Incidence and predictors of cutaneous manifestations during the early course of systemic sclerosis: a 10-year longitudinal study from the EUSTAR database.

OBJECTIVES To longitudinally map the onset and identify risk factors for skin sclerosis and digital ulcers (DUs) in patients with systemic sclerosis (SSc) from an early time point after the onset of Raynaud's phenomenon (RP) in the European Scleroderma Trials and Research (EUSTAR) cohort. METHODS 695 patients with SSc with a baseline visit within 1 year after RP onset were followed in the prospective multinational EUSTAR database. During the 10-year observation period, cumulative probabilities of cutaneous lesions were assessed with the Kaplan-Meier method. Cox proportional hazards regression analysis was used to evaluate risk factors. RESULTS The median modified Rodnan skin score (mRSS) peaked 1 year after RP onset, and was 15 points. The 1-year probability to develop an mRSS ≥2 in at least one area of the arms and legs was 69% and 25%, respectively. Twenty-five per cent of patients developed diffuse cutaneous involvement in the first year after RP onset. This probability increased to 36% during the subsequent 2 years. Only 6% of patients developed diffuse cutaneous SSc thereafter. The probability to develop DUs increased to a maximum of 70% at the end of the 10-year observation. The main factors associated with diffuse cutaneous SSc were the presence of anti-RNA polymerase III autoantibodies, followed by antitopoisomerase autoantibodies and male sex. The main factor associated with incident DUs was the presence of antitopoisomerase autoantibodies. CONCLUSION Early after RP onset, cutaneous manifestations exhibit rapid kinetics in SSc. This should be accounted for in clinical trials aiming to prevent skin worsening.

Criteria of election of postgraduate courses in graduated students of technological/ humanistic/ artistic professions : Subjective and contextual involvements to arrive at the conclusion of them

El aumento en la cantidad de estudios de posgrado y de sus cursantes derivados de la demanda por mayores credenciales académicas en lo laboral y por la búsqueda personal para especializarse profesionalmente, es un fenómeno observado en Argentina desde mediados de los años 90. Obtener el título final de estos estudios resulta un porcentaje muy inferior en relación al número de sus inscriptos. Tales motivos focalizaron nuestra atención para analizar tanto los criterios de elección del posgrado como las condiciones contextuales y subjetivas para alcanzar la titulación. Este estudio, de tipo cualitativo, investiga en tres carreras de Especialización que se cursan en diferentes Universidades nacionales , los aspectos de su organización y estilo propuesto para cursar y lograr la finalización de los estudios, así como las motivaciones de la elección de cursantes y egresados en tres ramas diferentes: artística, humanística y tecnológica. El conocimiento sobre la lógica de la organización y la particularidad del objeto de estudio de cada carrera permite analizar diferencias y semejanzas entre ellas aportando algunas propuestas para considerar en programas de formación; mientras que los trayectos de cursantes y egresados explican aspectos subjetivos que intervienen en la finalización o no del posgrado.

Criteria of election of postgraduate courses in graduated students of technological/ humanistic/ artistic professions : Subjective and contextual involvements to arrive at the conclusion of them

El aumento en la cantidad de estudios de posgrado y de sus cursantes derivados de la demanda por mayores credenciales académicas en lo laboral y por la búsqueda personal para especializarse profesionalmente, es un fenómeno observado en Argentina desde mediados de los años 90. Obtener el título final de estos estudios resulta un porcentaje muy inferior en relación al número de sus inscriptos. Tales motivos focalizaron nuestra atención para analizar tanto los criterios de elección del posgrado como las condiciones contextuales y subjetivas para alcanzar la titulación. Este estudio, de tipo cualitativo, investiga en tres carreras de Especialización que se cursan en diferentes Universidades nacionales , los aspectos de su organización y estilo propuesto para cursar y lograr la finalización de los estudios, así como las motivaciones de la elección de cursantes y egresados en tres ramas diferentes: artística, humanística y tecnológica. El conocimiento sobre la lógica de la organización y la particularidad del objeto de estudio de cada carrera permite analizar diferencias y semejanzas entre ellas aportando algunas propuestas para considerar en programas de formación; mientras que los trayectos de cursantes y egresados explican aspectos subjetivos que intervienen en la finalización o no del posgrado.

Criteria of election of postgraduate courses in graduated students of technological/ humanistic/ artistic professions : Subjective and contextual involvements to arrive at the conclusion of them

El aumento en la cantidad de estudios de posgrado y de sus cursantes derivados de la demanda por mayores credenciales académicas en lo laboral y por la búsqueda personal para especializarse profesionalmente, es un fenómeno observado en Argentina desde mediados de los años 90. Obtener el título final de estos estudios resulta un porcentaje muy inferior en relación al número de sus inscriptos. Tales motivos focalizaron nuestra atención para analizar tanto los criterios de elección del posgrado como las condiciones contextuales y subjetivas para alcanzar la titulación. Este estudio, de tipo cualitativo, investiga en tres carreras de Especialización que se cursan en diferentes Universidades nacionales , los aspectos de su organización y estilo propuesto para cursar y lograr la finalización de los estudios, así como las motivaciones de la elección de cursantes y egresados en tres ramas diferentes: artística, humanística y tecnológica. El conocimiento sobre la lógica de la organización y la particularidad del objeto de estudio de cada carrera permite analizar diferencias y semejanzas entre ellas aportando algunas propuestas para considerar en programas de formación; mientras que los trayectos de cursantes y egresados explican aspectos subjetivos que intervienen en la finalización o no del posgrado.

