of this dissertation was to describe the development and evaluation of a school-based program diffusion intervention designed to increase the rate of dissemination and adoption of the Child and Adolescent Trial for Cardiovascular Health, or CATCH program (recently renamed the Coordinated Approach to Child Health). ^ The first study described the process by which schools across the state of Texas spontaneously began to adopt the CATCH program after it was tested and proven effective in a multi-site randomized efficacy trial. A survey of teachers and administrator representatives of all schools on record that purchased the CATCH program, but were not involved in the efficacy trial, was used to find out who brought CATCH into the schools, how they garnered support for its adoption, why they decided to adopt the program, and what was involved in deciding to adopt. ^ The second study described how the Intervention Mapping framework guided the planning, development and implementation of a program for the diffusion of CATCH. An iterative process was used to integrate theory, literature, the experience of project staff and data from the target population into a meaningful set of program determinants and performance objectives. Proximal program objectives were specified and translated into both media and interpersonal communication strategies for program diffusion. ^ The third study assessed the effectiveness of the diffusion program in a case-comparison design. Three of the twenty Education Service Center regions in Texas were chosen, selected based on similar demographic criteria, and were followed for adoption of the CATCH curriculum. One of these regions received the full media and interpersonal channel intervention; a second received a reduced media-only intervention, and a third received no intervention. Results suggested the use of the interpersonal channels with media follow-up is an effective means to facilitate program dissemination and adoption. The media-alone condition was not effective in facilitating program adoption. ^

Physiologic and psychosocial stage-based differences for dietary fat consumption in women with type 2 diabetes

Purpose. This cross-sectional, observational study explored differences among groups staged for intent to decrease dietary fat intake in women with type 2 diabetes in relation to demographic, weight concern, physiological, and psychosocial variables. ^ Methods. A sample of 100 community-dwelling, English-speaking women, who were over age 30 and had type 2 diabetes for at least a year, was accessed through a culturally diverse endocrinology clinic. Subjects completed 7 self-report instruments: demographic sheet, with 11-point weight satisfaction scale; staging algorithm; fat intake (MEDFICTS); depression (CES-D); diabetes-specific dietary knowledge (ADKnowl), social support and self-efficacy scales (SE-Type 2). Physiological variables were abstracted from the medical record (HbA 1c, blood pressure, serum cholesterol and triglycerides). ^ Results. The women's average age was 57.69 years ( SD = 3.07); 50% were married. Subjects were well-educated ( M = 14 years; SD = 3.33), with average diabetes duration of 10.57 years (SD = 9.11), high body mass index (M = 35.72; SD = 8.36), low diabetes-specific dietary knowledge, low weight satisfaction, but in good diabetes control. Racial/ethnic composition was 44% non-Hispanic-White-American, 18% Hispanic-White-American, 15% non-Hispanic-African-American, 16% Hispanic-African-American and 5% other. Fat intake was low and differed by racial/ethnic demographics. The highest fat intake scores were for non-Hispanic-African-Americans (M = 53), followed by Hispanic-White-Americans (M = 51), non-Hispanic-White-Americans (M = 45), and Hispanic-African-Americans (M = 32), who had the lowest fat intake scores. ^ MANOVA analyses revealed no significant differences between stages of behavior change in relation to psychosocial or weight concern variables, age, education, HbA1c, or cholesterol levels. Single women were more likely to be in the three preaction stages (precontemplation, contemplation, and preparation); married women were equally distributed across stages (the preaction stages plus action and maintenance). African-American women (Hispanic and non-Hispanic) were more likely in contemplation and preparation. Triglycerides were higher in women in the action stage than contemplation or preparation. Systolic blood pressure was higher in action than preparation; diastolic blood pressure was higher in action than preaction. ^ Conclusions. Healthcare professionals should consider race, ethnicity, and marital status in client interactions. Dietary intake can vary according to both race and ethnicity; collapsing racial/ethnic groups can alter means and distributions, generating faulty conclusions. Further research is warranted to explore relationships between dietary self-care and marital status, race, ethnicity, and physiological variables. ^

