852 resultados para Post-mortem Change


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This table accompanies the manuscript entitled "Religion/Spirituality and Change in Meaning after Bereavement: Qualitative Evidence for the Meaning Making Model" by Wortmann & Park (2009). The table summarizes the sample characteristics for published, qualitative studies that describe the involvement of religion/spirituality in adjustment after bereavement. Fields include author(s)'s last name, publication year, population characteristics and sample size, study design, age of the bereaved, type or cause of death, and time post-loss.

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Television viewing is a sedentary behavior that is modifiable. Reducing media-related behaviors via parent-focused interventions may hold promise for decreasing childhood obesity. This feasibility study examines a novel parent-centered brief telephone-delivered Motivational Enhancement Interview (MEI) to encourage parents of 2nd and 4th graders to set a rules limiting TV time or remove the TV from the child's bedroom. This quasi-experimental sub-study was part of the larger CATCH: En Vivo pilot study conducted in a Hispanic population in the Texas Rio Grande Valley. Parents in the MEI condition were contacted via telephone and encouraged to meet the American Academy of Pediatrics (AAP) recommended 2 hours per day or less of TV. Unconditional logistic regression was used to analyze the data. At post-test, 85% of parents of 4th graders in the MEI group (compared to 71% at pre-test) reported having a rule limiting TV time. The adjusted odds ratio for the MEI group compared to the control group was 3.88, 95% CI (0.72-20.99). At pre-test, 63.16% of 2nd graders had a television in their bedrooms. The 2nd grade MEI intervention reduced that number to 41.03% (OR=0.25, 95%CI (0.08-0.82)). This first look at using MEI to target parents of children to modify TV behavior presents evidence on a promising strategy for modifying children's home media environment and warrants further investigation. ^

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Background. Colorectal cancer (CRC) survivors have to manage treatment side effects, psychosocial issues, and co-morbidities, as well as modify their lifestyles to decrease risk of recurrence and prolong life. Identifying survivors’ goals and key factors that influence their goals will highlight the issues cancer survivors face post-treatment and the resources needed to help them engage in health-promoting behaviors.^ Objectives and methods. This dissertation examines the health-related goals of post-treatment CRC survivors using two studies: (1) a qualitative study to identify and describe the health goals of CRC survivors during the transition from active treatment to post-treatment survivorship and follow-up care; and (2) a cross-sectional survey to identify CRC survivors’ goals, and key factors that influence their goals.^ Results. (1) The 41 qualitative interviews indicated participants’ health-related goals were to be healthy, get back to normal, and not have a cancer recurrence. Most of the CRC survivors reported they maintained healthy behaviors, made healthy behavior changes, or had goals to change their behavior. Respondents were empowered to improve their health by maintaining follow-up care and regular health screenings, and many were managing treatment side effects in an effort to improve functional abilities. (2) The cross-sectional study found that CRC survivors’ most prevalent goals were related to healthy behaviors (i.e., eat a healthy diet and engage in physical activity), and cancer care or disease management (i.e., keep up with health screenings and monitor symptoms). Goals that survivors identified as important were similar to goals they perceived were important to their providers (i.e., goals related to cancer care, disease management). Certain goals were statistically associated with age, barriers to achieving goals, social support and health-related quality of life.^ Conclusions. CRC survivors have health-promoting goals post-treatment and are interested in making health behavior changes. Goals ranged from cancer care/surveillance and disease management to healthy lifestyle modifications. Patients may need help resolving or managing treatment side effects or co-morbidities prior to implementing health promoting behaviors. Healthcare providers’ recommendations may be a powerful resource to encourage survivors to engage in health-promoting behaviors. Self-management and goal setting support could be an appropriate strategy to assist patients with achieving their post-treatment health goals.^

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A marked ocean acidification event and elevated atmospheric carbon dioxide concentrations following the extreme environmental conditions of the younger Cryogenian glaciation have been inferred from boron isotope measurements. Calcium and magnesium isotope analyses offer additional insights into the processes occurring during this time. Data from Neoproterozoic sections in Namibia indicate that following the end of glaciation the continental weathering flux transitioned from being of mixed carbonate and silicate character to a silicate-dominated one. Combined with the effects of primary dolomite formation in the cap dolostones, this caused the ocean to depart from a state of acidification and return to higher pH after climatic amelioration. Differences in the magnitude of stratigraphic isotopic changes across the continental margin of the southern Congo craton shelf point to local influences modifying and amplifying the global signal, which need to be considered in order to avoid overestimation of the worldwide chemical weathering flux.

