The HIV care cascade in Switzerland: reaching the UNAIDS/WHO targets for patients diagnosed with HIV.

OBJECTIVES To describe the HIV care cascade for Switzerland in the year 2012. DESIGN/METHODS Six levels were defined: (i) HIV-infected, (ii) HIV-diagnosed, (iii) linked to care, (iv) retained in care, (v) on antiretroviral treatment (ART), and (vi) with suppressed viral load (VL). We used data from the Swiss HIV Cohort Study (SHCS) complemented by a nationwide survey among SHCS physicians to estimate the number of HIV-patients not registered in the cohort. We also used Swiss ART sales data to estimate the number of patients treated outside the SHCS network. Based on the number of patients retained in care, we inferred the estimates for levels (i) to (iii) from previously published data. RESULTS We estimate that (i) 15,200 HIV-infected individuals lived in Switzerland in 2012 (margins of uncertainty, 13,400-19,300). Of those, (ii) 12,300 (81%) were diagnosed, (iii) 12,200 (80%) linked, and (iv) 11,900 (79%) retained in care. Broadly based on SHCS network data, (v) 10,800 (71%) patients were receiving ART, and (vi) 10,400 (68%) had suppressed (<200 copies/ml) VLs. The vast majority (95%) of patients retained in care were followed within the SHCS network, with 76% registered in the cohort. CONCLUSIONS Our estimate for HIV-infected individuals in Switzerland is substantially lower than previously reported, halving previous national HIV prevalence estimates to 0.2%. In Switzerland in 2012, 91% of patients in care were receiving ART, and 96% of patients on ART had suppressed VL, meeting recent UNAIDS/WHO targets.

Variation in treatment strategies of Swiss general practitioners for subclinical hypothyroidism in older adults.

QUESTIONS UNDER STUDY As the best management of subclinical hypothyroidism is controversial, we aimed to assess variations in treatment strategies depending on different Swiss regions, physician and patient characteristics. METHODS We performed a case-based survey among general practitioners (GPs) in different Swiss regions, which consisted of eight hypothetical cases presenting a female patient with subclinical hypothyroidism and nonspecific complaints differing by age, vitality status and thyroid-stimulating hormone (TSH) concentration. RESULTS A total of 262 GPs participated in the survey. There was considerable variation in the levothyroxine starting dose chosen by GPs, ranging from 25 µg to 100 µg. Across the Swiss regions, GPs in the Bern region were significantly more inclined to treat, with a higher probability of initiating treatment (60%, p = 0.01) and higher mean starting doses (45 µg, p <0.01) compared with the French-speaking region (44%, 36 µg); the Zurich region had intermediate values (52%, 39 µg). We found no association between treatment rate and other physician characteristics. GPs were more reluctant to initiate treatment in 85-year-old than in 70-year-old women (odds ratio [OR] 0.77, 95% confidence interval [CI] 0.63-0.94), and more likely to treat women with a TSH of 15 mU/l than those with a TSH of 6mU/l (OR 8.71, 95% CI 6.21-12.20). CONCLUSIONS There are strong variations in treatment strategies for elderly patients with subclinical hypothyroidism across different Swiss regions, including use of higher starting doses than the recommended 25 µg in the Swiss guidelines, which recommend a starting dose of 25 µg. These variations likely reflect the current uncertainty about the benefits of treatment, which arise from the current lack of evidence from adequately powered clinical trials.

European Psychiatric Association Guidance on psychotherapy in chronic depression across Europe

PURPOSE: Patients with chronic depression (CD) by definition respond less well to standard forms of psychotherapy and are more likely to be high utilizers of psychiatric resources. Therefore, the aim of this guidance paper is to provide a comprehensive overview of current psychotherapy for CD. The evidence of efficacy is critically reviewed and recommendations for clinical applications and research are given. METHODS: We performed a systematic literature search to identify studies on psychotherapy in CD, evaluated the retrieved documents and developed evidence tables and recommendations through a consensus process among experts and stakeholders. RESULTS: We developed 5 recommendations which may help providers to select psychotherapeutic treatment options for this patient group. The EPA considers both psychotherapy and pharmacotherapy to be effective in CD and recommends both approaches. The best effect is achieved by combined treatment with psychotherapy and pharmacotherapy, which should therefore be the treatment of choice. The EPA recommends psychotherapy with an interpersonal focus (e.g. the Cognitive Behavioural Analysis System of Psychotherapy [CBASP]) for the treatment of CD and a personalized approach based on the patient's preferences. DISCUSSION: The DSM-5 nomenclature of persistent depressive disorder (PDD), which includes CD subtypes, has been an important step towards a more differentiated treatment and understanding of these complex affective disorders. Apart from dysthymia, ICD-10 still does not provide a separate entity for a chronic course of depression. The differences between patients with acute episodic depression and those with CD need to be considered in the planning of treatment. Specific psychotherapeutic treatment options are recommended for patients with CD. CONCLUSION: Patients with chronic forms of depression should be offered tailored psychotherapeutic treatments that address their specific needs and deficits. Combination treatment with psychotherapy and pharmacotherapy is the first-line treatment recommended for CD. More research is needed to develop more effective treatments for CD, especially in the longer term, and to identify which patients benefit from which treatment algorithm.