Relevant drug to drug interactions between itraconazole and non-nucleoside reverse transcriptase inhibitors in HIV-infected patients on maintenance therapy for disseminated histoplasmosis

Objective. Itraconazole is recommended life-long for preventing relapse of disseminated histoplasmosis in HIV-infected patients. I sought to determine if serum itraconazole levels are affected by the type of Highly Active Anti-Retroviral Therapy (NNRTI or PI) being taken concomitantly to treat HIV. ^ Design. Retrospective cohort. ^ Methods. De-identified data were used from an IRB-approved parent study which identified patients on HAART and maintenance itraconazole for confirmed disseminated histoplasmosis between January 2003 and December 2006. Available itraconazole blood levels were abstracted as well as medications taken by each patient at the time of the blood tests. Mean itraconazole levels were compared using the student's t-test. ^ Results. 11 patients met study criteria. Patient characteristics were: median age 36, 91% men, 18% white, 18% black, 55% Hispanic and 9% Asians, median CD4 cell count 120 cells/mm3. 14 blood levels were available for analysis—8 on PI, 4 on NNRTI and 2 on both. 8/8 itraconazole levels obtained while taking concomitant PI were therapeutic (>0.4 μg/mL) in contrast to 0/4 obtained while taking NNRTI. Two patients switched from NNRTI to PI and reached therapeutic levels. Mean levels on NNRTI (0.05 μg/mL, s.d. 0.0) and on PI (2.45 μg/mL, s.d. 0.21) for these two patients were compared via a paired t-test (t = 16.00, d.f. = 1, P = 0.04). Remaining patient levels were compared using an unpaired t-test. Mean itraconazole on concomitant PI (n = 6) was 1.37 μg/mL (s.d. 0.74), while the mean on concomitant NNRTI was 0.05 μg/mL (s.d. 0.0), t = 2.39, d.f. = 6, P = 0.05. ^ Conclusions. Co-administration of NNRTI and itraconazole results in significant decreases in itraconazole blood levels, likely by inducing the CYP3A4 enzyme system. Itraconazole drug levels should be monitored in patients on concomitant NNRTI. PI-based HAART may be preferred over NNRTI-based HAART when using itraconazole to treat HIV-infected patients with disseminated histoplasmosis. ^

RE-AIM analysis of Internet-based psychotherapy

We live in an era where the Internet is expected to be available at the home, the workplace, schools, libraries, and even the corner café. Everyday, more and more of the world's population is connected to this growing minefield of information, many of whom use it to seek out services they need. Health services are amongst the many purchasable products currently available online. The Internet, thus, is a viable method of contacting populations that a provider would not traditionally be able to reach. A growing service in this area is the practice of Internet-based psychotherapy. This goes by many other names as well, such as e-counseling, telecounseling, web therapy, computer mediated counseling, Interapy, and many other variations. ^ This paper reviews the current available literature on the efficacy and associated concerns of Internet-based psychotherapy through the RE-AIM lens. After an evaluation of the selected studies, Internet-based psychotherapy may be able to reach a wider audience than with traditional means and also produces similar efficacy results to in-person therapy. However, providers are still reluctant to adopt Internet-based psychotherapy due to legal concerns, and long-term maintenance of these practices may be an issue. Further research into the effectiveness, cost, and legal issues surrounding Internet-based psychotherapy is recommended. ^

