893 resultados para high risk behavior


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Maritime accidents involving ships carrying passengers may pose a high risk with respect to human casualties. For effective risk mitigation, an insight into the process of risk escalation is needed. This requires a proactive approach when it comes to risk modelling for maritime transportation systems. Most of the existing models are based on historical data on maritime accidents, and thus they can be considered reactive instead of proactive. This paper introduces a systematic, transferable and proactive framework estimating the risk for maritime transportation systems, meeting the requirements stemming from the adopted formal definition of risk. The framework focuses on ship-ship collisions in the open sea, with a RoRo/Passenger ship (RoPax) being considered as the struck ship. First, it covers an identification of the events that follow a collision between two ships in the open sea, and, second, it evaluates the probabilities of these events, concluding by determining the severity of a collision. The risk framework is developed with the use of Bayesian Belief Networks and utilizes a set of analytical methods for the estimation of the risk model parameters. The model can be run with the use of GeNIe software package. Finally, a case study is presented, in which the risk framework developed here is applied to a maritime transportation system operating in the Gulf of Finland (GoF). The results obtained are compared to the historical data and available models, in which a RoPax was involved in a collision, and good agreement with the available records is found.

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This paper examines whether the IMF high interest rate policy was suitable for crisis-ridden East Asian economies. Using an "overshoot" model similar to that of Dornbusch's (1976), it shows that this sort of policy might cause an unnecessary deflationary adjusting process and have no effect on containing the real depreciation of exchange rates in the long run. The study also demonstrates that Thai economic data coincides quite well with the model presented here. Finally, it points out that the high interest policy itself might provoke high risk-premium, the existence of which, in turn, justifies the policy. This means that the policy has a self-fulfilling property. In conclusion, a "one-size-fits-all" adaptation of high interest rate policy in a currency crisis is very dangerous in general, and was inappropriate for East Asia. The desirable policy would have been to let currencies depreciate and keep interest rates stable.

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Prevalence of vitamin B12 deficiency is very common in elderly people and can reach values as high as 40.5% of the population. It can be the result of the interaction among several factors. Vitamin B12 deficiencies have been associated with neurological, cognitive deterioration, haematological abnormalities and cardiovascular diseases that have an important influence on the health of the elderly and their quality of life. It is necessary to approach the problems arisen from the lack of data relative to them. The main objective of this thesis was to analyse the evolution of vitamin B12 status and related parameters, lipid and haematological profiles and their relationship to health risk factors, and to functional and cognitive status over one year and to determine the effect of an oral supplementation of 500 μg of cyanocobalamin for a short period of 28 days. An additional objective was to analyze the possible effects of medicine intakes on vitamin B status. Three studies were performed: a) a one year longitudinal follow-up with four measure points; b) an intervention study providing an oral liquid supplement of 500 μg of cyanocobalamin for a 28 days period; and c) analysis of the possible effect of medication intake on vitamin B status using the ATC classification of medicines. The participants for these studies were recruited from nursing homes for the elderly in the Region of Madrid. Sixty elders (mean age 84 _ 7y, 19 men and 41 women) were recruited for Study I and 64 elders (mean age 82 _ 7y, 24 men and 40 women) for Study II. For Study III, baseline data from the initially recruited participants of the first two studies were used. An informed consent was obtained from all participants or their mentors. The studies were approved by the Ethical Committee of the University of Granada. Blood samples were obtained at each examination date and were analyzed for serum cobalamin, holoTC, serum and RBC folate and total homocysteine according to laboratory standard procedures. The haematological parameters analyzed were haematocrit, haemoglobin and MCV. For the lipid profile TG, total cholesterol, LDL- and HDLcholesterol were analyzed. Anthropometric measures (BMI, skinfolds [triceps and subscapular], waist girth and waist to hip ratio), functional tests (hand grip, arm and leg strength tests, static balance) and MMSE were obtained or administered by trained personal. The vitamin B12 supplement of Study II was administered with breakfast and the medication intake was taken from the residents’ anamnesis. Data were analyzed by parametric and non-parametric statistics depending on the obtained data. Comparisons were done using the appropriate ANOVAs or non-parametric tests. Pearsons’ partial correlations with the variable “time” as control were used to define the association of the analyzed parameters. XIII The results showed that: A) Over one year, in relationship to vitamin B status, serum cobalamin decreased, serum folate and mean corpuscular volumen increased significantly and total homocysteine concentrations were stable. Regarding blood lipid profile, triglycerides increased and HDL-cholesterol decreased significantly. Regarding selected anthropometric measurements, waist circumference increased significantly. No significant changes were observed for the rest of parameters. B) Prevalence of hyperhomocysteinemia was high in the elderly studied, ranging from 60% to 90 % over the year depending on the cut-off used for the classification. LDL-cholesterol values were high, especially among women, and showed a tendency to increase over the year. Results of the balance test showed a deficiency and a tendency to decrease; this indicates that the population studied is at high risk for falls. Lower extremity muscular function was deficient and showed a tendency to decrease. A highly significant relationship was observed between the skinfold of the triceps and blood lipid profile. C) Low cobalamin concentrations correlated significantly with low MMSE scores in the elderly studied. No correlations were observed between vitamin B12 status and functional parameters. D) Regarding vitamin B12 status, holo-transcobalamin seems to be more sensitive for diagnosis; 5-10% of the elderly had a deficiency using serum cobalamin as a criterion, and 45-52% had a deficiency when using serum holotranscobalamin as a criterion. E) 500 μg of cyanocobalamin administered orally during 28 days significantly improved vitamin B12 status and significantly decreased total homocysteine concentrations in institutionalized elderly. No effect of the intervention was observed on functional and cognitive parameters. F) The relative change (%) of improvement of vitamin B12 status was higher when using serum holo-transcobalamin as a criterion than serum cobalamin. G) Antiaenemic drug intake normalized cobalamin, urologic drugs and corticosteroids serum folate, and psychoanaleptics holo-transcobalamin levels. Drugs treating pulmonary obstruction increased total homocysteine concentration significantly. H) The daily mean drug intake was 5.1. Fiftynine percent of the elderly took medication belonging to 5 or more different ATC groups. The most prevalent were psycholeptic (53%), antiacid (53%) and antithrombotic (47%) drugs.

