How do we make the (right) diagnosis of acute appendicitis?

Objectives: To evaluate the correct diagnosis in unselected patients presenting withsuspected acute appendicitis in the Emergency Department in Hospital Trueta. To evaluate the different scenarios to achieve the correct diagnosis in patients with suspected acute appendicitis estimated by clinical evaluation without imaging, US only, CT only or US in all patients followed by CT after a non-diagnostic US.Design: Cross-sectional study conducted between April 2014 and March 2015.Settings: Medium-sized teaching hospital in Girona.Participants: Consecutive adult patients, 14 years old or older, with clinically suspectedacute appendicitis evaluated at the emergency department.Main outcome: Correct diagnosis of acute appendicitis

RiskDiff: A web tool for the analysis of the difference due to risk and demographic factors for incidence or mortality data.

Background Analysing the observed differences for incidence or mortality of a particular disease between two different situations (such as time points, geographical areas, gender or other social characteristics) can be useful both for scientific or administrative purposes. From an epidemiological and public health point of view, it is of great interest to assess the effect of demographic factors in these observed differences in order to elucidate the effect of the risk of developing a disease or dying from it. The method proposed by Bashir and Estève, which splits the observed variation into three components: risk, population structure and population size is a common choice at practice. Results A web-based application, called RiskDiff has been implemented (available at http://rht.iconcologia.net/riskdiff.htm webcite), to perform this kind of statistical analyses, providing text and graphical summaries. Code from the implemented functions in R is also provided. An application to cancer mortality data from Catalonia is used for illustration. Conclusions Combining epidemiological with demographical factors is crucial for analysing incidence or mortality from a disease, especially if the population pyramids show substantial differences. The tool implemented may serve to promote and divulgate the use of this method to give advice for epidemiologic interpretation and decision making in public health.

La calidad de las repoblaciones forestales: una aproximación desde la selvicultura y la ecofisiología

El proceso de repoblación forestal es bastante complejo, ya que implica numerosos factores, cada uno de los cuales debe ser comprendido de forma individual, y conocidas sus relaciones con otros factores con los cuales interactúa. La forma de evaluar de manera integral el resultado de estos factores es mediante el control de calidad. La respuesta de la planta en una estación particular va a depender de la capacidad de respuesta a unas condiciones ambientales limitantes, y de la forma en como esas condiciones limitan su supervivencia y crecimiento, o bien pueden ser modificadas para mejorar su arraigo. Las actividades culturales propias de las repoblaciones (ej. proceimiento de preparación, control de la vegetación, cuidados culturales, etc.) van a influir de manera directa en el éxito de la misma. La adecuada ejecución y el control de las mismas van a permitir mejorar el éxito de las repoblaciones, pero también ayudan a identificar las causas de las perdidas producidas y, por tanto, corregir defectos que condicionan su éxito final.

Present and future methodology for the implementation of decision support systems for traffic management

Real-time predictions are an indispensable requirement for traffic management in order to be able to evaluate the effects of different available strategies or policies. The combination of predicting the state of the network and the evaluation of different traffic management strategies in the short term future allows system managers to anticipate the effects of traffic control strategies ahead of time in order to mitigate the effect of congestion. This paper presents the current framework of decision support systems for traffic management based on short and medium-term predictions and includes some reflections on their likely evolution, based on current scientific research and the evolution of the availability of new types of data and their associated methodologies.

Choosing hybrid organizations for local services delivery : An empirical analysis of partial privatization

The empirical literature about factors explaining local government delivery choices has traditionally focused the attention on the public or private production dilemma. However, hybrid organizational forms such as mixed public-private firms are increasingly used in several European countries. This paper makes use of survey data from Spanish municipalities to examine motivations of local governments for engaging in hybrid organizational forms. Data refer to two very relevant local services: water distribution and solid waste collection. The empirical analysis indicates that the use of mixed firms emerge as a type of pragmatically based ‘third way’ between pure public and pure private production. Indeed, local governments make use of mixed firms when cost considerations (scale economies, transaction costs and soon), financial constraints and private interests exert contradictory pressures. On the contrary, political and ideological factors do not play any significant role on the local government decision of engaging or not in joint ventures with private partners.

Private micro-irrigation costs using reclaimed water

The cost of reusing water in micro-irrigation at the field level has not been studied in depth although the use of effluents in agriculture is a viable alternative in areas where water is scarce or there is intense competition for its use. The aim of the present study is to analyse the private costs of water reuse in micro-irrigation in an experimental plot. This analysis is intended to provide information about the decision a farmer would make when the choice to use conventional or reclaimed water is guided by cost criteria. The components of the total costs of different combinations of four types of filters and five emitters that can be installed in micro-irrigation systems using reclaimed water have been studied with the data obtained from an experimental plot in conditions similar to those of fruit orchards. Different scenarios that compared the costs of using conventional or reclaimed water in terms of water price and nutrient content were also studied. The results show that a proper combination of filters and emitters can save up to 33% in irrigation costs. Capital costs and maintenance costs were the most variable among the different combinations. Scenario analysis showed that the greater price of reclaimed water could be compensated by high nutrient contents, which would reduce fertilizer costs