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One of the most abrupt and yet unexplained past rises in atmospheric CO2 (10 p.p.m.v. in two centuries) occurred in quasi-synchrony with abrupt northern hemispheric warming into the Bølling/Allerød, 14,600 years ago. Here we use a U/Th-dated record of atmospheric D14C from Tahiti corals to provide an independent and precise age control for this CO2 rise. We also use model simulations to show that the release of old (nearly 14C-free) carbon can explain these changes in CO2 and D14C. The D14C record provides an independent constraint on the amount of carbon released (125 Pg C). We suggest, in line with observations of atmospheric CH4 and terrigenous biomarkers, that thawing permafrost in high northern latitudes could have been the source of carbon, possibly with contribution from flooding of the Siberian continental shelf during meltwater pulse 1A. Our findings highlight the potential of the permafrost carbon reservoir to modulate abrupt climate changes via greenhouse-gas feedbacks.

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The following paper is based on the author's two-year research and fieldwork in Iran and examines the process of political and social changes since the Iranian Revolution of 1979 and the subsequent impact of the Iran-Iraq War of 1980-88. This paper focuses on the transition of traditional, small villages into rusta-shahr or small rural cities and the first and second nation-wide elections of shoura or councils which were the first steps toward self-government. The author is guardedly optimistic regarding this democratic process but warns of possible future social unrest if changes are not more "balanced" between cities and rural areas and if the employment needs of the burgeoning younger generation are not met, political and social consequences may be catastrophic.

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Introduction : Economic reform in Indonesia after the Asian currency crisis is often discussed in parallel with Thailand and South Korea, which were alike hit by the crisis. It should however be noted that what happened in Indonesia was a change of political regime from authoritarianism to democracy, not just a change of government as seen in Thailand and South Korea. Indonesia’s post-crisis reform should be understood in the context of dismantling of the Soeharto regime to seek a new democratic state system.    In the political sphere, dramatic institutional changes have occurred since the downfall of the Soeharto government in May 1998. In comparison, changes in the economic sphere are more complex than the political changes, as the former involve at least three aspects. The first is the continuity in the basic framework of capitalist system with policy orientation toward economic liberalization. In this framework, the policies to overcome the crisis are continued from the last period of the Soeharto rule, under the support system of IMF and CGI (Consultative Group on Indonesia). The second aspect is the impact of the political regime change on the economic structure. It is considered that the structure of economic vested interests of the Soeharto regime is being disintegrated as the regime breaks down. The third aspect is the impact of the political regime change on economic policy-making process. The process of formulating and implementing policies has changed drastically from the Soeharto time. With these three aspects simultaneously at work, it is not so easy to identify which of them is the main cause for a given specific economic phenomenon emerging in Indonesia today.    Keeping this difficulty in mind, this paper attempts to situate the post-crisis economic reform in the broader context of the historical development of Indonesian economic policies and their achievements. We focus in particular on the reform policies for banking and corporate sectors and resulting structural changes in these sectors. This paper aims at understanding the significance of the changes in the economic ownership structure that are occurring in the post-Soeharto Indonesia. Economic policies here do not mean macro economic policies, such as fiscal, financial and trade policies, but refer to micro economic policies whereby the government intervenes in the economic ownership structure. In Section 1, we clarify why economic policies for intervening in the ownership structure are important in understanding Indonesia. Section 2 follows the historical development of Indonesia’s economic policies as specified above, throughout the four successive periods since Indonesia’s independence, namely, the parliamentary democracy period, the Guided Democracy period under Soekarno, the Soeharto-regime consolidation period, and the Soeharto-regime transfiguration period2. Then we observe what economic ownership structure was at work in the pre-crisis last days of the Soeharto rule as an outcome of the economic policies. In Section 3, we examine what structural changes have taken place in the banking and corporate sectors due to the reform policies in the post-crisis and post-Soeharto Indonesia. Lastly in Section 4, we interpret the current reorganization of the economic ownership in the context of the historical transition of the ownership structure, taking account of the changes in the policy-making processes under democratization.

