Una explicación del conflicto social sobre energía eólica en la comarca de la Terra Alta en Cataluña

El estudio investiga las razones que explican un conflicto sobre la instalación de parques eólicos en Terra Alta, una comarca rural de Cataluña. Identificamos tres razones principales. Primero, y de acuerdo con el marco conceptual de ecología política, el conflicto eólico forma parte de un conflicto más generalizado sobre la ‘macro-concentración’ de instalaciones energéticas en el sur de Cataluña que generan energía y beneficios económicos principalmente para el centro del desarrollo económico catalán. Segundo, el impacto paisajístico de los proyectos eólicos choca con iniciativas locales que impulsan el paisaje como un activo valioso capaz de sustentar la vida en la comarca. Por último, desequilibrios de poder en el sistema formal de toma de decisiones sobre parques eólicos impiden la inclusión de valores locales como criterios en el proceso de toma de decisiones y eso también genera conflicto. Para un desarrollo sostenible de energía eólica, la importancia del potencial eólico como criterio principal de localización debe ser reevaluada, y la negociación de la distribución de beneficios debe hacerse en la forma más abierta posible.

Rehabilitation needs assessment in persons with spinal cord injury following the 2010 earthquake in Haiti: a pilot study using an ICF-based tool.

OBJECTIVE: The aim of this pilot study was to describe problems in functioning and associated rehabilitation needs in persons with spinal cord injury after the 2010 earthquake in Haiti by applying a newly developed tool based on the International Classification of Functioning, Disability and Health (ICF). DESIGN: Pilot study. SUBJECTS: Eighteen persons with spinal cord injury (11 women, 7 men) participated in the needs assessment. Eleven patients had complete lesions (American Spinal Injury Association Impairment Scale; AIS A), one patient had tetraplegia. METHODS: Data collection included information from the International Spinal Cord Injury Core Data Set and a newly developed needs assessment tool based on ICF Core Sets. This tool assesses the level of functioning, the corresponding rehabilitation need, and required health professional. Data were summarized using descriptive statistics. RESULTS: In body functions and body structures, patients showed typical problems following spinal cord injury. Nearly all patients showed limitations and restrictions in their activities and participation related to mobility, self-care and aspects of social integration. Several environmental factors presented barriers to these limitations and restrictions. However, the availability of products and social support were identified as facilitators. Rehabilitation needs were identified in nearly all aspects of functioning. To address these needs, a multidisciplinary approach would be needed. CONCLUSION: This ICF-based needs assessment provided useful information for rehabilitation planning in the context of natural disaster. Future studies are required to test and, if necessary, adapt the assessment.

Health services utilization associated with cognitive impairment and dementia in older patients undergoing post-acute rehabilitation.

OBJECTIVE: To investigate the relationship between levels of cognitive impairment and health services utilization in older patients undergoing post-acute rehabilitation. DESIGN: Cross-sectional study. SETTING: Post-acute rehabilitation facility. PARTICIPANTS: Patients (N = 1764) aged 70 years and older admitted over 3 years. MEASUREMENTS: Sociodemographic, medical, and functional data were collected upon admission. Based on discharge diagnoses, patients were classified as cognitively intact, cognitively impaired with no dementia (CIND), and demented. RESULTS: Dementia and CIND were diagnosed in 425 (24.1%) and 301 (17.1%) patients, respectively. Gradients from cognitively intact to cognitively impaired to demented patients were observed in median length of stay (19, 22, and 25 days, P < .001), and institutionalization rates at discharge (4.2%, 7.6%, and 28.8%, P < .001). Among patients discharged home, similar gradients were observed in utilization of home care (68.2%, 79.7%, and 83.3%, P < .001) and day care (3.1%, 7.1%, and 14.3%, P < .001). After adjustment, compared with cognitively intact patients, only those with dementia still had longer stays (+2.7 days) and increased odds of institutionalization (adjOR 6.1, 95% CI 4.0-9.3, P < .001). Among patients discharged home, use of home and day care remained higher in those with dementia (adjOR 1.8, 95% CI 1.2-2.7, P = .005, and adjOR 1.8, 95% CI 1.2-2.7, P = .005, respectively), while CIND patients had higher odds of using home care (adjOR 1.6, 95% CI 1.1-2.4, P = .028). CONCLUSION: Among patients undergoing post-acute rehabilitation, those with dementia had increased use of both institutional and community care, whereas those with CIND had increased use of home care services only. Future studies should investigate specific strategies susceptible to reduce the related burden on health care systems.

The effect of colostrum source (goat vs. sheep) and timing of the first colostrum feeding (2h vs. 14h after birth) on body weight and immune status of artificially reared newborn lambs.

