Background: Individuals experiencing negative and potentially traumatic life events are at increased risk for suicidal thoughts and behaviors; however, suicidal outcomes are not inevitable. Individuals who attribute negative life events to external, transient, and specific factors, rather than internal, stable, and global self-characteristics, may experience fewer deleterious outcomes, including suicidal behavior. Aims: This study examines the moderating effect of explanatory style on the relationship between negative life experiences and suicide ideation in a college student sample. Methods: A total of 138 participants (73% female) were recruited from a rural. Eastern college and completed a self-report psychosocial assessment. Results: Optimistic explanatory style mitigates the influence of negative and potentially traumatic life events on thoughts of suicide, above and beyond the effects of hopelessness and depression. Conclusions: Beliefs about the origin, pervasiveness, and potential recurrence of a negative life event may affect psychological outcomes. Optimistic explanatory style was associated with reduced suicide ideation, whereas pessimistic explanatory style was associated with increased thoughts of suicide. Optimistic reframing of negative life events for clients may have treatment implications for the prevention of suicidal activity.

Objective: Suicide risk is a significant public health concern for college students and may be exacerbated by hopelessness resulting from negative life events (NLE), yet may be ameliorated by self-compassion. We examined the mediating role of hopelessness in the relation between NLE and suicidal behavior, and the moderating influence of self-compassion on all model paths. Participants: Participants were 338 undergraduates (89% white; 67% female). Data were collected from December 2014 to December 2015. Methods: Participants completed the Life Events Checklist for College Students, Beck Hopelessness Inventory, Self-Compassion Scale, and Suicidal Behaviors Questionnaire–Revised. Results: Negative life events were related to greater hopelessness and, in turn, to more suicidal behavior, yet self-compassion attenuated this effect. Conclusions: Self-compassion may buffer the NLE–hopelessness linkage, thereby reducing suicide risk among college students. Therapeutic promotion of self-compassion, and reduction of hopelessness, may be important suicide prevention strategies on college campuses.

Objective: Suicide risk is a significant public health concern for college students and may be exacerbated by hopelessness resulting from negative life events (NLE), yet may be ameliorated by self-compassion. We examined the mediating role of hopelessness in the relation between NLE and suicidal behavior, and the moderating influence of self-compassion on all model paths. Participants: Participants were 338 undergraduates (89% white; 67% female). Data were collected from December 2014 to December 2015. Methods: Participants completed the Life Events Checklist for College Students, Beck Hopelessness Inventory, Self-Compassion Scale, and Suicidal Behaviors Questionnaire–Revised. Results: Negative life events were related to greater hopelessness and, in turn, to more suicidal behavior, yet self-compassion attenuated this effect. Conclusions: Self-compassion may buffer the NLE–hopelessness linkage, thereby reducing suicide risk among college students. Therapeutic promotion of self-compassion, and reduction of hopelessness, may be important suicide prevention strategies on college campuses.

A life event is as an occurrence that involves a subsequent change in the life pattern of an individual (Holmes & Rahe, 1967). The current study investigated whether exposure to life events over the past year influenced hypothalamic-pituitary-adrenocortical (HPA) axis function in healthy children and adolescents, and explored whether sex, age, behavioural inhibition, trait anxiety, anxiety sensitivity, perceived parental bonding, and parental history of anxiety moderated this relationship. The sample included 147 healthy children and adolescents. Participants were administered Coddington’s Life Events Scale (CLES) and salivary cortisol was collected for the determination of the cortisol awakening response (CAR), diurnal cortisol, and cortisol reactivity to a laboratory stressor. Separate linear regression models were conducted for each cortisol profile. Results revealed that life events significantly predicted total CAR output, diurnal cortisol response, and cortisol reactivity to a laboratory stressor. Further, behavioural inhibition, trait anxiety, not having a parental history of anxiety, and paternal caring positively moderated some of the relationships between life events and cortisol profiles. Considering the physiological and psychological effects of early exposure to stress, this study is significant in understanding the impact of life events to improve the health of children and adolescents.