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Sudden cardiac death is one of the main causes of mortality in patients with structural heart disease. Although an implantable cardioverter de?brillator signi?cantly reduces the mortality rate, many patients never receive a shock. Identi?cation of high-risk patients would reduce the costs associated with this therapy and prevent the deleterious effect of inappropriate discharges. As scar tissue is the substrate of ventricular arrhythmias in patients with structural heart disease, scar characterization could allow strati?cation of the risk. The objective of this article is to review the role of scar characteristics in the pathogenesis of ventricular arrhythmias in patients with structural heart disease.

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A module to estimate risks of ozone damage to vegetation has been implemented in the Integrated Assessment Modelling system for the Iberian Peninsula. It was applied to compute three different indexes for wheat and Holm oak; daylight AOT40 (cumulative ozone concentration over 40 ppb), cumulative ozone exposure index according to the Directive 2008/50/EC (AOT40-D) and PODY (Phytotoxic Ozone Dose over a given threshold of Y nmol m−2 s−1). The use of these indexes led to remarkable differences in spatial patterns of relative ozone risks on vegetation. Ozone critical levels were exceeded in most of the modelling domain and soil moisture content was found to have a significant impact on the results. According to the outputs of the model, daylight AOT40 constitutes a more conservative index than the AOT40-D. Additionally, flux-based estimations indicate high risk areas in Portugal for both wheat and Holm oak that are not identified by AOT-based methods.

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Composite laminates on the nanoscale have shown superior hardness and toughness, but little is known about their high temperature behavior. The mechanical properties (elastic modulus and hardness) were measured as a function of temperature by means of nanoindentation in Al/SiC nanolaminates, a model metal–ceramic nanolaminate fabricated by physical vapor deposition. The influence of the Al and SiC volume fraction and layer thicknesses was determined between room temperature and 150 °C and, the deformation modes were analyzed by transmission electron microscopy, using a focused ion beam to prepare cross-sections through selected indents. It was found that ambient temperature deformation was controlled by the plastic flow of the Al layers, constrained by the SiC, and the elastic bending of the SiC layers. The reduction in hardness with temperature showed evidence of the development of interface-mediated deformation mechanisms, which led to a clear influence of layer thickness on the hardness.

