Level of incongruence during cardiac rehabilitation and prediction of future CVD-related hospitalizations plus all-cause mortality

Independent of traditional risk factors, psychosocial risk factors increase the risk of cardiovascular disease (CVD). Studies in the field of psychotherapy have shown that the construct of incongruence (meaning a discrepancy between desired and achieved goals) affects the outcome of therapy. We prospectively measured the impact of incongruence in patients after undergoing a cardiac rehabilitation program. We examined 198 CVD patients enrolled in a 8–12 week comprehensive cardiac rehabilitation program. Patients completed the German short version of the Incongruence Questionnaire and the SF-36 Health Questionnaire to measure quality of life (QoL) at discharge of rehabilitation. Endpoints at follow-up were CVD-related hospitalizations plus all-cause mortality. During a mean follow-up period of 54.3 months, 29 patients experienced a CVD-related hospitalization and 3 patients died. Incongruence at discharge of rehabilitation was independent of traditional risk factors a significant predictor for CVD-related hospitalizations plus all-cause mortality (HR 2.03, 95% CI 1.29–3.20, p = .002). We also found a significant interaction of incongruence with mental QoL (HR .96, 95% CI .92–.99, p = .027), i.e. incongruence predicted poor prognosis if QoL was low (p = .017), but not if QoL was high (p = .74). Incongruence at discharge predicted future CVD-related hospitalizations plus all-cause mortality and mental QoL moderated this relationship. Therefore, incongruence should be considered for effective treatment planning and outcome measurement.

Education and Training of Future Nuclear Engineers Through the use of an Interactive Plant Simulator

The successful experience of the Jose Cabrera Nuclear Power Plant Interactive Graphical Simulator implementation in the Nuclear Engineering Department in the Universidad Polite´cnica de Madrid, for the Education and Training of nuclear engineers is shown in this paper. The paper starts with the objectives and the description of the Simulator Aula, and the methodology of work following the recommendations of the IAEA for the use of nuclear reactor simulators for education. The practices and material prepared for the students, as well as the operational and accident situations simulated are provided.

Design and construction of the Barriga Dam spillway through an improved wedge-shaped block technology

The Barriga Dam (Burgos, Spain) is a unique case study because its trapezoid spillway is located on the dam body and is composed of wedge-shaped concrete blocks (WSB) that include certain relevant improvements. This note summarizes the main features of the studies, the key aspects of the final design of the WSB and their placement on the dam, and important details of the spillway design. The design team concluded the study by showing the suitability of this enhanced technology for application to small dams and ponds in the short term, even with unit flows above 5 m2/s.

Tunisia: Changes and Challenges of Political Transition. MEDPRO Technical Report No. 3/May 2011

For 23 years, a combination of harsh repression and impressive socio-economic development in Tunisia ensured a certain level of stability of Ben Ali’s regime. However, on 14 January 2011, after several weeks of anti-government protests, the President fled the country, revealing the fallacy of the ‘Tunisian model’. While the departure of Ben Ali is an important step towards Tunisia’s political change, the fate of its democratic transition remains uncertain. In light of these changes and challenges, this paper first assesses the factors underpinning the former stability of Ben Ali’s regime; it then investigates the causes of its underlying unsustainability, culminating in the anti-government popular uprising in December 2010-January 2011 and the removal of Ben Ali; finally the paper evaluates the prospects for a real democratic transition in Tunisia, by highlighting the main political and socio-economic challenges that confront the country

Design and construction of continously reinforced concrete airport pavements : final report /

Final report; August 1977.

Design and construction of covers for solid waste landfills /

Mode of access: Internet.

Design and construction of asphalt paving materials with crumb rubber modifier : state of the practice /

"May 1992."

Design and construction of radiochemical laboratories : a selected list of unclassified references.

"October 1, 1951."

Civil engineering bibliography on the design and construction of nuclear facilities /

"DTIE Issuance Date: December 1962."

Slide valve gears : an explanation of the action and construction of plain and cut-off slide valves /

Includes index.