Los jóvenes y la historia desde la perspectiva de profesores de Brasil, Argentina y Uruguay

Este trabajo presenta un análisis de la encuesta realizada a profesores de nivel secundario en 2008 en el marco de la investigación "Los Jóvenes y la Historia" que ha involucrado a docentes de Brasil, Argentina y Uruguay. La intención es articular los datos obtenidos con las interpretaciones que provisoriamente damos a los mismos no con afán de generalización sino con vocación de presentar indicios de una investigación en curso. En términos generales, el artículo presenta la perspectiva que un conjunto de profesores posee de la historia y su enseñanza y, sobre todo, la mirada que tienen de su tarea en las aulas y de sus estudiantes, elementos que resultan claves en el oficio de enseñar historia hoy

Los jóvenes y la historia desde la perspectiva de profesores de Brasil, Argentina y Uruguay

Este trabajo presenta un análisis de la encuesta realizada a profesores de nivel secundario en 2008 en el marco de la investigación "Los Jóvenes y la Historia" que ha involucrado a docentes de Brasil, Argentina y Uruguay. La intención es articular los datos obtenidos con las interpretaciones que provisoriamente damos a los mismos no con afán de generalización sino con vocación de presentar indicios de una investigación en curso. En términos generales, el artículo presenta la perspectiva que un conjunto de profesores posee de la historia y su enseñanza y, sobre todo, la mirada que tienen de su tarea en las aulas y de sus estudiantes, elementos que resultan claves en el oficio de enseñar historia hoy

Los jóvenes y la historia desde la perspectiva de profesores de Brasil, Argentina y Uruguay

Este trabajo presenta un análisis de la encuesta realizada a profesores de nivel secundario en 2008 en el marco de la investigación "Los Jóvenes y la Historia" que ha involucrado a docentes de Brasil, Argentina y Uruguay. La intención es articular los datos obtenidos con las interpretaciones que provisoriamente damos a los mismos no con afán de generalización sino con vocación de presentar indicios de una investigación en curso. En términos generales, el artículo presenta la perspectiva que un conjunto de profesores posee de la historia y su enseñanza y, sobre todo, la mirada que tienen de su tarea en las aulas y de sus estudiantes, elementos que resultan claves en el oficio de enseñar historia hoy

Generating context-aware recommendations using banking data in a mobile recommender system

The increasing adoption of smartphones by the society has created a new area of research in recommender systems. This new domain is based on using location and context-awareness to provide personalization. This paper describes a model to generate context-aware recommendations for mobile recommender systems using banking data in order to recommend places where the bank customers have previously spent their money. In this work we have used real data provided by a well know Spanish bank. The mobile prototype deployed in the bank Labs environment was evaluated in a survey among 100 users with good results regarding usefulness and effectiveness. The results also showed that test users had a high confidence in a recommender system based on real banking data.

Facilitating the creation of interactive multi-device Learning Objects using an online authoring tool

Learning Objects facilitate reuse leading to cost and time savings as well as to the enhancement of the quality of educational resources. However, teachers find it difficult to create or to find high quality Learning Objects, and the ones they find need to be customized. Teachers can overcome this problem using suitable authoring systems that enable them to create high quality Learning Objects with little effort. This paper presents an open source online e-Learning authoring tool called ViSH Editor together with four novel interactive Learning Objects that can be created with it: Flashcards, Virtual Tours, Enriched Videos and Interactive Presentations. All these Learning Objects are created as web applications, which can be accessed via mobile devices. Besides, they can be exported to SCORM including their metadata in IEEE LOM format. All of them are described in the paper including an example of each. This approach for creating Learning Objects was validated through two evaluations: a survey among authors and a formal quality evaluation of 209 Learning Objects created with the tool. The results show that ViSH Editor facilitates educators the creation of high quality Learning Objects.