HEALTH MAINTENANCE ORGANIZATION ENVIRONMENT: AN EMPIRICAL STUDY OF THE RELATIONSHIP OF EXTERNAL CONTEXT AND PERFORMANCE

The research project is an extension of a series of administrative science and health care research projects evaluating the influence of external context, organizational strategy, and organizational structure upon organizational success or performance. The research will rely on the assumption that there is not one single best approach to the management of organizations (the contingency theory). As organizational effectiveness is dependent on an appropriate mix of factors, organizations may be equally effective based on differing combinations of factors. The external context of the organization is expected to influence internal organizational strategy and structure and in turn the internal measures affect performance (discriminant theory). The research considers the relationship of external context and organization performance.^ The unit of study for the research will be the health maintenance organization (HMO); an organization the accepts in exchange for a fixed, advance capitation payment, contractual responsibility to assure the delivery of a stated range of health sevices to a voluntary enrolled population. With the current Federal resurgence of interest in the Health Maintenance Organization (HMO) as a major component in the health care system, attention must be directed at maximizing development of HMOs from the limited resources available. Increased skills are needed in both Federal and private evaluation of HMO feasibility in order to prevent resource investment and in projects that will fail while concurrently identifying potentially successful projects that will not be considered using current standards.^ The research considers 192 factors measuring contextual milieu (social, educational, economic, legal, demographic, health and technological factors). Through intercorrelation and principle components data reduction techniques this was reduced to 12 variables. Two measures of HMO performance were identified, they are (1) HMO status (operational or defunct), and (2) a principle components factor score considering eight measures of performance. The relationship between HMO context and performance was analysed using correlation and stepwise multiple regression methods. In each case it has been concluded that the external contextual variables are not predictive of success or failure of study Health Maintenance Organizations. This suggests that performance of an HMO may rely on internal organizational factors. These findings have policy implications as contextual measures are used as a major determinant in HMO feasibility analysis, and as a factor in the allocation of limited Federal funds. ^

Escape performance of temperate king scallop, Pecten maximus under ocean warming and acidification

Among bivalves, scallops are exceptional due to their capacity to escape from predators by swimming which is provided by rapid and strong claps that are produced by the phasic muscle interspersed with tonic muscle contractions. Based on the concept of oxygen and capacity-limited thermal tolerance, the following hypothesis was tested: ocean warming and acidification (OWA) would induce disturbances in aerobic metabolic scope and extracellular acid-case status and impair swimming performance in temperate scallops. Following long-term incubation under near-future OWA scenarios [20 vs. 10 °C (control) and 0.112 kPa CO2 (hypercapnia) vs. 0.040 kPa CO2 (normocapnic control)], the clapping performance and metabolic rates (MR) were measured in resting (RMR) and fatigued (maximum MR) king scallops, Pecten maximus, from Roscoff, France. Exposure to OA, either alone or combined with warming, left MR and swimming parameters such as the total number of claps and clapping forces virtually unchanged. Only the duration of the escape response was affected by OA which caused earlier exhaustion in hyper- than in normocapnic scallops at 10 °C. While maximum MR was unaffected, warm exposure increased RMR in both normocapnic and hypercapnic P. maximus resulting in similar Q 10 values of ~2.2. The increased costs of maintenance and the observation of strongly reduced haemolymph PO2 levels indicate that at 20 °C scallops have reached the upper thermal pejus range with unbalanced capacities for aerobic energy metabolism. As a consequence, warming to 20 °C decreased mean phasic force during escape performance until fatigue. The observed prolonged recovery time in warm incubated scallops might be a consequence of elevated metabolic costs at reduced oxygen availability in the warmth.

Slope stability analyses based on sediment cores of the Ligurian Margin, Southern France