El presente proyecto profesional “SISTEMA DE INFORMACIÓN PARA LA GESTIÓN DE EVENTOS EN LA MISIÓN PERUANA CENTRAL SUR” tiene como objetivo el desarrollo de un sistema para la Misión Peruana Central Sur (MPCS) con la finalidad de planificar, ejecutar y controlar los resultados de la ejecución de eventos planificados en un periodo determinado. La necesidad de realizar este proyecto se origina debido a que en los últimos años se ha visto perjudicada la imagen de la Misión, la difusión de sus objetivos estratégicos, Todo esto debido a una mala estimación del presupuesto anual por parte de los departamentos que conforman la MPCS. El proyectó está conformado por 8 Capítulos. En el primer capítulo se desarrolla la fundamentación teórica , en el segundo capítulo se presenta la propuesta de solución , en el tercer capítulo se detalla el modelado del negocio identificando los actores, trabajadores y procesos involucrados, en el cuarto capítulo se detallan los requerimientos relacionados a la propuesta de solución, en el quinto capítulo se dará detalle de la arquitectura del software, en el sexto capítulo se detallan los patrones de diseño ,así como el modelo físico de datos y su diccionario. En el sétimo capítulo se dará detalle a la documentación correspondiente a la calidad y pruebas del software y finalmente en el último capítulo se detalla la gestión del proyecto donde se identifican a los interesados, y se realiza el detalle del cronograma de ejecución con las actividades que se llevaron a cabo para desarrollar el presente proyecto. / This professional project “INFORMATION SYSTEM FOR EVENT MANAGEMENT IN THE SOUTH CENTRAL PERUVIAN MISSION” aims to develop a system for the South Central Peruvian Mission (MPCS) with the purpose of planning, executing and controlling the results of the execution of planned events in a given period. The need to carry out this project originates due to the fact that in recent years the image of the Mission, the dissemination of its strategic objectives has been damaged, all this due to a poor estimate of the annual budget by the departments that make up the MPCS The project is made up of 8 Chapters. In the first chapter the theoretical foundation is developed, in the second chapter the solution proposal is presented, in the third chapter the business modeling is detailed identifying the actors, workers and processes involved, in the fourth chapter the requirements related to The solution proposal, in the fifth chapter will be given details of the software architecture, in the sixth chapter the design patterns are detailed, as well as the physical data model and its dictionary. In the seventh chapter detail will be given to the documentation corresponding to the quality and testing of the software and finally in the last chapter the project management where the stakeholders are identified is detailed, and the execution schedule detail is carried out with the activities that were carried out to develop this project. / Tesis

Patients with atrial fibrillation (AF) are at increased risk of stroke. Warfarin anticoagulation therapy reduces the incidence of stroke and increases the incidence of hemorrhagic events. This dissertation further informs the decision to use anticoagulation therapy in AF patients by examining outcomes in patients with major hemorrhages, further examination of stroke risk in diabetic patients with AF, and by evaluating the association between warfarin and stroke while accounting for competing risk events. These studies utilized data from the AnTicoagulation and Risk Factors In Atrial Fibrillation (ATRIA) and ATRIA-CVRN (Cardiovascular Research Network) (Study 1 only) studies which consist of patients from Kaiser Permanente Northern and Southern California. Study 1 examined short and long-term mortality in patients who experienced major gastrointestinal (GI) hemorrhages. In the ATRIA cohort, patients using and not using warfarin at the time of GI hemorrhage were equally likely to die within 30-days, while in ATRIA-CVRN, patients using warfarin were much less likely to die within 30-days (adjusted mortality rate ratio (aMRR): 0.33, 95% CI: 0.16-0.70). For longer-term mortality, both cohorts were consistent with a reduced mortality rate among patients whose GI hemorrhage occurred while using warfarin. Study 2 assessed the association between diabetes characteristics (duration of diabetes and glycemic control) and incidence of ischemic stroke among patients with AF and diabetes. Duration ≥ 3 years was associated with a large increase in rate of stroke (adjusted hazard ratio (aHR): 2.04, 95% CI: 1.27-3.26) compared to patients with duration < 3 years. Patients with the poorest glycemic control (hemoglobin A1c (HbA1c) values ≥ 9.0%) did not have an increased rate of ischemic stroke compared to patients with HbA1c < 7.0%. Study 3 evaluated the association between warfarin and thromboembolism in analyses that did and did not account for competing death events. In analyses not accounting for competing events, the adjusted HR was 0.61 (95% CI: 0.54-0.69), and after accounting for competing death events this association was attenuated (aHR: 0.87, 95% CI: 0.77-0.99). In summary, these studies add to the literature about the benefits of warfarin therapy and risk of stroke in patients with AF, findings that can improve decisions about use of anticoagulants in patients with AF.