Sobre el comportamiento de micropilotes trabajando a flexión y/o cortante en estructuras de tierra

El empleo de los micropilotes en la ingeniería civil ha revolucionado las técnicas de estabilización de terraplenes a media ladera, ya que aunque los pilotes pueden ser la opción más económica, el uso de micropilotes permite llegar a sitios inaccesibles con menor coste de movimientos de tierras, realización de plataformas de trabajo de dimensiones reducidas, maquinaria necesaria es mucho más pequeña, liviana y versátil en su uso, incluyendo la posibilidad de situar la fabricación de morteros o lechadas a distancias de varias decenas de metros del elemento a ejecutar. Sin embargo, realizando una revisión de la documentación técnica que se tiene en el ámbito ingenieril, se comprobó que los sistemas de diseño de algunos casos (micropilotes en terraplenes a media ladera, micropilotes en pantallas verticales, micropilotes como “paraguas” en túneles, etc.) eran bastante deficientes o poco desarrollados. Premisa que permite concluir que el constructor ha ido por delante (como suele ocurrir en ingeniería geotécnica) del cálculo o de su análisis teórico. Del mismo modo se determinó que en su mayoría los micropilotes se utilizan en labores de recalce o como nueva solución de cimentación en condiciones de difícil acceso, casos en los que el diseño de los micropilotes viene definido por cargas axiales, de compresión o de tracción, consideraciones que se contemplan en reglamentaciones como la “Guía para el proyecto y la ejecución de micropilotes en obras de carretera” del Ministerio de Fomento. En los micropilotes utilizados para estabilizar terraplenes a media ladera y micropilotes actuando como muros pantalla, en los que éstos trabajan a esfuerzo cortante y flexión, no se dispone de sistemas de análisis fiables o no se introduce adecuadamente el problema de interacción terreno-micropilote. Además en muchos casos, los parámetros geotécnicos que se utilizan no tienen una base técnico-teórica adecuada por lo que los diseños pueden quedar excesivamente del lado de la seguridad, en la mayoría de los casos, o todo lo contrario. Uno de los objetivos principales de esta investigación es estudiar el comportamiento de los micropilotes que están sometidos a esfuerzos de flexión y cortante, además de otros objetivos de gran importancia que se describen en el apartado correspondiente de esta tesis. Cabe indicar que en este estudio no se ha incluido el caso de micropilotes quasi-horizontales trabajando a flexion (como los “paraguas” en túneles), por considerarse que estos tienen un comportamiento y un cálculo diferente, que está fuera del alcance de esta investigación. Se ha profundizado en el estudio del empleo de micropilotes en taludes, presentando casos reales de obras ejecutadas, datos estadísticos, problemas de diseño y ejecución, métodos de cálculo simplificados y modelación teórica en cada caso, efectuada mediante el empleo de elementos finitos con el Código Plaxis 2D. Para llevar a cabo los objetivos que se buscan con esta investigación, se ha iniciado con el desarrollo del “Estado del Arte” que ha permitido establecer tipología, aplicaciones, características y cálculo de los micropilotes que se emplean habitualmente. Seguidamente y a efectos de estudiar el problema dentro de un marco geotécnico real, se ha seleccionado una zona española de actuación, siendo ésta Andalucía, en la que se ha utilizado de manera muy importante la técnica de micropilotes sobre todo en problemas de estabilidad de terraplenes a media ladera. A partir de ahí, se ha realizado un estudio de las propiedades geotécnicas de los materiales (principalmente suelos y rocas muy blandas) que están presentes en esta zona geográfica, estudio que ha sido principalmente bibliográfico o a partir de la experiencia en la zona del Director de esta tesis. Del análisis realizado se han establecido ordenes de magnitud de los parámetros geotécnicos, principalmente la cohesión y el ángulo de rozamiento interno (además del módulo de deformación aparente o de un módulo de reacción lateral equivalente) para los diversos terrenos andaluces. Con el objeto de conocer el efecto de la ejecución de un micropilote en el terreno (volumen medio real del micropilote, una vez ejecutado; efecto de la presión aplicada en las propiedades del suelo circundante, etc.) se ha realizado una encuesta entre diversas empresas españolas especializadas en la técnica de los micropilotes, a efectos de controlar los volúmenes de inyección y las presiones aplicadas, en función de la deformabilidad del terreno circundante a dichos micropilotes, con lo que se ha logrado definir una rigidez a flexión equivalente de los mismos y la definición y características de una corona de terreno “mejorado” lograda mediante la introducción de la lechada y el efecto de la presión alrededor del micropilote. Con las premisas anteriores y a partir de los parámetros geotécnicos determinados para los terrenos andaluces, se ha procedido a estudiar la estabilidad de terraplenes apoyados sobre taludes a media ladera, mediante el uso de elementos finitos con el Código Plaxis 2D. En el capítulo 5. “Simulación del comportamiento de micropilotes estabilizando terraplenes”, se han desarrollado diversas simulaciones. Para empezar se simplificó el problema simulando casos similares a algunos reales en los que se conocía que los terraplenes habían llegado hasta su situación límite (de los que se disponía información de movimientos medidos con inclinómetros), a partir de ahí se inició la simulación de la inestabilidad para establecer el valor de los parámetros de resistencia al corte del terreno (mediante un análisis retrospectivo – back-análisis) comprobando a su vez que estos valores eran similares a los deducidos del estudio bibliográfico. Seguidamente se han introducido los micropilotes en el borde de la carretera y se ha analizado el comportamiento de éstos y del talud del terraplén (una vez construidos los micropilotes), con el objeto de establecer las bases para su diseño. De este modo y adoptando los distintos parámetros geotécnicos establecidos para los terrenos andaluces, se simularon tres casos reales (en Granada, Málaga y Ceuta), comparando los resultados de dichas simulaciones numéricas con los resultados de medidas reales de campo (desplazamientos del terreno, medidos con inclinómetros), obteniéndose una reproducción bastante acorde a los movimientos registrados. Con las primeras simulaciones se concluye que al instalar los micropilotes la zona más insegura de la ladera es la de aguas abajo. La superficie de rotura ya no afecta a la calzada que protegen los micropilotes. De ahí que se deduzca que esta solución sea válida y se haya aplicado masivamente en Andalucía. En esas condiciones, podría decirse que no se está simulando adecuadamente el trabajo de flexión de los micropilotes (en la superficie de rotura, ya que no les corta), aunque se utilicen elementos viga. Por esta razón se ha realizado otra