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Land conflicts in Rwanda have attracted particular attention because they have both environmental and political causes. This paper attempts to shed light on the nature of land conflicts in present-day Rwanda based on popular justice records and interviews collected in two rural areas. From the analyses of these data, two types of land confl ict can be distinguished. The first type consists of those among family members. Given that land is the most important asset for ordinary rural households, its inheritance often brings about conflicts between right-holders. Those of the second type are triggered by political change. Impacts of the two national-level violent conflicts in Rwanda, the “social revolution” just before independence and the civil war in the 1990s, are of tremendous significance in this context. The military victory of the former rebels in 1994 caused a massive return of Tutsi refugees, who were officially permitted to acquire land from the original inhabitants. Although no serious protestation against this policy has occurred thus far, it has produced various land conflicts. Dealing with potential grievances among original inhabitants is an important challenge for the present government.

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This paper explores the development of civil–military relations in Myanmar since 1988. After the Tatmadaw (Myanmar Armed Forces) took over the state by means of a coup d’état in 1988, the top generals ruled the country without recourse to significant formal political institutions such as a constitution, elections and parliament. A unique authoritarian regime, where political power was predominantly under the military’s influence, lasted for more than 20 years in the country. It seemed to many observers that the military regime was highly durable and that its dictator, General Than Shwe, had no intention of altering the highly repressive character of the political system. However, a new leader, President Thein Sein, who came to power in March 2011, has decided to implement some political and economic reforms that could undermine the Tatmadaw’s dominant role in politics and the economy. This paper examines the background to this sudden political change in Myanmar, focusing on the relationship between its dictator, the military and the state. This paper’s main argument is that Than Shwe has carefully prepared the transition of 2011 as a generational change in the Tatmadaw and in state leadership. The argument is also made that the challenges created by Thein Sein can be understood as a result of his redefinition of national security and balancing of security-centralism with state-led developmentalism.

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As can been seen from the U.S.'s non-ratification of the Kyoto Protocol, together with the negotiations toward the post-Kyoto Protocol framework, the U.S. and China have been quarrelling over their responsibilities and have contradicted one another over the introduction of compulsory domestic greenhouse gases emission reduction targets. Therefore, for a long time, it has been argued that the controversy between the two countries has hindered the process of forging an international agreement to deal with climate change. On the other hand, Sino-U.S. bilateral cooperation on climate change has significantly increased in recent years in summit talks and their Strategic & Economic Dialogue (S&ED), especially after the 15th Conference of Parties (COP) of the United Nations Framework Convention on Climate Change (UNFCCC) in Copenhagen, one of whose aims was to facilitate positive negotiations for the post-Kyoto Protocol agreement. Analyzing this in the light of recent developments, we find that the U.S. and China have tended to address climate change and related issues from a pluralistic viewpoint and approach, by regarding the achievement of bilateral cooperation and global agreements as their common strategic objective.