Several factors can affect lamb body weight (BW) and immune status during the first days of life, including colostrum source and timing of the first colostrum feeding. The aim of this study was to evaluate the effects of colostrum source (goat or sheep) and timing of the first colostrum feeding (2 or 14h after birth) on lamb BW and immune status. In this study, 40 lambs were removed from their dams at birth and randomly assigned into 4 groups of 10 lambs each. Lambs were subsequently fed at 2 or 14h after birth with goat or sheep colostrum. Blood samples and BW recording were performed before feeding. Blood plasma was used to measure the immunoglobulin concentration (IgG and IgM), chitotriosidase activity, and complement system activity (total and alternative pathways). In general, no differences in any of the measured variables were observed among the 4 groups, indicating that neither colostrum source nor timing of the first colostrum feeding had an effect on these variables. These findings may improve management on lamb farms that raise animals under artificial conditions, because our results indicate that it is not necessary to feed colostrum to lambs immediately after birth and that goat colostrum may be used to feed newborn lambs.

O processo de diagnosticar e o seu ensino

Este trabalho trata do ensino da habilidade para diagnosticar estudantes de enfermagem. Tem como objetivo geral verificar a adequação da elaboração do processo de análise e síntese e sua relação com o estabelecimento do diagnóstico de enfermagem. Após serem desenvolvidos os conteúdos programáticos previstos na disciplina de Enfermagem Médica, em face a uma situação hipotética, os alunos elaboraram o processo diagnóstico (RISNER, 1986) individualmente, chegando a um total de 106 formulações de Diagnóstico (Taxonomia I da North American Nursing Diagnosis Association - NANDA). As maiores dificuldades se deram na área do estabelecimento de "relações" e de "agrupamento de dados". Sugere-se que o desenvolvimento do processo de pensamento inerente à análise e síntese seja estimulado desde o início do curso de graduação.

Diagnósticos de enfermagem do paciente no período pós-operatório imediato

O objetivo deste estudo foi identificar os diagnósticos de enfermagem mais freqüentes de pacientes em pós-operatório imediato. Foi elaborada uma ficha de avaliação pós-anestésica do período pós-operatório que foi utilizada em 28 pacientes nas primeiras duas horas em que permaneceram em centro de recuperação pós-anestésica. Os diagnósticos de enfermagem foram estabelecidos com base na Taxionomia I dos Diagnósticos de Enfermagem da North American Nursing Diagnosis Association -NANDA. Foram identificados os seguintes diagnósticos: risco para injúria (100,0%), risco para infecção (92,8%), senso-percepção alterada (89,2%), risco para aspiração (82,1%), mobilidade física prejudicada (71,4%), integridade tissular prejudicada (82,1%) e hipotermia (67,8%).

Atendimento à mulher vítima de violência sexual: protocolo de assistência de Enfermagem

O Ministério da Saúde preconiza o atendimento integral e humanizado às mulheres vítimas de violência sexual. Teve-se por objetivo descrever o Protocolo de Enfermagem na Assistência às Mulheres Vítimas de Violência Sexual do Centro de Atenção Integral à Saúde da Mulher da Universidade Estadual de Campinas, recentemente revisado. Para tanto, seguiram-se as etapas do processo de enfermagem e após a identificação dos principais diagnósticos da North American Nursing Diagnosis Association (NANDA) foram determinadas as intervenções, com base em normas técnicas nacionais e internacionais. O protocolo atual engloba o atendimento imediato e tardio, o acompanhamento ambulatorial e as ações relacionadas à interrupção legal da gravidez decorrente do estupro. O protocolo de enfermagem tem proporcionado à cliente um atendimento integral e humanizado e à enfermeira, maior autonomia na sua área de atuação, favorecendo o trabalho colaborativo e interativo com a equipe multidisciplinar.

Sistematização da Assistência de Enfermagem em Unidade de Terapia Intensiva sustentada pela Teoria de Wanda Horta

O objetivo foi implementar a Sistematização da Assistência de Enfermagem (SAE), tendo como referencial a Teoria das Necessidades Humanas Básicas de Wanda de Aguiar Horta e o Diagnóstico de Enfermagem da North American Nursing Diagnosis Association (NANDA), partindo da avaliação do conhecimento da equipe de enfermagem sobre a SAE e incluindo a sua participação nesse processo. É uma pesquisa-ação de cunho qualitativo, realizada na Unidade de Terapia Intensiva de um Hospital da cidade de Brusque, Santa Catarina, de outubro de 2006 a março de 2007. Pode-se perceber que os profissionais da enfermagem sabem pouco sobre a SAE, porém possuem grande interesse em aprender e desenvolvê-la em sua prática diária. Conclui-se que foi possível realizar uma sistematização de assistência de fácil aplicação, através da utilização de impressos simples que forneceram todas as informações necessárias para o desenvolvimento qualificado do cuidado de enfermagem.