simulación, basada en las siguientes hipótesis: − Se desprecia totalmente la masa potencialmente deslizante, es decir, la que está por delante de la fila exterior de micros. − La estratigrafía del terreno es similar a la considerada en las primeras simulaciones. − La barrera de micropilotes está constituida por dos elementos inclinados (uno hacia dentro del terraplén y otro hacia fuera), con inclinación 1(H):3(V). − Se puede introducir la rigidez del encepado. − Los micros están separados 0,556 m ó 1,00 m dentro de la misma alineación. − El empotramiento de los micropilotes en el sustrato resistente puede ser entre 1,5 y 7,0 m. Al “anular” el terreno que está por delante de los micropilotes, a lo largo del talud, estos elementos empiezan claramente a trabajar, pudiendo deducirse los esfuerzos de cortante y de flexión que puedan actuar sobre ellos (cota superior pero prácticamente muy cerca de la solución real). En esta nueva modelación se ha considerado tanto la rigidez equivalente (coeficiente ϴ) como la corona de terreno tratado concéntrico al micropilote. De acuerdo a esto último, y gracias a la comparación de estas modelaciones con valores reales de movimientos en laderas instrumentadas con problemas de estabilidad, se ha verificado que existe una similitud bastante importante entre los valores teóricos obtenidos y los medidos en campo, en relación al comportamiento de los micropilotes ejecutados en terraplenes a media ladera. Finalmente para completar el análisis de los micropilotes trabajando a flexión, se ha estudiado el caso de micropilotes dispuestos verticalmente, trabajando como pantallas discontinuas provistas de anclajes, aplicado a un caso real en la ciudad de Granada, en la obra “Hospital de Nuestra Señora de la Salud”. Para su análisis se utilizó el código numérico CYPE, basado en que la reacción del terreno se simula con muelles de rigidez Kh o “módulo de balasto” horizontal, introduciendo en la modelación como variables: a) Las diferentes medidas obtenidas en campo; b) El espesor de terreno cuaternario, que por lo que se pudo determinar, era variable, c) La rigidez y tensión inicial de los anclajes. d) La rigidez del terreno a través de valores relativos de Kh, recopilados en el estudio de los suelos de Andalucía, concretamente en la zona de Granada. Dicha pantalla se instrumentó con 4 inclinómetros (introducidos en los tubos de armadura de cuatro micropilotes), a efectos de controlar los desplazamientos horizontales del muro de contención durante las excavaciones pertinentes, a efectos de comprobar la seguridad del conjunto. A partir del modelo de cálculo desarrollado, se ha comprobado que el valor de Kh pierde importancia debido al gran número de niveles de anclajes, en lo concerniente a las deformaciones horizontales de la pantalla. Por otro lado, los momentos flectores son bastante sensibles a la distancia entre anclajes, al valor de la tensión inicial de los mismos y al valor de Kh. Dicho modelo también ha permitido reproducir de manera fiable los valores de desplazamientos medidos en campo y deducir los parámetros de deformabilidad del terreno, Kh, con valores del orden de la mitad de los medidos en el Metro Ligero de Granada, pero visiblemente superiores a los deducibles de ábacos que permiten obtener Kh para suelos granulares con poca cohesión (gravas y cuaternario superior de Sevilla) como es el caso del ábaco de Arozamena, debido, a nuestro juicio, a la cementación de los materiales presentes en Granada. En definitiva, de las anteriores deducciones se podría pensar en la optimización del diseño de los micropilotes en las obras que se prevean ejecutar en Granada, con similares características al caso de la pantalla vertical arriostrada mediante varios niveles de anclajes y en las que los materiales de emplazamiento tengan un comportamiento geotécnico similar a los estudiados, con el consiguiente ahorro económico. Con todo ello, se considera que se ha hecho una importante aportación para el diseño de futuras obras de micropilotes, trabajando a flexión y cortante, en obras de estabilización de laderas o de excavaciones. Using micropiles in civil engineering has transformed the techniques of stabilization of embankments on the natural or artificial slopes, because although the piles may be the cheapest option, the use of micropiles can reach inaccessible places with lower cost of earthworks, carrying out small work platforms. Machinery used is smaller, lightweight and versatile, including the possibility of manufacturing mortars or cement grouts over distances of several tens of meters of the element to build. However, making a review of the technical documentation available in the engineering field, it was found that systems designed in some cases (micropiles in embankments on the natural slopes, micropiles in vertical cut-off walls, micropiles like "umbrella" in tunnels, etc.) were quite poor or underdeveloped. Premise that concludes the builder has gone ahead (as usually happen in geotechnical engineering) of calculation or theoretical analysis. In the same way it was determined that most of the micropiles are used in underpinning works or as a new foundation solution in conditions of difficult access, in which case the design of micropiles is defined by axial, compressive or tensile loads, considered in regulations as the " Handbook for the design and execution of micropiles in road construction" of the Ministry of Development. The micropiles used to stabilize embankments on the slopes and micropiles act as retaining walls, where they work under shear stress and bending moment, there are not neither reliable systems analysis nor the problem of soil-micropile interaction are properly introduced. Moreover, in many cases, the geotechnical parameters used do not have a proper technical and theoretical basis for what designs may be excessively safe, or the opposite, in most cases. One of the main objectives of this research is to study the behavior of micro piles which are subjected to bending moment and shear stress, as well as other important objectives described in the pertinent section of this thesis. It should be noted that this study has not included the case of quasi-horizontal micropiles working bending moment (as the "umbrella" in tunnels), because it is considered they have a different behavior and calculation, which is outside the scope of this research. It has gone in depth in the study of using micropiles on slopes, presenting real cases of works made, statistics, problems of design and implementation, simplified calculation methods and theoretical modeling in each case, carried out by using FEM (Finite Element Method) Code Plaxis 2D. To accomplish the objectives of this research, It has been started with the development of the "state of the art" which stipulate types, applications, characteristics and calculation of micropiles that are commonly used. In order to study the problem in a real geotechnical field, it has been selected a Spanish zone of action, this being