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La presente Tesis Doctoral se realizó con el fin de estimar conjuntamente la respuesta agronómica y fisiológica de la vid (Vitis vinifera L.), así como los efectos sobre la evolución de la maduración, composición y la calidad de la uva y del vino, bajo la aplicación de diferentes déficit hídricos en pre-envero y post-envero, dentro de un marco de referencia de cambio climático. La variación climática que prevén los estudios sobre el cambio climático, resulta un factor decisivo en la eficiencia del uso del agua en la vid. En zonas cálidas, las estrategias de cultivo del viñedo frente al cambio climático deben de ir dirigidas a atenuar sus efectos sobre el crecimiento y el desarrollo de la vid, haciéndose imprescindible el estudio pormenorizado del déficit hídrico como factor decisivo en la obtención de las uvas adecuadas, ya que son la clave indispensable para el éxito en la elaboración del vino, y de forma muy especial en los vinos enfocados a un sector de alta calidad. El ensayo se llevó a cabo en un viñedo comercial de Bodegas Licinia, en la Comunidad de Madrid, durante los años 2010 y 2011. La variedad estudiada fue Cabernet sauvignon / 41 B, plantada a un marco de plantación de 3 m x 1 m, con un guiado vertical de la vegetación. El dispositivo experimental fue totalmente al azar, y se establecieron 4 tratamientos experimentales con 4 grados de disponibilidad hídrica, déficit moderado continuo (T0,45-0,6), déficit severo continuo (T0-0,3), déficit severo después de envero (T0,45-0,3) y déficit severo antes de envero (T0-0,6). En cada tratamiento se distribuyeron 3 repeticiones. El año 2010 fue el más lluvioso de los años de ensayo, con 478 mm de precipitaciones anuales, lo que supuso 146 mm más que en el año 2011. Su distribución a lo largo del ciclo fue más homogénea en el año 2010, mientras que en 2011 las precipitaciones contabilizadas en el período de maduración de la uva fueron nulas. La temperatura media subió 0,9ºC en 2011, respecto a 2010 y en cuanto a la integral térmica eficaz, en 2011 se acumularon, desde el 1 de abril hasta el final de ciclo, 217 grados•día más que en 2010. El déficit hídrico en pre-envero, modificó notablemente el crecimiento vegetativo y la producción de cosecha de la parcela de ensayo, no así la fertilidad de las yemas. El tratamiento con mayor disponibilidad hídrica (T0,45-0,6) obtuvo el mayor peso de baya, y los tratamientos con menor déficit hídrico en pre-envero (T0,45-0,6 y T0,45-0,3) registraron los mayores rendimientos de cosecha, mientras que las menores tasas de cuajado correspondieron al tratamiento con un déficit severo continuo (T0-0,3). La parcela de ensayo se caracterizó por un exceso de vigor y un alto crecimiento vegetativo. El pH del mosto se vio afectado por el déficit hídrico, disminuyendo su valor en el tratamiento de déficit hídrico severo antes de envero (T0-0,6). Organolépticamente, no se percibieron diferencias significativas en los vinos elaborados en función del déficit hídrico, y respecto a su composición físico-química, solo existieron diferencias en la concentración de ácido L-Málico, con mayores concentraciones en los tratamientos sin déficit hídrico en pre-envero, T0,45-0,6 y T0,45-0,3. El déficit hídrico modificó notablemente el color del vino, aumentando los valores de las coordenadas CIELAB a* y b*, la luminosidad (L*), croma (C*) y tonalidad (H*), para los tratamientos con un déficit severo en pre-envero (T0-0,3 y T0-0,6) y disminuyendo estas en el tratamiento con mayor disponibilidad hídrica (T0,45-0,6). Del mismo modo, mediante el análisis de color por métodos tradicionales, IPT e IC de los vinos, aumentó en los tratamientos con mayor déficit hídrico en pre-envero (T0-0,3 y T0-0,6), respecto a los tratamientos de mayor disponibilidad (T0,45-0,6 y T0,45-0,3). La concentración de taninos de la baya en vendimia, no se vio afectada por el déficit hídrico, aunque sí estuvo relacionada positivamente con el tamaño de las bayas. Organolépticamente, los hollejos del año 2011 resultaron con menor frescura, acidez, afrutado, sensación herbácea e intensidad tánica, aunque con mayor astringencia respecto a 2010. Las pepitas fueron más astringentes y aromáticas pero menos crujientes, sin llegar a los niveles de madurez del año 2010. El catador relacionó los taninos con la calidad del vino, asociándolos con un mayor cuerpo, acidez, intensidad, equilibrio gustativo, amargor y menor astringencia en la fase gustativa. La concentración