Motivating Young Students to Start a Career in Nuclear: The Basic Course of Science and Nuclear Technology, An Educational Activity of Spanish Young Generation in Nuclear (JÓVENES NUCLEARES)

The main objective of this course, conducted by Jóvenes Nucleares (Spanish Young Generation in Nuclear, JJNN), a non-profit organization that depends on the Spanish Nuclear Society (SNE) is to pass on basic knowledge about Science and Nuclear Technology to the general public, mostly students and introduce them to its most relevant points. The purposes of this course are to provide general information, to answer the most common questions about Nuclear Energy and to motivate the young students to start a career in nuclear. Therefore, it is directed mainly to high school and university students, but also to general people that wants to learn about the key issues of such an important matter in our society. Anybody could attend the course, as no specific scientific education is required. The course is done at least once a year, during the Annual Meeting of the Spanish Nuclear Society, which takes place in a different Spanish city each time. The course is done also to whichever university or institution that asks for it to JJNN, with the only limit of the presenter´s availability. The course is divided into the following chapters: Physical nuclear and radiation principles, Nuclear power plants, Nuclear safety, Nuclear fuel, Radioactive waste, Decommission of nuclear facilities, Future nuclear power plants, Other uses of nuclear technology, Nuclear energy, climate change and sustainable development. The course is divided into 15 minutes lessons on the above topics, imparted by young professionals, experts in the field that belongs either to the Spanish Young Generation in Nuclear, either to companies and institutions related with nuclear energy. At the end of the course, a 200 pages book with the contents of the course is handed to every member of the audience. This book is also distributed in other course editions at high schools and universities in order to promote the scientific dissemination of the Nuclear Technology. As an extra motivation, JJNN delivers a course certificate to the assistants. At the end of the last edition course, in Santiago de Compostela, the assistants were asked to provide a feedback about it. Some really interesting lessons were learned, that will be very useful to improve next editions of the course. As a general conclusion of the courses it can be said that many of the students that have assisted to the course have increased their motivation in the nuclear field, and hopefully it will help the young talents to choose the nuclear field to develop their careers

La reutilización de efluentes depurados en España: retrospectiva, desarrollo del marco normativo, estudio de las tecnologías de regeneración frente a los biorreactores de membrana y sus costes en función del uso