Andalusia, in which it has been used in a very important way, the technique of micropiles especially in embankments stability on natural slopes. From there, it has made a study of the geotechnical properties of the materials (mainly very soft soils and rocks) that are found in this geographical area, which has been mainly a bibliographic study or from the experience in the area of the Director of this thesis. It has been set orders of magnitude of the geotechnical parameters from analyzing made, especially the cohesion and angle of internal friction (also apparent deformation module or a side reaction module equivalent) for various typical Andalusian ground. In order to determine the effect of the implementation of a micropile on the ground (real average volume of micropile once carried out, effect of the pressure applied on the properties of the surrounding soil, etc.) it has conducted a survey among various skilled companies in the technique of micropiles, in order to control injection volumes and pressures applied, depending on the deformability of surrounding terrain such micropiles, whereby it has been possible to define a bending stiffness and the definition and characteristics of a crown land "improved" achieved by introducing the slurry and the effect of the pressure around the micropile. With the previous premises and from the geotechnical parameters determined for the Andalusian terrain, we proceeded to study the stability of embankments resting on batters on the slope, using FEM Code Plaxis 2D. In the fifth chapter "Simulation of the behavior of micropiles stabilizing embankments", there were several different numerical simulations. To begin the problem was simplified simulating similar to some real in which it was known that the embankments had reached their limit situation (for which information of movements measured with inclinometers were available), from there the simulation of instability is initiated to set the value of the shear strength parameters of the ground (by a retrospective analysis or back-analysis) checking these values were similar to those deduced from the bibliographical study Then micropiles have been introduced along the roadside and its behavior was analyzed as well as the slope of embankment (once micropiles were built ), in order to establish the basis for its design. In this way and taking the different geotechnical parameters for the Andalusian terrain, three real cases (in Granada, Malaga and Ceuta) were simulated by comparing the results of these numerical simulations with the results of real field measurements (ground displacements measured with inclinometers), getting quite consistent information according to registered movements. After the first simulations it has been concluded that after installing the micropiles the most insecure area of the natural slope is the downstream. The failure surface no longer affects the road that protects micropiles. Hence it is inferred that this solution is acceptable and it has been massively applied in Andalusia. Under these conditions, one could say that it is not working properly simulating the bending moment of micropiles (on the failure surface, and that does not cut them), although beam elements are used. Therefore another simulation was performed based on the following hypotheses: − The potentially sliding mass is totally neglected, that is, which is ahead of the outer row of micropiles. − Stratigraphy field is similar to the one considered in the first simulations. − Micropiles barrier is constituted by two inclined elements (one inward and one fill out) with inclination 1 (H): 3 (V). − You can enter the stiffness of the pile cap. − The microlies lines are separated 0.556 m or 1.00 m in the same alignment. − The embedding of the micropiles in the tough substrate can be between 1.5 and 7.0 m. To "annul" the ground that is in front of the micro piles, along the slope, these elements clearly start working, efforts can be inferred shear stress and bending moment which may affect them (upper bound but pretty close to the real) solution. In this new modeling it has been considered both equivalent stiffness coefficient (θ) as the treated soil crown concentric to the micropile. According to the latter, and by comparing these values with real modeling movements on field slopes instrumented with stability problems, it was verified that there is quite a significant similarity between the obtained theoretical values and the measured field in relation to the behavior of micropiles executed in embankments along the natural slope. Finally to complete the analysis of micropiles working in bending conditions, we have studied the case of micropiles arranged vertically, working as discontinued cut-off walls including anchors, applied to a real case in the city of Granada, in the play "Hospital of Our Lady of the Health ". CYPE numeric code, based on the reaction of the ground is simulated spring stiffness Kh or "subgrade" horizontal, introduced in modeling was used as variables for analysis: a) The different measurements obtained in field; b) The thickness of quaternary ground, so that could be determined, was variable, c) The stiffness and the prestress of the anchors. d) The stiffness of the ground through relative values of Kh, collected in the study of soils in Andalusia, particularly in the area of Granada. (previously study of the Andalusia soils) This cut-off wall was implemented with 4 inclinometers (introduced in armor tubes four micropiles) in order to control the horizontal displacements of the retaining wall during the relevant excavations, in order to ensure the safety of the whole. From the developed model calculation, it was found that the value of Kh becomes less important because a large number of anchors levels, with regard to the horizontal deformation of the cut-off wall. On the other hand, the bending moments are quite sensitive to the distance between anchors, the initial voltage value thereof and the value of Kh. This model has also been reproduced reliably displacement values measured in the field and deduce parameters terrain deformability, Kh, with values around half the measured Light Rail in Granada, but visibly higher than deductible of abacuses which can obtain Kh for granular soils with low cohesion (upper Quaternary gravels and Sevilla) such as Abacus Arozamena, because, in our view, to cementing materials in Granada. In short, previous deductions you might think on optimizing the design of micropiles in the works that are expected to perform in Granada, with similar characteristics to the case of the vertical cut-off wall braced through several levels of anchors and in which materials location have a geotechnical behavior similar to those studied, with the consequent economic savings. With all this, it is considered that a significant contribution have been made for the design of future works of micropiles, bending moment and shear stress working in slope stabilization works or excavations.