de taninos en los vinos se vio favorecida con el déficit hídrico en pre-envero y post-envero. Los tratamientos con mayor déficit hídrico en pre-envero, T0-0,6 y T0-0,3, obtuvieron las menores concentraciones de potasio en mostos y vinos. Las relaciones entre la concentración de potasio, ácido L-Málico y el porcentaje de color rojo puro (dA(%)) resultaron altamente significativas, de modo que las mayores tasas de potasio en el vino se asociaron a los valores más bajos de color rojo y a los mayores de ácido L-Málico. ABSTRACT The present Doctoral Thesis has been done in order to estimate the grapevine (Vitis vinifera L.) agronomic and physiologic performance or response as well as the impact in the grape and wine maturity, composition and quality evolution, with different water deficits. The variation in climate that the global warming studies for seen is a key factor for the grapevine water use efficiency. In warm areas the farming vineyards strategy to face the climatic change, should be focused on diminish the effects on the grapevine growth and development, so that the water deficit detailed analysis becomes decisive to obtain the appropriate grapes, that are the main subject for a successful wine production and especially for top quality wines. The trial was carried out in a commercial vineyard in Chinchón (Madrid), Licinia winery, during the 2010 and 2011 seasons. The grape variety studied was Cabernet Sauvignon grafted onto 41B with a vine spacing 3m x 1m trained as VSP. Experimental design consisted on 4 irrigation treatments with 3 replications totally randomized. Irrigation treatments were: moderate regulated deficit (T0,45-0,6), severe continuous deficit (T0-0,3), severe post-veraison deficit (T0,45-0,3) and severe pre veraison deficit (T0-0,6). The 2010 was rainier year than the 2011; Total annual rain in 2010 was 478 mm, which resulted in 146 mm more than in 2011. The distribution along the vine cycle was more homogeneous in the 2010, whereas precipitations in 2011 along the grape maturity period were nonexistent. The average temperature in 2011 was 0,9ºC higher than that of the 2010 and regarding to the thermal integral, in the 2011 from 1st April to the end of the growing cycle, was 217 degrees•day higher than that in 2010. Water deficit significantly modified the vegetative growth and yield but, it did not modified bud fertility. The treatment with the highest water availability (T0,45-0,6) got the highest berry size, the lowest berry set rates were found in the severe continuous deficit treatment (T0-0,3). The plot studied in this trial was characterized by both excessive vigour and vegetative growth. Water deficit modified the pH must by, reducing it in the severe water deficit during pre-veraison (T0-0,6). There were not differences in wine tasting between the water deficits treatments. Regarding to the physical-chemical composition, it only existed differences in the L-malic acid concentration, resulting higher concentrations in the water deficit pre-veraison treatments: T0,45-0,6 y T0,45-0,3. Water deficit significantly modified wine colour by, increasing the CIELAB coordinates a* and b*, the brightness (L*), croma (C*) and tonality (H*), in the lower water availability pre-veraison treatments (T0-0,3 y T0-0,6), and reducing them in the in the moderate continuous water deficit ones (T0,45-0,6). By means of traditional wine colour parameters analyses, red colour percentage, TPI, they became higher in the lower water availability pre-veraison treatments (T0-0,3 y T0-0,6), than in those with higher availability (T0,45-0,6 y T0,45-0,3). At harvest, berry tannins concentrations was not affected by the water deficit although it did in a positive way, in the berry size. Berry tasting in 2011, resulted in a lower freshness, acidity, fruity, herbaceous flavour and tannic intensity, but with higher astringency respect to the 2010 season. Seeds, in 2011, were more astringent and aromatic as in the 2010, but less crunchy, without getting to the point of maturity. The taster linked the tannins to wine quality, associating them with a higher bodiest wine, acidity, intensity, taste balance, bitterness and with a lower astringency in the tasting stage. Treatments with a higher water deficit up to veraison T0-0,6 y T0-0,3 got less musts and wines potassium concentration. The relation between L-malic acid and the full red color percentage (dA(%)), were highly related, resulting the higher potassium content the lower wine quality.