La reutilización de efluentes depurados siempre ha sido una opción en lugares con déficit coyuntural o estructural de recursos hídricos, se haya o no procedido a la regulación y planificación de esta práctica. La necesidad se crea a partir de las demandas de una zona, normalmente riego agrícola, que ven un mejor desarrollo de su actividad por contar con este recurso. España es el país de la UE que más caudal reutiliza, y está dentro de los diez primeros a nivel mundial. La regulación de esta práctica por el RD 1620/2007, ayudó a incorporar la reutilización de efluentes depurados a la planificación hidrológica como parte de los programas de medidas, con objeto de mitigar presiones, como son las extracciones de agua superficial y subterránea, o mejoras medioambientales evitando un vertido. El objeto de este trabajo es conocer la situación de la reutilización de efluentes depurados en España, los diferentes escenarios y planteamientos de esta actividad, el desarrollo del marco normativo y su aplicabilidad, junto a los tratamientos que permiten alcanzar los límites de calidad establecidos en la normativa vigente, en función de los distintos usos. Además, se aporta un análisis de costes de las distintas unidades de tratamiento y tipologías de líneas de regeneración, tanto de las utilizadas después de un tratamiento secundario como de otras opciones de depuración, como son los biorreactores de membrana (MBRs). Para el desarrollo de estos objetivos, en primer lugar, se aborda el conocimiento de la situación de la reutilización en España a través de una base de datos diseñada para cubrir todos los aspectos de esta actividad: datos de la estación depuradora de aguas residuales (EDAR), de la estación regeneradora (ERA), caudales depurados, reutilizados, volúmenes utilizados y ubicación de los distintos usos, tipos de líneas de tratamiento, calidades del agua reutilizada, etc. Las principales fuentes de información son las Confederaciones Hidrográficas (CCHH) a través de las concesiones de uso del agua depurada, las entidades de saneamiento y depuración de las distintas comunidades autónomas (CCAA), ayuntamientos, Planes Hidrológicos de Cuenca (PHC) y visitas a las zonas más emblemáticas. Además, se revisan planes y programas con el fin de realizar una retrospectiva de cómo se ha ido consolidando y desarrollando esta práctica en las distintas zonas de la geografía española. Se han inventariado 322 sistemas de reutilización y 216 tratamientos de regeneración siendo el más extendido la filtración mediante filtro arena seguido de una desinfección mediante hipoclorito, aunque este tratamiento se ha ido sustituyendo por un físico-químico con decantación lamelar, filtro de arena y radiación ultravioleta, tratamiento de regeneración convencional (TRC), y otros tratamientos que pueden incluir membranas, tratamientos de regeneración avanzados (TRA), con dosificación de hipoclorito como desinfección residual, para adaptarse al actual marco normativo. El uso más extendido es el agrícola con el 70% del caudal total reutilizado, estimado en 408 hm3, aunque la capacidad de los tratamientos de regeneración esperada para 2015, tras el Plan Nacional de Reutilización de Aguas (PNRA), es tres veces superior. Respecto al desarrollo normativo, en las zonas donde la reutilización ha sido pionera, las administraciones competentes han ido desarrollando diferentes recomendaciones de calidad y manejo de este tipo de agua. El uso agrícola, y en zonas turísticas, el riego de campos de golf, fueron los dos primeros usos que tuvieron algún tipo de recomendación incluso reglamentación. Esta situación inicial, sin una normativa a nivel estatal ni recomendaciones europeas, creó cierta incertidumbre en el avance de la reutilización tanto a nivel de concesiones como de planificación. En la actualidad sigue sin existir una normativa internacional para la reutilización y regeneración de efluentes depurados. Las recomendaciones de referencia a nivel mundial, y en concreto para el uso agrícola, son las de la OMS (Organización Mundial de la Salud) publicadas 1989, con sus posteriores revisiones y ampliaciones (OMS, 2006). Esta norma combina tratamientos básicos de depuración y unas buenas prácticas basadas en diferentes niveles de protección para evitar problemas sanitarios. Otra normativa que ha sido referencia en el desarrollo del marco normativo en países donde se realiza esta práctica, son las recomendaciones dadas por la Agencia Medioambiente Estadunidense (USEPA, 2012) o las publicadas por el Estado de California (Título 22, 2001). Estas normas establecen unos indicadores y valores máximos dónde el tratamiento de regeneración es el responsable de la calidad final en función del uso. Durante 2015, la ISO trabajaba en un documento para el uso urbano donde se muestra tanto los posibles parámetros que habría que controlar como la manera de actuar para evitar posibles riesgos. Por otro lado, la Comisión Europea (CE) viene impulsando desde el 2014 la reutilización de aguas depuradas dentro del marco de la Estrategia Común de Implantación de la Directiva Marco del Agua, y fundamentalmente a través del grupo de trabajo de “Programas de medidas”. Para el desarrollo de esta iniciativa se está planteando sacar para 2016 una guía de recomendaciones que podría venir a completar el marco normativo de los distintos Estados Miembros (EM). El Real Decreto 1620/2007, donde se establece el marco jurídico de la reutilización de efluentes depurados, tiende más a la filosofía implantada por la USEPA, aunque la UE parece más partidaria de una gestión del riesgo, donde se establecen unos niveles de tolerancia y unos puntos de control en función de las condiciones socioeconómicas de los distintos Estados, sin entrar a concretar indicadores, valores máximos o tratamientos. Sin embargo, en la normativa estadounidense se indican una serie de tratamientos de regeneración, mientras que, en la española, se hacen recomendaciones a este respecto en una Guía sin validez legal. Por tanto, queda sin regular los procesos para alcanzar estos estándares de calidad, pudiendo ser éstos no apropiados para esta práctica. Es el caso de la desinfección donde el uso de hipoclorito puede generar subproductos indeseables. En la Guía de recomendaciones para la aplicación del RD, publicada por el Ministerio de Agricultura y Medioambiente (MAGRAMA) en 2010, se aclaran cuestiones frecuentes sobre la aplicación del RD, prescripciones técnicas básicas para los sistemas de reutilización, y buenas prácticas en función del uso. Aun así, el RD sigue teniendo deficiencias en su aplicación siendo necesaria una revisión de la misma, como en las frecuencias de muestreo incluso la omisión de algunos parámetros como huevos de nematodos que se ha demostrado ser inexistentes tras un tratamiento de regeneración convencional. En este sentido, existe una tendencia a nivel mundial a reutilizar las aguas con fines de abastecimiento, incluir indicadores de presencia de virus o protozoos, o incluir ciertas tecnologías como las membranas u oxidaciones avanzadas para afrontar temas como los contaminantes emergentes. Otro de los objetivos de este trabajo es el estudio de tipologías de tratamiento en función de los usos establecidos en el RD 1620/2007 y sus costes asociados, siendo base de lo establecido a este respecto en la Guía y PNRA anteriormente indicados. Las tipologías de tratamiento propuestas se dividen en líneas con capacidad de desalar y las que no cuentan con una unidad de desalación de aguas salobres de ósmosis inversa o electrodiálisis reversible. Se realiza esta división al tener actuaciones en zonas costeras donde el agua de mar entra en los colectores, adquiriendo el agua residual