Modeling extreme events is one of the central tasks in risk management and planning, as catastrophes and crises put human lives and financial assets at stake. A common approach to estimate the likelihood of extreme events, using extreme value theory (EVT), studies the asymptotic behavior of the ``tail" portion of data, and suggests suitable parametric distributions to fit the data backed up by their limiting behaviors as the data size or the excess threshold grows. We explore an alternate approach to estimate extreme events that is inspired from recent advances in robust optimization. Our approach represents information about tail behaviors as constraints and attempts to estimate a target extremal quantity of interest (e.g, tail probability above a given high level) by imposing an optimization problem to find a conservative estimate subject to the constraints that encode the tail information capturing belief on the tail distributional shape. We first study programs where the feasible region is restricted to distribution functions with convex tail densities, a feature shared by all common parametric tail distributions. We then extend our work by generalizing the feasible region to distribution functions with monotone derivatives and bounded or infinite moments. In both cases, we study the statistical implications of the resulting optimization problems. Through investigating their optimality structures, we also present how the worst-case tail in general behaves as a linear combination of polynomial decay tails. Numerically, we develop results to reduce these optimization problems into tractable forms that allow solution schemes via linear-programming-based techniques.

Introduction : Dans la population pédiatrique, la prescription des antipsychotiques (AP) connait une hausse majeure ces quinze dernières années malgré une Autorisation de Mise sur le Marché (AMM) française limitée à quelques molécules AP avec des indications réduites. Cela conduit à un taux de prescription hors AMM important avec des modalités de prescription dépendantes du prescripteur en l’absence de recommandations de prescription et de surveillance. De plus, la littérature relève un nombre inquiétant d’événements indésirables (EI) associé à un manque de données sur les conséquences à moyen et long terme. Méthode : L’étude ETAPE nationale, multicentrique, prospective a été financée par l’Agence Nationale de Sécurité du Médicament et des produits dérivés. L’objectif principal était de déterminer le taux d’incidence des EI au cours d’un suivi de 12 mois chez des enfants et des adolescents de 6 à 18 ans exposés pour la première fois à un AP quel que soit le motif de la prescription. Le suivi proposé était de 12 mois avec 5 visites (à l’inclusion, puis à 3, 6, 9 et 12 mois). Une recherche exhaustive des EI a été réalisée à chaque visite grâce à la passation d’échelles cliniques, un examen physique et des bilans complémentaires. Résultats : L’étude a débuté en Avril 2013, la période d’inclusion s’est étendue sur deux ans et le suivi s’est terminé en Avril 2016. Au total, 200 patients ont été inclus. Les données de 190 patients ont été analysées. L’âge moyen était de 12 ± 2,99 ans, avec une proportion de 75% de garçons. A l’inclusion, 91% des patients ont reçu un AP en monothérapie et 9% au moins deux psychotropes. Rispéridone et aripiprazole étaient les AP les plus prescrits. Parmi les prescriptions d’AP, 20,5% répondaient à une AMM. Parmi les EI potentiellement attribuables à l’AP : 15,4% étaient neuromoteurs, 14,8% gastroentérologiques, 12,2% métaboliques et 11,8% étaient des symptômes généraux. Le taux d’incidence des EI était de 11,52 EI par personne-année (IC 95% [9,83 ; 13,20]). Chez les 108 patients avec un suivi complet de 12 mois, 52,7% des EI sont apparus au cours du premier trimestre d’exposition (représentés principalement par les EI généraux et hormonaux). Néanmoins, l’apparition des EI était observée pendant toute la durée du suivi. Parmi ces patients, 25,8 % ont présenté au moins un EI sévère ou extrêmement sévère. De plus, la présence des EI s’est révélée stable au cours des 12 mois. Conclusion : Ce travail a contribué à mettre en évidence dans une population naïve pédiatrique nationale un fort taux d’incidence d’EI et un taux d’apparition et de présence des EI stable sur 12 mois. La présence d’EI sévères a touché un quart de la population ayant complété le suivi. Perspectives : Sur un échantillon de 55 patients niçois nous chercherons l’impact du polymorphisme génétique des cytochromes dans le métabolisme des AP et sur l’apparition des EI. L’ensemble de ces travaux a pour objectif de contribuer à la mise en place de recommandations de prescription et de surveillance des paramètres cliniques, biologiques et électrocardiographiques lors de l’introduction d’un AP en population pédiatrique pour améliorer la balance bénéfice/risque. / Background In France, as in the rest of the world, the off-label prescription of antipsychotics is on the rise in the pediatric population. In the literature, we noticed a significant lack of data on drug safety and adverse events in the naïve pediatric population treated by antipsychotic in the short as well as in the long term. In addition, studies independent of pharmaceutical laboratories are lacking. Method ETAPE Study was a naturalistic prospective multicenter study conducted between April 2013 and May 2016. Type of AP, concomitant treatment, clinical evaluation and AEs were registered at inclusion and 3-, 6-, 9- and 12-months follow up. This trial is registered with ClinicalTrials.gov, number NCT02007928. The main objective was to determine the incidence rate of adverse events (AEs) in the antipsychotic-naïve pediatric population treated by antipsychotic (AP) during a 12-months. Outcomes A total of 190 patients were analyzed. The mean age was 12 ± 2.99 years, with 75% being males. At baseline, 91% of patients received AP monotherapy and 9% received at least two psychotropic drugs. Risperidone and aripiprazole were the most frequently prescribed AP. 20.5% of prescriptions were in label. Among the AEs potentially attributable to AP, 15.4% were neuromotor, 14.8% gastroenterological, 12.2% metabolic and 11.8% general symptoms. The overall incidence rate was 11.52 AE per person-years (IC 95% [9.83; 13.20]). In patients completing completed FU (n=108), 52.7% of AEs appeared during the first 3 months, but onset of AE was noted during the 12-months FU. 25.8 % of patients have been exposed to at least one severe or extreme severity AE. The persistence of AEs was stable during the 12-months FU.Interpretation The high incidence rate of AEs, the severity and the persistence of AEs justify the necessity of clinical and biological follow-up of AEs during at least 12-months of AP treatment.