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Los recientes avances tecnológicos han encontrado un potencial campo de explotación en la educación asistida por computador. A finales de los años 90 surgió un nuevo campo de investigación denominado Entornos Virtuales Inteligentes para el Entrenamiento y/o Enseñanza (EVIEs), que combinan dos áreas de gran complejidad: Los Entornos Virtuales (EVs) y los Sistemas de Tutoría Inteligente (STIs). De este modo, los beneficios de los entornos 3D (simulación de entornos de alto riesgo o entornos de difícil uso, etc.) pueden combinarse con aquéllos de un STIs (personalización de materias y presentaciones, adaptación de la estrategia de tutoría a las necesidades del estudiante, etc.) para proporcionar soluciones educativas/de entrenamiento con valores añadidos. El Modelo del Estudiante, núcleo de un SIT, representa el conocimiento y características del estudiante, y refleja el proceso de razonamiento del estudiante. Su complejidad es incluso superior cuando los STIs se aplican a EVs porque las nuevas posibilidades de interacción proporcionadas por estos entornos deben considerarse como nuevos elementos de información clave para el modelado del estudiante, incidiendo en todo el proceso educativo: el camino seguido por el estudiante durante su navegación a través de escenarios 3D; el comportamiento no verbal tal como la dirección de la mirada; nuevos tipos de pistas e instrucciones que el módulo de tutoría puede proporcionar al estudiante; nuevos tipos de preguntas que el estudiante puede formular, etc. Por consiguiente, es necesario que la estructura de los STIs, embebida en el EVIE, se enriquezca con estos aspectos, mientras mantiene una estructura clara, estructurada, y bien definida. La mayoría de las aproximaciones al Modelo del Estudiante en STIs y en IVETs no consideran una taxonomía de posibles conocimientos acerca del estudiante suficientemente completa. Además, la mayoría de ellas sólo tienen validez en ciertos dominios o es difícil su adaptación a diferentes STIs. Para vencer estas limitaciones, hemos propuesto, en el marco de esta tesis doctoral, un nuevo mecanismo de Modelado del Estudiante basado en la Ingeniería Ontológica e inspirado en principios pedagógicos, con un modelo de datos sobre el estudiante amplio y flexible que facilita su adaptación y extensión para diferentes STIs y aplicaciones de aprendizaje, además de un método de diagnóstico con capacidades de razonamiento no monótono. El método de diagnóstico es capaz de inferir el estado de los objetivos de aprendizaje contenidos en el SIT y, a partir de él, el estado de los conocimientos del estudiante durante su proceso de aprendizaje. La aproximación almodelado del estudiante propuesta ha sido implementada e integrada en un agente software (el agente de modelado del estudiante) dentro de una plataforma software existente para el desarrollo de EVIEs denominadaMAEVIF. Esta plataforma ha sido diseñada para ser fácilmente configurable para diferentes aplicaciones de aprendizaje. El modelado del estudiante presentado ha sido implementado e instanciado para dos tipos de entornos de aprendizaje: uno para aprendizaje del uso de interfaces gráficas de usuario en una aplicación software y para un Entorno Virtual para entrenamiento procedimental. Además, se ha desarrollado una metodología para guiar en la aplicación del esta aproximación de modelado del estudiante a cada sistema concreto.---ABSTRACT---Recent technological advances have found a potential field of exploitation in computeraided education. At the end of the 90’s a new research field emerged, the so-called Intelligent Virtual Environments for Training and/or Education (IVETs), which combines two areas of great complexity: Virtual Environments (VE) and Intelligent Tutoring Systems (ITS). In this way, the benefits of 3D environments (simulation of high risk or difficult-to-use environments, etc.) may be combined with those of an ITS (content and presentation customization, adaptation of the tutoring strategy to the student requirements, etc.) in order to provide added value educational/training solutions. The StudentModel, core of an ITS, represents the student’s knowledge and characteristics, and reflects the student’s reasoning process. Its complexity is even higher when the ITSs are applied on VEs because the new interaction possibilities offered by these environments must be considered as new key information pieces for student modelling, impacting all the educational process: the path followed by the student during their navigation through 3D scenarios; non-verbal behavior such as gaze direction; new types of hints or instructions that the tutoring module can provide to the student; new question types that the student can ask, etc. Thus, it is necessary for the ITS structure, which is embedded in the IVET, to be enriched by these aspects, while keeping a clear, structured and well defined architecture. Most approaches to SM on ITSs and IVETs don’t consider a complete enough taxonomy of possible knowledge about the student. In addition, most of them have validity only in certain domains or they are hard to be adapted for different ITSs. In order to overcome these limitations, we have proposed, in the framework of this doctoral research project, a newStudentModeling mechanism that is based onOntological Engineering and inspired on pedagogical principles, with a wide and flexible data model about the student that facilitates its adaptation and extension to different ITSs and learning applications, as well as a rich diagnosis method with non-monotonic reasoning capacities. The diagnosis method is able to infer the state of the learning objectives encompassed by the ITS and, fromit, the student’s knowledge state during the student’s process of learning. The proposed student modelling approach has been implemented and integrated in a software agent (the student modeling agent) within an existing software platform for the development of IVETs called MAEVIF. This platform was designed to be easily configurable for different learning applications. The proposed student modeling has been implemented and it has been instantiated for two types of learning environments: one for learning to use the graphical user interface of a software application and a Virtual Environment for procedural training. In addition, a methodology to guide on the application of this student modeling approach to each specific system has been developed.