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Las enfermedades no transmisibles provocan cada ano 38 millones de fallecimientos en el mundo. Entre ellas, tan solo cuatro enfermedades son responsables del 82% de estas muertes: las enfermedades cardiovasculares, las enfermedades crónicas respiratorias, la diabetes, y el cáncer. Se prevé que estas cifras aumenten en los próximos anos, ya que las tendencias indican que en el año 2030 las muertes por esta causa ascenderán a 53 millones de personas. La Organización Mundial de la Salud (OMS) considera importante buscar soluciones para afrontar esta situación y ha solicitado a los gobiernos del mundo la implementación de intervenciones para mejorar los hábitos de vida de las personas y reducir así el riesgo de desarrollo de enfermedades no trasmisibles. Cada año se producen 32 millones de infartos de miocardio y derrames celebrales, de los cuales 12.5 son mortales. En el mundo entre el 40% y 75% de la víctimas de un infarto de miocardio mueren antes de su ingreso en el hospital. En los casos que sobreviven, la adopción de un estilo de vida saludable puede evitar infartos sucesivo, y supone un ahorro potencial de 6 billones de euros al año. La rehabilitación cardiaca es un programa individualizado que aplica un método multidisciplinar para ayudar al paciente a recuperar su condición física, a gestionar la enfermedad cardiovascular y sus comorbilidades, a adoptar hábitos de vida saludables, y a promover su salud mental. La rehabilitación cardiaca requiere la total involucración y motivación del paciente, solo de esta manera se podrán promover hábitos saludables y mejorar la gestión y prevención de su enfermedad. Aunque la participación en los programas de rehabilitación cardiaca es baja, hoy en día existen programas de rehabilitación cardiaca que el paciente puede realizar en su casa. Estos suponen una solución prometedora para aumentar la participación. La rehabilitación cardiaca se considera una intervención integral donde los modelos de psicología de la salud son aplicados para promover un cambio en el estilo de vida de las personas así como para ayudarles a afrontar su propia enfermedad. Existen métodos para implementar cambios de hábitos y de aptitud, y también se considera muy relevante promover no solo el bienestar físico sino también el mental. Existen tecnologías que promueven los cambios de comportamientos en los seres humanos. En concreto, las tecnologías persuasivas y los sistemas de apoyo al cambio de comportamientos modelan las características, las estrategias y los métodos de diseño para promover cambios usando la tecnología. Pero estos modelos tienen algunas limitaciones: todavía no se ha definido que rol tienen las emociones en el cambio de comportamientos y como traducir los métodos de la psicología de la salud en la tecnología. Esta tesis se centra en tres elementos que tienen un rol clave en los cambios de hábitos y actitud: el estado físico, el estado mental, y la tecnología. -Estado de salud: un estado de salud critico puede modificar la actitud del ser humano respecto al cambio. A la vez un buen estado de salud hace que la necesidad del cambio sea menos percibida. -Estado emocional: la actitud tiene un componente afectivo. Los estados emocionales negativos pueden reducir la habilidad de una persona para adoptar nuevos comportamientos. La salud mental es la situación ideal donde los individuos tienen predisposición a los cambios. La tecnología puede ayudar a las personas a adoptar nuevos hábitos, así como a mantener una salud física y mental. Este trabajo de investigación se centra en el diseño de tecnologías para la mejora del estado físico y emocional de las personas. Se ha propuesto un marco de diseño llamado “Well.Be.Sign”. El marco se basa en tres aspectos: El marco teórico: representa los elementos que se tienen que definir para diseñar tecnologías para promover el bienestar de las personas. -El diagrama de influencia: presenta las fuerzas de ‘persuasión’ en el contexto de la salud. El rol de las tecnologías persuasivas ha sido contextualizado en una dimensión donde otros elementos influencian el usuario.  