Submarine slope failures of various types and sizes are common along the tectonic and seismically active Ligurian margin, northwestern Mediterranean Sea, primarily because of seismicity up to ~M6, rapid sediment deposition in the Var fluvial system, and steepness of the continental slope (average 11°). We present geophysical, sedimentological and geotechnical results of two distinct slides in water depth >1,500 m: one located on the flank of the Upper Var Valley called Western Slide (WS), another located at the base of continental slope called Eastern Slide (ES). WS is a superficial slide characterized by a slope angle of ~4.6° and shallow scar (~30 m) whereas ES is a deep-seated slide with a lower slope angle (~3°) and deep scar (~100 m). Both areas mainly comprise clayey silt with intermediate plasticity, low water content (30-75 %) and underconsolidation to strong overconsolidation. Upslope undeformed sediments have low undrained shear strength (0-20 kPa) increasing gradually with depth, whereas an abrupt increase in strength up to 200 kPa occurs at a depth of ~3.6 m in the headwall of WS and ~1.0 m in the headwall of ES. These boundaries are interpreted as earlier failure planes that have been covered by hemipelagite or talus from upslope after landslide emplacement. Infinite slope stability analyses indicate both sites are stable under static conditions; however, slope failure may occur in undrained earthquake condition. Peak earthquake acceleration from 0.09 g on WS and 0.12 g on ES, i.e. M5-5.3 earthquakes on the spot, would be required to induce slope instability. Different failure styles include rapid sedimentation on steep canyon flanks with undercutting causing superficial slides in the west and an earthquake on the adjacent Marcel fault to trigger a deep-seated slide in the east.

Domestic Market-based Industrial Cluster Development in Modern China

China’s huge domestic market is constantly expanding, and is low-end demand oriented and highly dispersed. The domestic market-based development of China’s industrial cluster, however, is not only a quantitative expansion, but has also been accompanied with remarkable qualitative upgrading. Specialized markets are a microcosm that clearly indicate this paradoxical phenomenon. By analyzing three typical cases of industrial clusters that have specialized markets, this paper will make the case that under modern China’s market conditions, the local public sector is the crucial driving force for upgrading industrial clusters, which organize complicated transactions, promote quality control, and stimulate the division of labor.

Heart Failure Monitoring System Based on Wearable and Information Technologies

In Europe, Cardiovascular Diseases (CVD) are the leading source of death, causing 45% of all deceases. Besides, Heart Failure, the paradigm of CVD, mainly affects people older than 65. In the current aging society, the European MyHeart Project was created, whose mission is to empower citizens to fight CVD by leading a preventive lifestyle and being able to be diagnosed at an early stage. This paper presents the development of a Heart Failure Management System, based on daily monitoring of Vital Body Signals, with wearable and mobile technologies, for the continuous assessment of this chronic disease. The System makes use of the latest technologies for monitoring heart condition, both with wearable garments (e.g. for measuring ECG and Respiration); and portable devices (such as Weight Scale and Blood Pressure Cuff) both with Bluetooth capabilities

An iPhone-based application for promoting type 2 diabetic patients self- management towards healthy lifestyle habits

— In 2000, according to the World Health Organization, at least 171 million people, 2.8% of the population worldwide, suffered from diabetes. The Centres for Disease Control has defined it as an epidemic disease. Its incidence is increasing rapidly, and it is estimated that by 2030 this number will almost double. Diabetes mellitus occurs throughout the world, but is more common (especially type 2) in the more developed countries. Diabetes is a chronic condition that occurs when pancreas does not assure enough insulin secretion or when the body does not consume the insulin produced. Insulin is a hormone that regulates blood sugar. The effect of uncontrolled diabetes is the hyperglycaemia (blood sugar), which eventually seriously damage many organs and systems, especially the nerves and blood vessels. Diabetes type 2 (most common type of diabetes) is highly correlated with elderly people, obesity or overweight. Promoting a healthy lifestyle helps patients to improve their quality of life and in many cases to avoid complications related to the disease. This paper is intended to describe an iPhone-based application for self-management of type 2 diabetic patients, which allow them improving their lifestyle through healthy diet, physical activity and education