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Esta pesquisa investiga a influência de intervenções lúdicas na diminuição da ansiedade materna com mães de recém-nascidos pré-termo hospitalizados, em um hospital universitário da Grande São Paulo. São estudadas 30 mães que tiveram parto prematuro, com faixa etária entre 16 e 40 anos e escolaridade até 2º grau, por meio de estudo avaliativo-interventivo-evolutivo. Inicia-se por uma entrevista psicológica semidirigida, com o objetivo de traçar o histórico gestacional, seguida de aplicação da Escala de Ansiedade, Depressão e Irritabilidade IDA, visando identificar o nível de ansiedade materna e do Inventário de Percepção Neonatal IPN-I para verificar a expectativa das mães em relação ao comportamento de choro, alimento e vômito de seus bebês pré-termo. A seguir são efetuadas intervenções grupais lúdicas em 16 encontros, um a cada semana, de 60 minutos, segundo modelo piagetiano, que estimula processos afetivosemocionais e cognitivos. Os dados relativos ao histórico gestacional revelam que 75% das mães encontram-se na segunda gestação e já sofreram aborto ou óbito fetal; têm ida de gestacional média de 31 semanas; peso médio do bebê ao nascer de 1.640g. e tempo de internação médio de 39,93 dias. Na análise do IDA em relação à ansiedade, 75% delas apresentam escore de alta intensidade (11,25), também alto quanto à depressão (10); o escore médio (3,73) da irritabilidade exteriorizada acompanha o da irritabilidade interiorizada (3,23). A correlação entre depressão e ansiedade indica que uma reação emocional segue a outra, não havendo diferença significativa importante entre ambas (p=0,306). O IPN-I comprova que as 30 mães têm expectativas em relação ao próprio filho similares aos bebês em geral, mostrando escores médios de 8,63 e 9,20, respectivamente, confirmados pelo escore 10,0 apontado em 75% da amostra, o que configura uma alta expectativa quanto aos aspectos de sono, alimentação e vômito dos bebês. A análise qualitativa revela que a criação de grupos lúdicos mostra-se favorável, com alta adesão e motivação das mães, favorecendo a diminuição da ansiedade, a adaptação à realidade vivida e a interação mãe-bebê de forma saudável durante a internação. O estudo apresenta a trajetória interventiva de três casos emblemáticos de diferentes níveis de ansiedade, ilustrando esta evolução. Estes dados sugerem que esta modalidade de intervenção caracterize-se como uma medida de prevenção, promoção e preservação da saúde física e psíquica da mãe e do recémnascido prematuro, com repercussões na família e na sociedade.(AU)