A Porposal: "Agro-ERASMUS"

The rural population is getting smaller as percentage of the total population in the countries. There is a constant depopulation of rural areas to urban areas. The most extreme data are in countries like USA, where the rural population is 1.5%, from which 1% of that amount is part time and only 0.5% full time. On the other side, we have countries with more than 50% rural population. Related to training, cultural development, business and specific weight in society, rural residents have no significance in their societies. As they are few, and separated across the territory they have no influence on their societies. Comparing the USA farmer with one from the EU, we see that the American one is a businessperson and the European one, in most cases is a farm worker. To reduce this gap between these different farmers, we believe that we must train the new generations of children belonging to farming Europe. They must have a common language, English; they must know other countries culture and farming systems, live and network with other young Europeans colleagues,future young farmers. It is what we have coined as AGRO-ERASMUS. A project to be placed within the EU Common Agriculture Policies. The project must be designed before its implementation. Even some previous experience should make better viability. It should make use of a network of agricultural universities in several European countries. Each university would build a "farm school" where young people would learn "English?, and visit and work in small agricultural practices with a correct use of the time. One important subject dealing with should be agribusiness. The procedure based on the ?Farm School? (F-S) experience, should start with young people from 13 years up to 18 years. Their attendance, every summer, to the F-S should be rotated between different countries besides their own. The first and second year, with young people 13/14 years old, the Farm School would last less than three weeks in an English speaking country (Ireland, UK or someone else). They should live with a local family the time they stay outside of the Farm School (F-S). This two years period must be devoted to learn and become familiar with the English language and cultural differences. The rest of the four years left, the Farm Schools will have longer duration and be placed in other countries from the network. The living way would be in multinational teams of young people where the only spoken language would be English. After six years of summer oexistence speaking English and learning new competences and skills with colleagues from other countries, we would have a great team of young and future European farmers, able to travel free and confident through the whole Europe and ready to be engaged in productive, commercial and research activities. These new young farmers may revive European agriculture and would not look any more like rural habitants, but international business-farmers, professionally speaking. In a brief survey among the assistants to the Fifth International Academic Conference titled "Alternative Income Sources in Small Agricultural Holdings of the European Union" held in Krakow (PL) in June 2015, participants from universities and countries like Poland, Hungary, Rep. Czech, Portugal, Romania, etc., expressed the necessity of addressing this problem in a new and bold way.