un contenido en sales que es limitante en algunos usos. Para desarrollar este objetivo se han estudiado las unidades de tratamiento más implantadas en ERAs españolas en cuanto a fiabilidad para conseguir determinada calidad y coste, tanto de implantación como de explotación. El TRC, tiene un coste de implantación de 28 a 48 €.m-3.d y de explotación de 0,06 a 0,09 €. m-3, mientras que, si se precisara desalar, este coste se multiplica por diez en la implantación y por cinco en la explotación. En caso de los usos que requieren de TRA, como los domiciliarios o algunos industriales, los costes serían de 185 a 398 €.m-3.d en implantación y de 0,14 a 0,20 €.m-3 en explotación. En la selección de tecnologías de regeneración, la capacidad del tratamiento en relación al coste es un indicador fundamental. Este trabajo aporta curvas de tendencia coste-capacidad que sirven de herramienta de selección frente a otros tratamientos de regeneración de reciente implantación como son los MBR, u otros como la desalación de agua de mar o los trasvases entre cuencas dentro de la planificación hidrológica. En España, el aumento de las necesidades de agua de alta calidad en zonas con recursos escasos, aumento de zonas sensibles como puntos de captación para potables, zonas de baño o zonas de producción piscícola, y en ocasiones, el escaso terreno disponible para la implantación de nuevas plantas depuradoras (EDARs), han convertido a los MBRs, en una opción dentro del marco de la reutilización de aguas depuradas. En este trabajo, se estudia esta tecnología frente a los TRC y TRA, aportando igualmente curvas de tendencia coste-capacidad, e identificando cuando esta opción tecnológica puede ser más competitiva frente a los otros tratamientos de regeneración. Un MBR es un tratamiento de depuración de fangos activos donde el decantador secundario es sustituido por un sistema de membranas de UF o MF. La calidad del efluente, por tanto, es la misma que el de una EDAR seguida de un TRA. Los MBRs aseguran una calidad del efluente para todos los usos establecidos en el RD, incluso dan un efluente que permite ser directamente tratado por las unidades de desalación de OI o EDR. La implantación de esta tecnología en España ha tenido un crecimiento exponencial, pasando de 13 instalaciones de menos de 5.000 m3. d-1 en el 2006, a más de 55 instalaciones en operación o construcción a finales del 2014, seis de ellas con capacidades por encima de los 15.000 m3. d-1. Los sistemas de filtración en los MBR son los que marcan la operación y diseño de este tipo de instalaciones. El sistema más implantado en España es de membrana de fibra hueca (MFH), sobre todo para instalaciones de gran capacidad, destacando Zenon que cuenta con el 57% de la capacidad total instalada. La segunda casa comercial con mayor número de plantas es Kubota, con membranas de configuración placa plana (MPP), que cuenta con el 30 % de la capacidad total instalada. Existen otras casas comerciales implantadas en MBR españoles como son Toray, Huber, Koch o Microdym. En este documento se realiza la descripción de los sistemas de filtración de todas estas casas comerciales, aportando información de sus características, parámetros de diseño y operación más relevantes. El estudio de 14 MBRs ha posibilitado realizar otro de los objetivos de este trabajo, la estimación de los costes de explotación e implantación de este tipo de sistemas frente a otras alternativas de tratamiento de regeneración. En este estudio han participado activamente ACA y ESAMUR, entidades públicas de saneamiento y depuración de Cataluña y Murcia respectivamente, que cuentan con una amplia experiencia en la explotación de este tipo de sistemas. Este documento expone los problemas de operación encontrados y sus posibles soluciones, tanto en la explotación como en los futuros diseños de este tipo de plantas. El trabajo concluye que los MBRs son una opción más para la reutilización de efluentes depurados, siendo ventajosos en costes, tanto de implantación como de explotación, respecto a EDARs seguidas de TRA en capacidades por encima de los 10.000 m3.d-1. ABSTRACT The reuse of treated effluent has always been an option in places where a situational or structural water deficit exists, whether regulatory and/or planning efforts are completed or not. The need arises from the demand of a sector, commonly agricultural irrigation, which benefits of this new resource. Within the EU, Spain is ahead in the annual volume of reclaimed water, and is among the top ten countries at a global scale. The regulation of this practice through the Royal Decree 1620/2007 has helped to incorporate the water reuse to the hydrological plans as a part of the programme of measures to mitigate pressures such as surface or ground water extraction, or environmental improvements preventing discharges. The object of this study is to gain an overview of the state of the water reuse in Spain, the different scenarios and approaches to this activity, the development of the legal framework and its enforceability, together with the treatments that achieve the quality levels according to the current law, broken down by applications. Additionally, a cost analysis of technologies and regeneration treatment lines for water reclamation is performed, whereas the regeneration treatment is located after a wastewater treatment or other options such as membrane bioreactors (MBR). To develop the abovementioned objectives, the state of water reuse in Spain is studied by means of a database designed to encompass all aspects of the activity: data from the wastewater treatment plants (WWTP), from the water reclamation plants (WRP), the use of reclaimed water, treated water and reclaimed water annual volumes and qualities, facilities and applications, geographic references, technologies, regeneration treatment lines, etc. The main data providers are the River Basin authorities, through the concession or authorization for water reuse, (sanitary and wastewater treatment managers from the territorial governments, local governments, Hydrological Plans of the River Basins and field visits to the main water reuse systems. Additionally, a review of different plans and programmes on wastewater treatment or water reuse is done, aiming to put the development and consolidation process of this activity in the different regions of Spain in perspective. An inventory of 322 reuse systems and 216 regeneration treatments has been gathered on the database, where the most extended regeneration treatment line was sand filtration followed by hypochlorite disinfection, even though recently it is being replaced by physical–chemical treatment with a lamella settling system, depth sand filtration, and a disinfection with ultraviolet radiation and hypochlorite as residual disinfectant, named conventional regeneration treatment (CRT), and another treatment that may include a membrane process, named advanced regeneration treatment (ART), to adapt to legal requirements. Agricultural use is the most extended, accumulating 70% of the reclaimed demand, estimated at 408 hm3, even though the expected total capacity of WRPs for 2015, after the implementation of the National Water Reuse Plan (NWRP) is three times higher. According to the development of the water reuse legal framework, there were pioneer areas where competent authorities developed different quality and use recommendations for this new resource. Agricultural use and golf course irrigation in touristic areas were the first two uses with recommendations and even legislation. The initial lack of common legislation for water reuse at a national or European level created some doubts which affected the implementation of