Estudio de la tolerancia al daño de los materiales y sistemas de pretensado

La mayoría de las estructuras de hormigón pretensadas construidas en los últimos 50 años han demostrado una excelente durabilidad cuando su construcción se realiza atendiendo las recomendaciones de un buen diseño así como una buena ejecución y puesta en obra de la estructura. Este hecho se debe en gran parte al temor que despierta el fenómeno de la corrosión bajo tensión típico de las armaduras de acero de alta resistencia. Menos atención se ha prestado a la susceptibilidad a la corrosión bajo tensión de los anclajes de postensado, posiblemente debido a que se han reportado pocos casos de fallos catastróficos. El concepto de Tolerancia al Daño y la Mecánica de la Fractura en estructuras de Ingeniería Civil ha empezado a incorporarse recientemente en algunas normas de diseño y cálculo de estructuras metálicas, sin embargo, aún está lejos de ser asimilado y empleado habitualmente por los ingenieros en sus cálculos cuando la ocasión lo requiere. Este desconocimiento de los aspectos relacionados con la Tolerancia al Daño genera importantes gastos de mantenimiento y reparación. En este trabajo se ha estudiado la aplicabilidad de los conceptos de la Mecánica de la Fractura a los componentes de los sistemas de postensado empleados en ingeniería civil, empleándolo para analizar la susceptibilidad de las armaduras activas frente a la corrosión bajo tensiones y a la pérdida de capacidad portante de las cabezas de anclajes de postensado debido a la presencia de defectos. Con este objeto se han combinado tanto técnicas experimentales como numéricas. Los defectos superficiales en los alambres de pretensado no se presentan de manera aislada si no que existe una cierta continuidad en la dirección axial así como un elevado número de defectos. Por este motivo se ha optado por un enfoque estadístico, que es más apropiado que el determinístico. El empleo de modelos estadísticos basados en la teoría de valores extremos ha permitido caracterizar el estado superficial en alambres de 5,2 mm de diámetro. Por otro lado la susceptibilidad del alambre frente a la corrosión bajo tensión ha sido evaluada mediante la realización de una campaña de ensayos de acuerdo con la actual normativa que ha permitido caracterizar estadísticamente su comportamiento. A la vista de los resultados ha sido posible evaluar como los parámetros que definen el estado superficial del alambre pueden determinar la durabilidad de la armadura atendiendo a su resistencia frente a la corrosión bajo tensión, evaluada mediante los ensayos que especifica la normativa. En el caso de las cabezas de anclaje de tendones de pretensado, los defectos se presentan de manera aislada y tienen su origen en marcas, arañazos o picaduras de corrosión que pueden producirse durante el proceso de fabricación, transporte, manipulación o puesta en obra. Dada la naturaleza de los defectos, el enfoque determinístico es más apropiado que el estadístico. La evaluación de la importancia de un defecto en un elemento estructural requiere la estimación de la solicitación local que genera el defecto, que permite conocer si el defecto es crítico o si puede llegar a serlo, si es que progresa con el tiempo (por fatiga, corrosión, una combinación de ambas, etc.). En este trabajo los defectos han sido idealizados como grietas, de manera que el análisis quedara del lado de la seguridad. La evaluación de la solicitación local del defecto ha sido calculada mediante el empleo de modelos de elementos finitos de la cabeza de anclaje que simulan las condiciones de trabajo reales de la cabeza de anclaje durante su vida útil. A partir de estos modelos numéricos se ha analizado la influencia en la carga de rotura del anclaje de diversos factores como la geometría del anclaje, las condiciones del apoyo, el material del anclaje, el tamaño del defecto su forma y su posición. Los resultados del análisis numérico han sido contrastados satisfactoriamente mediante la realización de una campaña experimental de modelos a escala de cabezas de anclaje de Polimetil-metacrilato en los que artificialmente se han introducido defectos de diversos tamaños y en distintas posiciones. ABSTRACT Most of the prestressed concrete structures built in the last 50 years have demonstrated an excellent durability when they are constructed in accordance with the rules of good design, detailing and execution. This is particularly true with respect to the feared stress corrosion cracking, which is typical of high strength prestressing steel wires. Less attention, however, has been paid to the stress corrosion cracking susceptibility of anchorages for steel tendons for prestressing concrete, probably due to the low number of reported failure cases. Damage tolerance and fracture mechanics concepts in civil engineering structures have recently started to be incorporated in some design and calculation rules for metallic structures, however it is still far from being assimilated and used by civil engineers in their calculations on a regular basis. This limited knowledge of the damage tolerance basis could lead to significant repair and maintenance costs. This work deals with the applicability of fracture mechanics and damage tolerance concepts to the components of prestressed systems, which are used in civil engineering. Such concepts have been applied to assess the susceptibility of the prestressing steel wires to stress corrosion cracking and the reduction of load bearing capability of anchorage devices due to the presence of defects. For this purpose a combination of experimental work and numerical techniques have been performed. Surface defects in prestressing steel wires are not shown alone, though a certain degree of continuity in the axial direction exist. A significant number of such defects is also observed. Hence a statistical approach was used, which is assumed to be more appropriate than the deterministic approach. The use of statistical methods based in extreme value theories has allowed the characterising of the surface condition of 5.2 mm-diameter wires. On the other hand the stress corrosion cracking susceptibility of the wire has been assessed by means of an experimental testing program in line with the current regulations, which has allowed statistical characterisasion of their performances against stress corrosion cracking. In the light of the test results, it has been possible to evaluate how the surface condition parameters could determine the durability of the active metal armour regarding to its resistance against stress corrosion cracking assessed by means of the current testing regulations. In the case of anchorage devices for steel tendons for prestressing concrete, the damage is presented as point defects originating from dents, scratches or corrosion pits that could be produced during the manufacturing proccess, transport, handling, assembly or use. Due to the nature of these defects, in this case the deterministic approach is more appropriate than the statistical approach. The assessment of the relevancy of defect in a structural component requires the computation of the stress intensity factors, which in turn allow the evaluation of whether the size defect is critical or could become critical with the progress of time (due to fatigue, corrosion or a combination of both effects). In this work the damage is idealised as tiny cracks, a conservative hypothesis. The stress intensity factors have been calculated by means of finite element models of the anchorage representing the real working conditions during its service life. These numeric models were used to assess the impact of some factors on the rupture load of the anchorage, such the anchorage geometry, material, support conditions, defect size, shape and its location. The results from the numerical analysis have been succesfully correlated against the results of the experimental testing program of scaled models of the anchorages in poly-methil methacrylate in which artificial damage in several sizes and locations were introduced.