Distributed all-atom simulations of intrinsically unstructured proteins

The Computational Biophysics Group at the Universitat Pompeu Fabra (GRIB-UPF) hosts two unique computational resources dedicated to the execution of large scale molecular dynamics (MD) simulations: (a) the ACMD molecular-dynamics software, used on standard personal computers with graphical processing units (GPUs); and (b) the GPUGRID. net computing network, supported by users distributed worldwide that volunteer GPUs for biomedical research. We leveraged these resources and developed studies, protocols and open-source software to elucidate energetics and pathways of a number of biomolecular systems, with a special focus on flexible proteins with many degrees of freedom. First, we characterized ion permeation through the bactericidal model protein Gramicidin A conducting one of the largest studies to date with the steered MD biasing methodology. Next, we addressed an open problem in structural biology, the determination of drug-protein association kinetics; we reconstructed the binding free energy, association, and dissaciociation rates of a drug like model system through a spatial decomposition and a Makov-chain analysis. The work was published in the Proceedings of the National Academy of Sciences and become one of the few landmark papers elucidating a ligand-binding pathway. Furthermore, we investigated the unstructured Kinase Inducible Domain (KID), a 28-peptide central to signalling and transcriptional response; the kinetics of this challenging system was modelled with a Markovian approach in collaboration with Frank Noe’s group at the Freie University of Berlin. The impact of the funding includes three peer-reviewed publication on high-impact journals; three more papers under review; four MD analysis components, released as open-source software; MD protocols; didactic material, and code for the hosting group.

Ultra-Thin PCC Overlays, January 2005

· Evaluate conventional methods of slab removal and asphalt surface preparation for subsequent overlays of portland cement concrete (PCC) in the “remove and replace” areas. · Evaluate existing asphaltic concrete surface under the “remove and patch” areas of rehabilitation areas and evaluate joint formation in the areas of patching. · Evaluate polypropylene fiber enhanced concrete at the three-inch depth to determine the cost/benefit of its inclusion. · Evaluate the performance of the rehabilitated ultra-thin whitetopping sections and the extended performance of the existing ultra-thin sections with and without patching. · Validate existing ultra-thin whitetopping design procedures of the Portland Cement Association (PCA) and American Concrete Pavement Association (ACPA) for application in Iowa.

Field Experiments of Current Concrete Pavement Surface Characteristics Practices: Iowa Data Collection and Analysis, December 2005

One of the most important issues in portland cement concrete pavement research today is surface characteristics. The issue is one of balancing surface texture construction with the need for durability, skid resistance, and noise reduction. The National Concrete Pavement Technology Center at Iowa State University, in conjunction with the Federal Highway Administration, American Concrete Pavement Association, International Grinding and Grooving Association, Iowa Highway Research Board, and other states, have entered into a three-part National Surface Characteristics Program to resolve the balancing problem. As a portion of Part 2, this report documents the construction of 18 separate pavement surfaces for use in the first level of testing for the national project. It identifies the testing to be done and the limitations observed in the construction process. The results of the actual tests will be included in the subsequent national study reports.

Sistematização da Assistência de Enfermagem para acompanhamento ambulatorial de pacientes com esclerose múltipla

Relato da experiência de enfermeiros na implementação da sistematização da assistência de enfermagem para acompanhamento ambulatorial em um centro interdisciplinar de atendimento a pacientes com esclerose múltipla de um hospital público de Fortaleza, Ceará. Essa implementação é baseada nas classificações da North American Nursing Diagnosis Association International, Classificação das Intervenções de Enfermagem e Classificação dos Resultados de Enfermagem. Um dos resultados diz respeito à sistematização do cuidado de enfermagem, partindo da identificação e da compreensão das respostas dos pacientes com esclerose múltipla aos problemas de saúde reais e potenciais. A sistematização enseja ampliar os conhecimentos por meio de uma prática pautada em evidências científicas, além de favorecer a atuação do enfermeiro em uma abordagem integral e fomentar outras investigações.

Evaluation of U.S. and European Concrete Pavement Noise Reduction Methods, July 2006

Highway noise is one of the most pressing of the surface characteristics issues facing the concrete paving industry. This is particularly true in urban areas, where not only is there a higher population density near major thoroughfares, but also a greater volume of commuter traffic (Sandberg and Ejsmont 2002; van Keulen 2004). To help address this issue, the National Concrete Pavement Technology Center (CP Tech Center) at Iowa State University (ISU), Federal Highway Administration (FHWA), American Concrete Pavement Association (ACPA), and other organizations have partnered to conduct a multi-part, seven-year Concrete Pavement Surface Characteristics Project. This document contains the results of Part 1, Task 2, of the ISU-FHWA project, addressing the noise issue by evaluating conventional and innovative concrete pavement noise reduction methods. The first objective of this task was to determine what if any concrete surface textures currently constructed in the United States or Europe were considered quiet, had long-term friction characteristics, could be consistently built, and were cost effective. Any specifications of such concrete textures would be included in this report. The second objective was to determine whether any promising new concrete pavement surfaces to control tire-pavement noise and friction were in the development stage and, if so, what further research was necessary. The final objective was to identify measurement techniques used in the evaluation.