water reuse, both from a planning and a licensing point of view. Currently there is still a lack of common international legislation regarding water reuse, technologies and applications. Regarding agricultural use, the model recommendations at a global scale are those set by the World Health Organization published in 1989, and subsequent reviews and extensions about risk prevention (WHO, 2006). These documents combine wastewater treatments with basic regeneration treatments reinforced by good practices based on different levels of protection to avoid deleterious health effects. Another relevant legal reference for this practices has been the Environmental Protection Agency of the US (USEPA, 2012), or those published by the State of California (Title 22, 2001). These establish indicator targets and maximum thresholds where regeneration treatment lines are responsible for the final quality according to the different uses. During 2015, the ISO has worked on a document aimed at urban use, where the possible parameters to be monitored together with risk prevention have been studied. On the other hand, the European Commission has been promoting the reuse of treated effluents within the Common Implementation Strategy of the Water Framework Directive, mainly through the work of the Programme of Measures Working Group. Within this context, the publication of a recommendation guide during 2016 is intended, as a useful tool to fill in the legal gaps of different Member States on the matter. The Royal Decree 1620/2007, where the water reuse regulation is set, resembles the principles of the USEPA more closely, even though the EU shows a tendency to prioritize risk assessment by establishing tolerance levels and thresholds according to socioeconomic conditions of the different countries, without going into details of indicators, maximum thresholds or treatments. In contrast, in the US law, regeneration treatments are indicated, while in the Spanish legislation, the only recommendations to this respect are compiled in a non-compulsory guide. Therefore, there is no regulation on the different treatment lines used to achieve the required quality standards, giving room for inappropriate practices in this respect. This is the case of disinfection, where the use of hypochlorite may produce harmful byproducts. In the recommendation Guide for the application of the Royal Decree (RD), published by the Ministry of Agriculture and Environment (MAGRAMA) in 2010, clarifications of typical issues that may arise from the application of the RD are given, as well as basic technical parameters to consider in reuse setups, or good practices according to final use. Even so, the RD still presents difficulties in its application and requires a review on issues such as the sampling frequency of current quality parameters or even the omission of nematode eggs indicator, which have been shown to be absent after CRT. In this regard, there is a global tendency to employ water reuse for drinking water, including indicators for the presence of viruses and protozoans, or to include certain technologies such as membranes or advanced oxidation processes to tackle problems like emerging pollutants. Another of the objectives of this study is to provide different regeneration treatment lines to meet the quality requirements established in the RD 1620/2007 broken down by applications, and to estimate establishment and operational costs. This proposal has been based on what is established in the above mentioned Guide and NWRP. The proposed treatment typologies are divided in treatment trains with desalination, like reverse osmosis or reversible electrodialisis, and those that lack this treatment for brackish water. This separation is done due to coastal facilities, where sea water may permeate the collecting pipes, rising salt contents in the wastewater, hence limiting certain uses. To develop this objective a study of the most common treatment units set up in Spanish WRPs is conducted in terms of treatment train reliability to obtain an acceptable relationship between the required quality and the capital and operational costs. The CRT has an establishment cost of 28 to 48 €.m-3.d and an operation cost of 0.06 to 0.09 €.m-3, while, if desalination was required, these costs would increase tenfold for implementation and fivefold for operation. In the cases of uses that require ART, such as residential or certain industrial uses, the costs would be of 185 to 398 €.m-3.d for implementation and of 0.14 to 0.20 €.m-3 for operation. When selecting regeneration treatment lines, the relation between treatment capacity and cost is a paramount indicator. This project provides cost-capacity models for regeneration treatment trains. These may serve as a tool when selecting between different options to fulfill water demands with MBR facilities, or others such as sea water desalination plants or inter-basin water transfer into a water planning framework. In Spain, the requirement for high quality water in areas with low resource availability, the increasing number of sensitive zones, such as drinking water extraction, recreational bathing areas, fish protected areas and the lack of available land to set up new WWTPs, have turned MBRs into a suitable option for water reuse. In this work this technology is analyzed in contrast to CRT and ART, providing cost-capacity models, and identifying when and where this treatment option may outcompete other regeneration treatments. An MBR is an activated sludge treatment where the secondary settling is substituted by a membrane system of UF or MF. The quality of the effluent is, therefore, comparable to that of a WWTP followed by an ART. MBRs ensure a sufficient quality level for the requirements of the different uses established in the RD, even producing an effluent that can be directly treated in OI or EDR processes. The implementation of this technology in Spain has grown exponentially, growing from 13 facilities with less than 5000 m3.d-1 in 2006 to above 55 facilities operating by the end of 2014, 6 of them with capacities over 15000 m3.d-1. The membrane filtration systems for MBR are the ones that set the pace of operation and design of this type of facilities. The most widespread system in Spain is the hollow fiber membrane configuration, especially on high flow capacities, being Zenon commercial technology, which mounts up to 57% of the total installed capacity, the main contributor. The next commercial technology according to plant number is Kubota, which uses flat sheet membrane configuration, which mounts up to 30% of the total installed capacity. Other commercial technologies exist within the Spanish MBR context, such as Toray, Huber, Koch or Microdym. In this document an analysis of all of these membrane filtration systems is done, providing information about their characteristics and relevant design and operation parameters. The study of 14 full scale running MBRs has enabled to pursue another of the objectives of this work: the estimation of the implementation and operation costs of this type of systems in contrast to other regeneration alternatives. Active participation of ACA and ESAMUR, public wastewater treatment and reuse entities of Cataluña and Murcia respectively, has helped attaining this objective. A number of typical operative problems and their possible solutions are discussed, both for operation and plant design purposes. The conclusion of this study is that MBRs are another option to consider for water reuse, being advantageous in terms of both implementation and operational costs, when compared with WWTPs followed by ART, when considering flow capacities above 10000 m3.d-1.