El proceso de diseño: describe el proceso de diseño utilizando una metodología iterativa e incremental que aplica una combinación de métodos de diseño existentes (Diseño Orientado a Objetivos, Diseño de Sistemas Persuasivos) así como elementos originales de este trabajo de investigación. Los métodos se han aplicados para diseñar un sistema que ofrezca un programa de tele-rehabilitación cardiaca. Inicialmente se ha diseñado un prototipo de acuerdo con las necesidades del usuario. En segundo lugar, el prototipo se ha extendido especificando la intervención requerida para al programa de rehabilitación cardiaca. Finalmente el sistema se ha desarrollado y validado en un ensayo clínico con grupo control, donde se observaron las variaciones del estado cardiovascular, el nivel de conocimiento acerca de la enfermedad, la percepción de la enfermedad, la persistencia de hábitos saludables, y la aceptabilidad del sistema. Los resultados muestran que el grupo de intervención tiene una superior capacidad cardiovascular, mejor conocimiento acerca de la enfermedad, y más percepción de control de la enfermedad. Asimismo, en algunos casos se ha registrado persistencia de los hábitos de ejercicios 6 meses después del uso del sistema. Otros dos estudios se han presentado para demonstrar la relevancia del estado emocional del usuario en el diseño de aplicaciones para la promoción del bienestar.  En personas con una grave enfermedad crónica como la insuficiencia cardiaca, donde se ha presentado las conexiones entre estado de salud y estado emocional. En el estudio se ensena la relaciones que tienen los síntomas y las emociones negativas y como un estado negativo emocional puede empeorar la condición física del paciente. -Personas con trastornos del humor: el estudio muestra como las emociones pueden tener un impacto en la percepción de la tecnología por parte del usuario. ABSTRACT Noncommunicable diseases (NCDs) cause the death of 38 million people every year. Four major NCDs are responsible for 82% of these deaths: cardio vascular disease, chronic respiratory disease, diabetes and cancer. These pandemic numbers are projected to raise to 53 million deaths in 2030, and for this reason the assembly of the World Health Organization (WHO) considers communicable diseases as an urgent need to be addressed. It is also a trend to advocate the adoption of mobile technology to deliver health services and to promote healthy behaviours among citizens, but adopting healthS promoting lifestyle is still a difficult task facing human tendencies. Within this context, there is a promising opportunity: persuasive technologies. These technologies are intentionally designed to change a person’s attitudes or behaviours; when applied in this context, than can be used to change health-related attitudes, beliefs, and behaviours. Each year there are 32 million heart attacks and strokes globally, of which about 12.5 million are fatal. Worldwide between 40 and 75% of all heart-attack victims die before reaching hospital. Avoiding a second heart attack by improving adherence to lifestyle and medication regimens has a cost saving potential of around €6 billion per year. In most of the cases the cardiovascular event has been provoked by unhealthy lifestyle. Furthermore, after an MI event the patient's decision to adopt or not healthier behaviour will influence the progress of the disease. Cardio-rehabilitation is an individualized program that follows a multidisciplinary approach to support the user to recover from the Myocardial Infarction, manage the Cardio Vascular Disease and the comorbidities, adopt healthy habits, and cope with any emotional distress. Cardio- rehabilitation requires patient participation and willingness to perform behavioral modifications and change the attitude toward the management and prevention of the disease. Participation in the Cardio Rehabilitation program is not high; the home-based rehabilitation program is a promising solution to increase participation. Nowadays cardio rehabilitation is considered a comprehensive intervention in which models of health psychology are applied to promote the behaviour change of the individuals. Relevant methods that have been successfully applied to foster healthy habits include the Health Belief Model and the Trans Theoretical Model. Studies also demonstrate the importance to promote not only the physical but also the mental well being of the individuals. The idea of also promoting behaviour change using technologies has been defined by the literature as persuasive technologies or behaviour change support systems, in which the features, the strategies and the design method have been modelled to foster the behaviour change using technology. Limitations have been found in this model: there is still research to be done on the role of the emotions and how psychological health intervention can be translated into computer methods. This research focuses on three elements that could foster behaviour change in individuals: the physical and emotional status of the person, and the technology. Every component can influence the user's attitude