A RELAÇÃO ENTRE O USO DOS CONTROLES DE GESTÃO E A CONTINUIDADE DAS PEQUENAS E MÉDIAS EMPRESAS

O trabalho tem como finalidade à pesquisa de controles de gestão empresarial essencial a todas as empresas, inclusive as chamadas pequenas e médias, que buscam sua excelência e continuidade para um bom desempenho econômico, financeiro e social. Diversos estudos já foram realizados a fim de evidenciar a importância dos controles gerenciais para as organizações, porém uma grande dificuldade encontrada nestas empresas é aplicar a teoria na prática. Sendo assim, será apresentada neste trabalho uma pesquisa entre pequenas e médias empresas localizadas nos municípios de São Bernardo do Campo, Santo André, São Caetano do Sul e Diadema e como estas empresas têm utilizado controles gerenciais no processo de gestão empresarial. No contexto das pequenas e médias empresas, pode-se perceber que o processo decisório é restrito e limitado a determinadas pessoas, portanto, o grau de responsabilidade nas decisões para estas empresas tem um grande teor de importância. Nas empresas familiares também é possível identificar características semelhantes ao processo decisório, por fim, a pesquisa irá analisar a relação do uso de controles gerenciais e a continuidade dessas empresas. A metodologia utilizada foi a descritiva e a quantitativa, através do uso de questionário e os resultados obtidos foram apresentados apenas como das empresas participantes da pesquisa, podendo ser identificados a relação do uso de controles de gestão e quais os controles mais utilizados.(AU)