A neural system for human visual working memory

Working memory is the process of actively maintaining a representation of information for a brief period of time so that it is available for use. In monkeys, visual working memory involves the concerted activity of a distributed neural system, including posterior areas in visual cortex and anterior areas in prefrontal cortex. Within visual cortex, ventral stream areas are selectively involved in object vision, whereas dorsal stream areas are selectively involved in spatial vision. This domain specificity appears to extend forward into prefrontal cortex, with ventrolateral areas involved mainly in working memory for objects and dorsolateral areas involved mainly in working memory for spatial locations. The organization of this distributed neural system for working memory in monkeys appears to be conserved in humans, though some differences between the two species exist. In humans, as compared with monkeys, areas specialized for object vision in the ventral stream have a more inferior location in temporal cortex, whereas areas specialized for spatial vision in the dorsal stream have a more superior location in parietal cortex. Displacement of both sets of visual areas away from the posterior perisylvian cortex may be related to the emergence of language over the course of brain evolution. Whereas areas specialized for object working memory in humans and monkeys are similarly located in ventrolateral prefrontal cortex, those specialized for spatial working memory occupy a more superior and posterior location within dorsal prefrontal cortex in humans than in monkeys. As in posterior cortex, this displacement in frontal cortex also may be related to the emergence of new areas to serve distinctively human cognitive abilities.

Treinamento de habilidades sociais com universitários da área de fonoaudiologia: análise de conteúdo