Computerized advice on drug dosage to improve prescribing practice.

BACKGROUND: Maintaining therapeutic concentrations of drugs with a narrow therapeutic window is a complex task. Several computer systems have been designed to help doctors determine optimum drug dosage. Significant improvements in health care could be achieved if computer advice improved health outcomes and could be implemented in routine practice in a cost effective fashion. This is an updated version of an earlier Cochrane systematic review, by Walton et al, published in 2001. OBJECTIVES: To assess whether computerised advice on drug dosage has beneficial effects on the process or outcome of health care. SEARCH STRATEGY: We searched the Cochrane Effective Practice and Organisation of Care Group specialized register (June 1996 to December 2006), MEDLINE (1966 to December 2006), EMBASE (1980 to December 2006), hand searched the journal Therapeutic Drug Monitoring (1979 to March 2007) and the Journal of the American Medical Informatics Association (1996 to March 2007) as well as reference lists from primary articles. SELECTION CRITERIA: Randomized controlled trials, controlled trials, controlled before and after studies and interrupted time series analyses of computerized advice on drug dosage were included. The participants were health professionals responsible for patient care. The outcomes were: any objectively measured change in the behaviour of the health care provider (such as changes in the dose of drug used); any change in the health of patients resulting from computerized advice (such as adverse reactions to drugs). DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and assessed study quality. MAIN RESULTS: Twenty-six comparisons (23 articles) were included (as compared to fifteen comparisons in the original review) including a wide range of drugs in inpatient and outpatient settings. Interventions usually targeted doctors although some studies attempted to influence prescriptions by pharmacists and nurses. Although all studies used reliable outcome measures, their quality was generally low. Computerized advice for drug dosage gave significant benefits by:1.increasing the initial dose (standardised mean difference 1.12, 95% CI 0.33 to 1.92)2.increasing serum concentrations (standradised mean difference 1.12, 95% CI 0.43 to 1.82)3.reducing the time to therapeutic stabilisation (standardised mean difference -0.55, 95%CI -1.03 to -0.08)4.reducing the risk of toxic drug level (rate ratio 0.45, 95% CI 0.30 to 0.70)5.reducing the length of hospital stay (standardised mean difference -0.35, 95% CI -0.52 to -0.17). AUTHORS' CONCLUSIONS: This review suggests that computerized advice for drug dosage has some benefits: it increased the initial dose of drug, increased serum drug concentrations and led to a more rapid therapeutic control. It also reduced the risk of toxic drug levels and the length of time spent in the hospital. However, it had no effect on adverse reactions. In addition, there was no evidence to suggest that some decision support technical features (such as its integration into a computer physician order entry system) or aspects of organization of care (such as the setting) could optimise the effect of computerised advice.

Análisis de viabilidad técnica-económica del parque eólico Altos de Peralta

RESUMEN La energia eolica se considera una forma indirecta de energia solar. Entre el 1 y 2% de la energia proveniente del sol se convierte en viento, debido al movimiento del aire ocasionado por el desigual calentamiento de la superficie terrestre. La energia cinetica del viento puede transformarse en energia util, tanto mecanica como electrica. La energia eolica, transformada en energia mecanica ha sido historicamente aprovechada, pero su uso para la generacion de energia electrica es mas reciente, en respuesta a la crisis del petroleo y a los impactos ambientales derivados del uso de combustibles. El objetivo principal de este trabajo es hacer un analisis de viabilidad desde un punto de vista tecnico y economico de un parque eolico situado en el municipio de Barasoain (Navarra). Desde el punto de vista tecnico se han estudiado los aspectos constructivos del parque considerando sus diferentes infraestructuras de obra civil y electrica asi como los niveles de recurso eolico. En el ambito economico y financiero se han analizado los aspectos y ratios mas relevantes que definen un proyecto de estas caracteristicas asi como el modelo de financiacion elegida basada en el Project- Finance. Entre las conclusiones mas destacadas de este proyecto cabe destacar la contribucion de la construccion del parque al desarrollo social y economico de la zona donde queda ubicado contribuyendo a la creacion de puestos de trabajo, tanto en la fase de construccion como de explotacion y una perfecta armonia con condicionantes medioambientales de la zona. El analisis tecnico realizado nos indica la viabilidad tecnica del parque tanto desde el punto de vista de recurso eolico como la idoneidad para poder evacuar la energia producida. Por otro lado, los resultados obtenidos cumplen perfectamente con los estandares requeridos por los financiadores de los parques y resultando ser muy atractivos para sus accionistas