and behaviour in the following ways: ' Physical status: bad physical status could change human attitude toward the necessity to adopt health behaviours; at the same time, good health status reduces the need to adopt healthy habits. ' Emotional status: the attitude has an affective component, negative emotional state can reduce the ability of a person to adopt new behaviours, and mental well being is the ideal situation in which individuals have a predisposition to adopt healthy behaviours. ' Technology: it can help users to adopt new behaviours and can also be support to promote physical and emotional status. Following this approach the idea driven in this research is that technology that is designed to improve the physical status and the emotional status of the individual could better foster behaviour change. According to this principle, the Well.Be.Sign framework has been proposed. The framework is based on three views: ' The theoretical framework: it represents the patterns that have to be defined to design the technologies to promote well being. ' The influence diagram: it shows the persuasive forces in the context of health care. The role of the persuasive technologies is contextualized in a wider universe where other factors and persuasive forces influence a patient. ' The design process: it shows the process of design using an iterative, incremental methodology that applies a combination of existing methodologies (Goal Directed Design and Persuasive System Design) and others that are original to this research. The methods have been applied to design a system to deliver cardio rehabilitation at home: first a prototype has been defined according to the user’s needs, then it has been extended with the specific intervention required for the cardio–rehabilitation, finally the system has been developed and validated in a controlled clinical study in which the cardiovascular fitness, the level of knowledge, the perception of the illness, the persistence of healthy habits and the system acceptance (only the intervention group) were measured. The results show that the intervention group increased cardiovascular capacity, knowledge, feeling of control of illness and perceived benefits of exercise at the end of the study. After six months of the study, a followSup of the exercise habits was performed. Some individuals of the intervention group continued to be engaged in the running exercise sessions promoted in the designed system. Two other cases have been presented to demonstrate the foundations of the Well.Be.Sign’s approach to promote both physical and emotional status: ' People affected by Heart Failure, in which a bidirectional connection between health status and emotions has been discussed with patients. Two correlations were demonstrated: the relationship between symptoms and negative emotional response, and that negative emotional status is correlated with worsening of chronic conditions. ' People with mood disorders: the study shows that emotions could also impact how the user perceives the technology.

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This study investigates a new way of assessing change in psychotherapy, with the goal of decreasing the schism in the field of psychology between research and clinical practice. Change in psychotherapy was assessed in clients presenting with depressive symptoms who were seeking therapy at the Professional Psychology Center (PPC) at the University of Denver. Prior to beginning treatment, the subjects completed the Beck Depression Inventory- II (BDI-II) and the Symptom Checklist-90-R (SCL-90), and were also assessed by independent clinicians using the Shedler-Westen Assessment Procedure II (SWAP-II). Six to nine months later, after completing at least 12 psychotherapy sessions (range 12-21 sessions), the assessment procedure was repeated.There were no significant differences pre- to post-treatment on any measure. However, two subjects in the sample appeared to benefit from treatment, as assessed by both the self-report measures and the SWAP-II. The findings for these two subjects suggest that the SWAP-II can provide a greater depth of understanding about what can change in therapy than self-report measures alone. Possible reasons for the lack of treatment effects in the larger sample are discussed.

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This folded leaf contains a two-page handwritten poem written by a Harvard College sophomore on February 19, 1765, on the death of Harvard Professor Edward Wigglesworth. The poem begins, "Werefore this change? / Erst I was wont on this Day to frequent..."