Além do aprendizado de conhecimentos básicos e técnicos, promover competência social e habilidades interpessoais de universitários da área da Saúde torna-se fundamental para o desenvolvimento de relações saudáveis e produtivas no contexto acadêmico e na linha do cuidado. O campo das Habilidades Sociais, uma área da Psicologia, tem fornecido fundamentação desde a metodologia de avaliação de repertório social, até programas de Treinamento de Habilidades Sociais (THS) em contextos educacionais. Atualmente, é crescente o interesse em pesquisas qualitativas na Saúde por englobar o universo de significados, motivos, crenças, valores e atitudes, correspondendo a um espaço mais profundo das relações humanas. Objetivos: Investigar do ponto de vista qualitativo o programa de THS com universitários, oferecido pela disciplina de Psicologia III no Curso de Fonoaudiologia; descrever as potencialidades e dificuldades do repertório de HS conforme a autopercepção dos universitários; identificar os ganhos percebidos pelos universitários ao longo do programa de THS; analisar a relação entre o THS com o autoconhecimento nas relações interpessoais e na relação profissional-paciente. Metodologia: Participaram desta pesquisa 22 universitários, com faixa etária entre 19 e 21 anos de ambos os sexos, que cursavam o segundo ano do Curso de Fonoaudiologia de uma Instituição de Ensino Superior do interior paulista. Empregaram-se abordagem qualitativa e análise de conteúdo dos relatos produzidos pelos universitários no 1o, 8o e 15o encontros do THS e das sínteses (8o e 15o). Resultados: Foram identificadas três temas para análise: \"A importância do conhecimento teórico/técnico para a formação do fonoaudiólogo\", \"A importância do THS no contexto acadêmico e para a prática clínica\" e \"Avaliação dos universitários sobre os efeitos do THS\". No que se refere ao conhecimento teórico/técnico, os relatos apontaram a importância de que este seja desenvolvido de maneira contínua, valorizando as metodologias ativas empregadas. Quanto ao treinamento, os participantes descreveram maior prevalência de potencialidades e dificuldades das habilidades assertivas nos relacionamentos interpessoais do contexto acadêmico. Também foi apontada maior dificuldade de empatia com colegas e na comunicação com professores. No contexto profissional, as dificuldades permearam a ansiedade de falar em público e ser assertivo ao trabalhar em grupo. Quanto aos ganhos identificados, prevaleceu a assertividade com os dois interlocutores envolvidos nesta pesquisa; porém, todas as habilidades sociais tiveram resultados considerados positivos nos dois contextos, destacando a comunicação empática com paciente como facilitadora do processo terapêutico. O THS foi avaliado positivamente, pois permitiu a identificação de potencialidades, dificuldades e ganhos no repertório de HS no contexto acadêmico, sendo apontado como uma forma de preparação para a prática clínica, promovendo o autoconhecimento, o desenvolvimento de comportamentos socialmente habilidosos e a generalização para outros contextos. Conclusão: A inserção do THS na formação profissional de universitários na Fonoaudiologia mostrou-se bastante promissora ao ampliar o repertório de habilidades e competências para além do conhecimento teórico/técnico, tendo o autoconhecimento papel central neste processo, culminando com mudanças de comportamento na vida pessoal e profissional. Salienta-se a relevância do THS em cursos de graduação na área da Saúde, pelo contexto da relação profissional-paciente.

Sobrevida de mulheres e homens com 60 anos e mais no município de São Paulo - Estudo SABE: as diferenças nas semelhanças em características do curso de vida

Objetivos: Avaliar numa coorte de idosos se há diferenças entre as situações do curso de vida que contribuem para uma maior chance de sobrevida em homens e mulheres com 60 anos e mais. Métodos: 2.143 idosos entrevistados em 2000 foram acompanhados durante quase 15 anos. Utilizou-se na análise estatística o teste de associação para amostras complexas (Rao-Scott), o estimador produto limite de Kaplan-Meier, o teste de log-rank, análise univariada e multivariada do modelo de riscos proporcionais de Cox, sendo construídos, através deste último, dois modelos finais por gênero, ao nível de significância de 5 por cento . Resultados e discussão: Dos 836.204 idosos paulistanos representados pelo estudo 51,6 por cento continuavam vivos (43,0 por cento dos homens e 57,7 por cento das mulheres). Em ambos os gêneros, os/as que tinham boas condições materiais e que realizavam sem dificuldade e sem ajuda mais da metade das atividades básicas e instrumentais de vida diária (ABVD/AIVD) apresentaram maior chance de sobrevivência. O mesmo foi verificado naquelas mulheres com menos de duas limitações de determinadas doenças, nas casadas, nas que ofereciam algum tipo de ajuda e nas que realizaram ações preventivas em relação a sua condição de saúde. Entre os homens o mesmo ocorreu naqueles que se referiram ser chefe de família, nos que tinham participação comunitária, nos que residiam com algum outro morador que foi ou ia à escola, que trabalharam predominantemente como proprietário ou por conta própria e nos que relataram ter tido alguma doença em seus primeiros quinzes anos de vida. Conclusão: As chances de sobrevida são diferentes entre gêneros, e entre si, mesmo em situações aparentemente semelhantes do curso de vida vivenciados e presentes em homens e mulheres idosas.

A qualitative exploration of the impact of the economic recession in Spain on working, living and health conditions: reflections based on immigrant workers' experiences

Background: This study aimed to analyse how immigrant workers in Spain experienced changes in their working and employment conditions brought about Spain's economic recession and the impact of these changes on their living conditions and health status. Method: We conducted a grounded theory study. Data were obtained through six focus group discussions with immigrant workers (n = 44) from Colombia, Ecuador and Morocco, and two individual interviews with key informants from Romania living in Spain, selected by theoretical sample. Results: Three categories related to the crisis emerged – previous labour experiences, employment consequences and individual consequences – that show how immigrant workers in Spain (i) understand the change in employment and working conditions conditioned by their experiences in the period prior to the crisis, and (ii) experienced the deterioration in their quality of life and health as consequences of the worsening of employment and working conditions during times of economic recession. Conclusion: The negative impact of the financial crisis on immigrant workers may increase their social vulnerability, potentially leading to the failure of their migratory project and a return to their home countries. Policy makers should take measures to minimize the negative impact of economic crisis on the occupational health of migrant workers in order to strengthen social protection and promote health and well-being.