A flexible (C)LP-based approach to the analysis of object-oriented programs

Static analyses of object-oriented programs usually rely on intermediate representations that respect the original semantics while having a more uniform and basic syntax. Most of the work involving object-oriented languages and abstract interpretation usually omits the description of that language or just refers to the Control Flow Graph(CFG) it represents. However, this lack of formalization on one hand results in an absence of assurances regarding the correctness of the transformation and on the other it typically strongly couples the analysis to the source language. In this work we present a framework for analysis of object-oriented languages in which in a first phase we transform the input program into a representation based on Horn clauses. This allows on one hand proving the transformation correct attending to a simple condition and on the other being able to apply an existing analyzer for (constraint) logic programming to automatically derive a safe approximation of the semantics of the original program. The approach is flexible in the sense that the first phase decouples the analyzer from most languagedependent features, and correct because the set of Horn clauses returned by the transformation phase safely approximates the standard semantics of the input program. The resulting analysis is also reasonably scalable due to the use of mature, modular (C)LP-based analyzers. The overall approach allows us to report results for medium-sized programs.

A program transformation for continuation call-based tabled execution

The advantages of tabled evaluation regarding program termination and reduction of complexity are well known —as are the significant implementation, portability, and maintenance efforts that some proposals (especially those based on suspensión) require. This implementation effort is reduced by program transformation-based continuation cali techniques, at some eñrciency cost. However, the traditional formulation of this proposal by Ramesh and Cheng limits the interleaving of tabled and non-tabled predicates and thus cannot be used as-is for arbitrary programs. In this paper we present a complete translation for the continuation cali technique which, using the runtime support needed for the traditional proposal, solves these problems and makes it possible to execute arbitrary tabled programs. We present performance results which show that CCall offers a useful tradeoff that can be competitive with state-of-the-art implementations.