A RELAÇÃO ENTRE O USO DOS CONTROLES DE GESTÃO E A CONTINUIDADE DAS PEQUENAS E MÉDIAS EMPRESAS

O trabalho tem como finalidade à pesquisa de controles de gestão empresarial essencial a todas as empresas, inclusive as chamadas pequenas e médias, que buscam sua excelência e continuidade para um bom desempenho econômico, financeiro e social. Diversos estudos já foram realizados a fim de evidenciar a importância dos controles gerenciais para as organizações, porém uma grande dificuldade encontrada nestas empresas é aplicar a teoria na prática. Sendo assim, será apresentada neste trabalho uma pesquisa entre pequenas e médias empresas localizadas nos municípios de São Bernardo do Campo, Santo André, São Caetano do Sul e Diadema e como estas empresas têm utilizado controles gerenciais no processo de gestão empresarial. No contexto das pequenas e médias empresas, pode-se perceber que o processo decisório é restrito e limitado a determinadas pessoas, portanto, o grau de responsabilidade nas decisões para estas empresas tem um grande teor de importância. Nas empresas familiares também é possível identificar características semelhantes ao processo decisório, por fim, a pesquisa irá analisar a relação do uso de controles gerenciais e a continuidade dessas empresas. A metodologia utilizada foi a descritiva e a quantitativa, através do uso de questionário e os resultados obtidos foram apresentados apenas como das empresas participantes da pesquisa, podendo ser identificados a relação do uso de controles de gestão e quais os controles mais utilizados.(AU)

Episodic star formation in a group of LAEs at z=5.07

We are undertaking a search for high-redshift low-luminosity Lyman Alpha sources in the SHARDS (Survey for High-z Absorption Red and Dead Sources) survey. Among the pre-selected Lyman Alpha sources two candidates were spotted, located 3.19 arcsec apart, and tentatively at the same redshift. Here, we report on the spectroscopic confirmation with Gran Telescopio Canarias of the Lyman Alpha emission from this pair of galaxies at a confirmed spectroscopic redshifts of z=5.07. Furthermore, one of the sources is interacting/merging with another close companion that looks distorted. Based on the analysis of the spectroscopy and additional photometric data, we infer that most of the stellar mass of these objects was assembled in a burst of star formation 100 Myr ago. A more recent burst (2 Myr old) is necessary to account for the measured Lyman Alpha flux. We claim that these two galaxies are good examples of Lyman Alpha sources undergoing episodic star formation. Besides, these sources very likely constitute a group of interacting Lyman Alpha emitters (LAEs).

A reliable and valid questionnaire was developed to measure computer vision syndrome at the workplace

Objectives: To design and validate a questionnaire to measure visual symptoms related to exposure to computers in the workplace. Study Design and Setting: Our computer vision syndrome questionnaire (CVS-Q) was based on a literature review and validated through discussion with experts and performance of a pretest, pilot test, and retest. Content validity was evaluated by occupational health, optometry, and ophthalmology experts. Rasch analysis was used in the psychometric evaluation of the questionnaire. Criterion validity was determined by calculating the sensitivity and specificity, receiver operator characteristic curve, and cutoff point. Testeretest repeatability was tested using the intraclass correlation coefficient (ICC) and concordance by Cohen’s kappa (k). Results: The CVS-Q was developed with wide consensus among experts and was well accepted by the target group. It assesses the frequency and intensity of 16 symptoms using a single rating scale (symptom severity) that fits the Rasch rating scale model well. The questionnaire has sensitivity and specificity over 70% and achieved good testeretest repeatability both for the scores obtained [ICC 5 0.802; 95% confidence interval (CI): 0.673, 0.884] and CVS classification (k 5 0.612; 95% CI: 0.384, 0.839). Conclusion: The CVS-Q has acceptable psychometric properties, making it a valid and reliable tool to control the visual health of computer workers, and can potentially be used in clinical trials and outcome research.

Paving the Way for Micro-, Small- and Medium-Sized Enterprises in the Southern Mediterranean. CEPS Policy Brief No. 314, 14 January 2014

The upheavals of the Arab Spring in the southern Mediterranean led to domestic and international demands on the governments in the region to implement reforms aimed at enhancing business and investment conditions especially for micro, small- and medium-sized enterprises (MSMEs), which carry out an overwhelming majority of the region’s economic activity. A comprehensive survey among some 600 high-growth potential MSMEs in Algeria, Egypt, Morocco and Tunisia identified and ranked the key obstacles impeding their high-growth potential. This Policy Brief summarises the main results and policy recommendations that can be drawn from this survey, which has been analysed in depth by Ayadi & De Groen (2014).