Evolution of extracellular polymeric substances produced in two submerged membrane bioreactors working at high sludge age

This research paper deals with the evolution of the extracellular polymeric substances (EPS) produced in the mixed liquor of two 25 L bench-scale membrane bioreactors (MBRs), with micro (MF-MBR) and ultrafiltration (UF-MBR) submerged membranes. The conclusion focuses on the relationship between the operation and how EPS respond, demonstrating that significant changes in EPS concentration were commonly observed when abrupt changes in the operational conditions took place. Bound EPS (EPSb) showed moderate positive statistical correlations with sludge age and MLSS for the two MBRs. Soluble EPS (EPSs), on the other hand, showed a moderate negative statistical correlation between EPSs with the two parameters analyzed for MF-MBR and no correlation with the UF-MBR was found. With respect to the composition of EPS, EPSb were mostly made up of proteins (44–46%) whereas in EPSs, the three components (proteins, carbohydrates, and humic substances) appeared in approximately the same proportion. The statistical analysis exhibited strong positive correlations between EPSb and their constituents, however for EPSs, the correlation was strong only with carbohydrates and moderate with humic substances.

Effect of economic recession on psychosocial working conditions by workers' nationality

Background: Several publications have documented the effects of economic recessions on health. However, little is known about how economic recessions influence working conditions, especially among vulnerable workers. Objective: To explore the effects of 2008 economic crisis on the prevalence of adverse psychosocial working conditions among Spanish and foreign national workers. Methods: Data come from the 2007 and 2011 Spanish Working Conditions Surveys. Survey year, sociodemographic, and occupational information were independent variables and psychosocial factors exposures were dependent variables. Analyses were stratified by nationality (Spanish versus foreign). Prevalence and adjusted prevalence ratios (aPRs) of psychological job demands, job control, job social support, physical demands and perceived job insecurity were estimated using Poisson regression. Results: The Spanish population had higher risk of psychological and physical job demand (aPR = 1.07, 95% CI = [1.04–1.10] and aPR = 1.05, 95% CI = [1.01–1.09], respectively) in 2011 compared to 2007. Among both Spanish and foreign national workers, greater aPR were found for job loss in 2011 compared to 2007 (aPR = 2.47, 95% CI = [2.34–2.60]; aPR = 2.44, 95% CI = [2.15–2.77], respectively). Conclusion: The 2008 economic crisis was associated with a significant increase in physical demands in Spanish workers and increased job insecurity for both Spanish and foreign workers.

Emergent Brazil and the Curse of the ‘Hen’s Flight’. CEPS Working Document No. 379, 27 February 2013

The ‘Emergent Brazil’ growth model is reaching its limits. Its main engines have been slowing significantly since the beginning of the global financial and economic crisis. Even its much-praised predictable macroeconomic policy has been eroded by political interference. Inflationary pressures are growing and GDP performance is anaemic. As ominous, Brazil cannot compensate for its domestic deficiencies with an export drive. Commodity exports are suffering with the world economic slow-down and the manufacturing industries’ competitiveness is in sharp decline. Brazil has put all its trade negotiation eggs into the South American and WTO baskets, and now its export market share is threatened by the Doha Round paralysis, the Latin American Alianza del Pacífico, and the US-led initiatives for a Trans-Pacific Partnership and a trade and investment agreement with the EU. Paradoxically, this alarming situation opens a window of opportunity. There is a mounting national consensus on the need to tackle head-on the country’s and its industries’ lack of competitiveness. That means finding a solution to the much-decried ‘Brazil Cost’ and stimulating private-sector investment. It also entails an aggressive trade-negotiating stance in order to secure better access to foreign markets and to foster more competition in the domestic one. The most promising near-term goal would be the conclusion of the EU–Mercosur trade talks. A scenario to overcome the paralysis of these negotiations could trail two parallel paths: bilateral EU–Brazil agreements on ‘anything but trade’ combined with a sequencing of the EU–Mercosur talks where each member of the South American bloc could adopt faster or slower liberalisation commitments and schedules.

The EU and Brazil: Partnering in an uncertain world? CEPS Working Document No. 382, 13 May 2013

The international system is changing fast and both the European Union and Brazil will need to adapt. This paper argues that such a process of adjustment may bring the two closer together, even if their starting points differ considerably. Europe looks at the ongoing redistribution of power as a challenge, Brazil as an opportunity. Europe is coping with the detrimental impact of the economic crisis on its international profile; Brazil is enhancing its influence in its region and beyond. Their normative outlook is broadly compatible; their political priorities and behaviour in multilateral frameworks often differ, from trade to development and security issues. Despite the crisis, however, there are signals of renewed engagement by the EU on the international stage, with a focus on its troubled neighbourhood and partnerships with the US and large emerging actors such as Brazil. The latter is charting an original course in international affairs as a rising democratic power from the traditional South with no geopolitical opponents and a commitment to multilateralism. In testing the limits of its international influence, Brazil will need dependable partners and variable coalitions that go well beyond the BRICS format, which is not necessarily sustainable. This contribution suggests that the strategic partnership between the EU and Brazil may grow stronger not only as a platform to deepen economic ties and sustain growth, but also as a tool to foster cooperation in political and security affairs including crisis management, preventive diplomacy and human rights.