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Esta pesquisa investiga a influência de intervenções lúdicas na diminuição da ansiedade materna com mães de recém-nascidos pré-termo hospitalizados, em um hospital universitário da Grande São Paulo. São estudadas 30 mães que tiveram parto prematuro, com faixa etária entre 16 e 40 anos e escolaridade até 2º grau, por meio de estudo avaliativo-interventivo-evolutivo. Inicia-se por uma entrevista psicológica semidirigida, com o objetivo de traçar o histórico gestacional, seguida de aplicação da Escala de Ansiedade, Depressão e Irritabilidade IDA, visando identificar o nível de ansiedade materna e do Inventário de Percepção Neonatal IPN-I para verificar a expectativa das mães em relação ao comportamento de choro, alimento e vômito de seus bebês pré-termo. A seguir são efetuadas intervenções grupais lúdicas em 16 encontros, um a cada semana, de 60 minutos, segundo modelo piagetiano, que estimula processos afetivosemocionais e cognitivos. Os dados relativos ao histórico gestacional revelam que 75% das mães encontram-se na segunda gestação e já sofreram aborto ou óbito fetal; têm ida de gestacional média de 31 semanas; peso médio do bebê ao nascer de 1.640g. e tempo de internação médio de 39,93 dias. Na análise do IDA em relação à ansiedade, 75% delas apresentam escore de alta intensidade (11,25), também alto quanto à depressão (10); o escore médio (3,73) da irritabilidade exteriorizada acompanha o da irritabilidade interiorizada (3,23). A correlação entre depressão e ansiedade indica que uma reação emocional segue a outra, não havendo diferença significativa importante entre ambas (p=0,306). O IPN-I comprova que as 30 mães têm expectativas em relação ao próprio filho similares aos bebês em geral, mostrando escores médios de 8,63 e 9,20, respectivamente, confirmados pelo escore 10,0 apontado em 75% da amostra, o que configura uma alta expectativa quanto aos aspectos de sono, alimentação e vômito dos bebês. A análise qualitativa revela que a criação de grupos lúdicos mostra-se favorável, com alta adesão e motivação das mães, favorecendo a diminuição da ansiedade, a adaptação à realidade vivida e a interação mãe-bebê de forma saudável durante a internação. O estudo apresenta a trajetória interventiva de três casos emblemáticos de diferentes níveis de ansiedade, ilustrando esta evolução. Estes dados sugerem que esta modalidade de intervenção caracterize-se como uma medida de prevenção, promoção e preservação da saúde física e psíquica da mãe e do recémnascido prematuro, com repercussões na família e na sociedade.(AU)

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Objectives: To validate a self administered postal questionnaire appraising risk of coronary heart disease. To determine whether use of this questionnaire increased the percentage of people at high risk of coronary heart disease and decreased the percentage of people at low risk who had their cholesterol concentration measured.

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Studies on natural populations and harvesting biological resources have led to the view, commonly held, that (i) populations exhibiting chaotic oscillations run a high risk of extinction; and (ii) a decrease in emigration/exploitation may reduce the risk of extinction. Here we describe a simple ecological model with emigration/depletion that shows behavior in contrast to this. This model displays unusual dynamics of extinction and survival, where populations growing beyond a critical rate can persist within a band of high depletion rates, whereas extinction occurs for lower depletion rates. Though prior to extinction at lower depletion rates the population exhibits chaotic dynamics with large amplitudes of variation and very low minima, at higher depletion rates the population persists at chaos but with reduced variation and increased minima. For still higher values, within the band of persistence, the dynamics show period reversal leading to stability. These results illustrate that chaos does not necessarily lead to population extinction. In addition, the persistence of populations at high depletion rates has important implications in the considerations of strategies for the management of biological resources.