While all business leaders face problems with voluntary employee turnover, fast food business leaders often face turnover rates at twice the national average. Using Weiss and Cropanzano's affective events theory, this exploratory multiple case study detailed the investigation into strategies that fast food business leaders use to establish an appealing working environment that reduces employee turnover. A purposeful sampling process identified 9 fast food business leaders from 3 different fast food organizations within the Omaha, Nebraska metro area who had successfully established a positive working environment that reduced employee turnover. Data collection included semistructured interviews and review of company documents. Using Yin's 5 step analytic approach, 3 themes (fairness, communication, and trust) emerged relative to fast food business leaders' strategies to establish an appealing working environment that reduces employee turnover. Fairness included fair interpersonal treatment, regulation, and wage setting. Communication included training, employee engagement, and corrective actions. Fast food business leaders used trust as a feedback mechanism for their fairness and communications strategies. Business leaders using strategies of fairness, communication, and trust to establish appealing working environments that reduce employee turnover could increase profitability and productivity within the fast food industry. The implication for positive social change is that more consistent employment and less work-related stress increases the potential for employees and their families to become more involved within their communities.

Sprites, halos, and elves are members of a family of short-lived, luminous phenomena known as Transient Luminous Events (TLEs), which occur in the middle atmosphere. Sprites are vertical glows occurring at altitudes typically ranging from ~40 to 90 km. In video imagery they exhibit a red color at their top, with blue tendril-like structure at low altitudes. Elves are disk-like glows that occur at the base of the ionosphere, with diameters of ~100-300 km, and have very short lifetimes (~2-3 ms). Halos are diffuse glows that occur at low altitudes, have diameters <100 >km, and have a duration that may last up to 10s of ms. A majority of the studies of TLEs have taken place over the Midwestern U.S. where they were first discovered. This area produces large thunderstorms, which in turn generate large lightning discharges that have been associated with the formation of TLEs. Studies have used the low frequency radiation that initiates with these strokes to study characteristics of these events. This low frequency radiation has been used to determine where large numbers of TLEs may occur. Extreme southern Brazil is a region of the globe believed to have many TLEs, but few studies on these phenomena. Two collaborative campaigns involving Utah State University proceeded in 2002- 2003, and in 2006. Multiple TLE images were made, proving this is, indeed, a region of the globe where these types of events are prominent. In particular, one storm in February 2003 produced over 440 TLEs imaged by USU video cameras. Of these events, over 100 of them had associated halos. Statistical studies for halos previously had been performed in the U.S., but never abroad. Also, several events from the February storm have been associated with negative cloud to ground lightning, a surprising occurrence, as to date, less than a handful of such events have ever been witnessed or published. In analyzing the TLEs from this campaign, we have shown the halos are similar to those seen in the U.S., even though the storms may be somewhat different. Also, detailed analyses of the negative events show both temporal and spatial morphology heretofore never reported on.