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Evidências apontam para forte relação independente entre maus tratos na infância, comportamentos disruptivos e prejuízos em funções executivas. No entanto, ainda não é completamente compreendido como estes três fatores se relacionam entre si. Esta pesquisa avaliou a relação entre maus-tratos na infância e transtornos do comportamento disruptivo, testando desempenho em funções executivas como possível mediador e moderador desta relação. A presente pesquisa está inserida no estudo \"Coorte de escolares de alto risco para o desenvolvimento de psicopatologia e resiliência na infância e adolescência - projeto Prevenção\", projeto integrante do Instituto Nacional de Ciência e Tecnologia de Psiquiatria do Desenvolvimento para Infância e Adolescência (INCT-INPD), o qual incluiu 2500 crianças em idade escolar de São Paulo e Porto Alegre (Brasil). As crianças foram extensamente avaliadas com entrevistas diagnósticas, relatos de pais e da própria criança sobre maus tratos e com testes neuropsicológicos. Resultados indicam associação de maus tratos na infância e transtornos do comportamento disruptivo, porém não foi encontrada associação entre maus tratos e funções executivas. Crianças com transtornos do comportamento disruptivo apresentaram pior desempenho em teste específico para avaliação de flexibilidade cognitiva. Desempenho em funções executivas não agiu como mediador ou moderador da associação entre maus tratos e transtornos do comportamento disruptivo. Desta forma, os resultados indicam que a associação entre experiências de maus tratos e transtornos do comportamento disruptivo ocorre independentemente do desempenho em funções executivas. Futuros estudos longitudinais são fundamentais para confirmar estes resultados e elucidar os mecanismos cognitivos envolvidos nesta associação causal

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Childhood obesity is an epidemic that is having devastating effects on the physical and psychological health of children. The core processes of Acceptance and Commitment Therapy (ACT) are explored in this paper relative to how they can be applied as interventions in an early life obesity prevention model. While reviewing research in childhood obesity intervention models, this paper proposes a study that involves conducting behavioral health consultations with mothers whose children are at high risk for becoming overweight.

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The negotiations between Greece and the EU and IMF tested the unity, limits, stamina and financial interdependence of eurozone member states. Greece emerged wounded from the fray, but Prime Minister Alexis Tsipras has established beyond doubt his dominance in Greek politics, in defiance of partisan competitors at home and his counterparts’ wishes in the rest of Europe. In this EPIN Commentary the authors argue that – beyond the political significance of SYRIZA’s third electoral victory in seven months – this vote of confidence brings certain characteristics of both Greek and EU politics into sharper relief. The high-risk political activism undertaken by Syriza’s leadership in the first half of 2015 has (re)opened the debate about what kind of EU we live in, and contributed to the creation of another type of discourse in Europe – one that has so far been the preserve of established elites.

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BACKGROUND Canine atopic dermatitis (CAD) is a chronic inflammatory skin disease triggered by allergic reactions involving IgE antibodies directed towards environmental allergens. We previously identified a ~1.5 Mb locus on canine chromosome 27 associated with CAD in German shepherd dogs (GSDs). Fine-mapping indicated association closest to the PKP2 gene encoding plakophilin 2. RESULTS Additional genotyping and association analyses in GSDs combined with control dogs from five breeds with low-risk for CAD revealed the top SNP 27:19,086,778 (p = 1.4 × 10(-7)) and a rare ~48 kb risk haplotype overlapping the PKP2 gene and shared only with other high-risk CAD breeds. We selected altogether nine SNPs (four top-associated in GSDs and five within the ~48 kb risk haplotype) that spanned ~280 kb forming one risk haplotype carried by 35 % of the GSD cases and 10 % of the GSD controls (OR = 5.1, p = 5.9 × 10(-5)), and another haplotype present in 85 % of the GSD cases and 98 % of the GSD controls and conferring a protective effect against CAD in GSDs (OR = 0.14, p = 0.0032). Eight of these SNPs were analyzed for transcriptional regulation using reporter assays where all tested regions exerted regulatory effects on transcription in epithelial and/or immune cell lines, and seven SNPs showed allelic differences. The DNA fragment with the top-associated SNP 27:19,086,778 displayed the highest activity in keratinocytes with 11-fold induction of transcription by the risk allele versus 8-fold by the control allele (pdifference = 0.003), and also mapped close (~3 kb) to an ENCODE skin-specific enhancer region. CONCLUSIONS Our experiments indicate that multiple CAD-associated genetic variants located in cell type-specific enhancers are involved in gene regulation in different cells and tissues. No single causative variant alone, but rather multiple variants combined in a risk haplotype likely contribute to an altered expression of the PKP2 gene, and possibly nearby genes, in immune and epithelial cells, and predispose GSDs to CAD.