How to manage a virtual library?

Introduction. The Andalusian Public Health System Virtual Library (Biblioteca Virtual del Sistema Sanitario Público de Andalucía, BV-SSPA) was created in June 2006, after being determined by the II Quality Plan in the key process Guarantee the Knowledge Exchange into the Health System which was established by the Strategy IV, Knowledge Management, 2005-2008. It is a government strategy with its own budget and management with the aim of rationalizing the subscriptions into the Andalusian Health System and democratizing the health professional access to qualify scientific information, regardless of the professional workplace. Andalusia is a wide region with more than 8 million inhabitants, more than 90,000 health professionals for 41 hospitals, 1,500 primary healthcare centres, and 12 centres for non-medical attention purposes, and the Virtual Library was created to cover all this Health Services. Before the creation of the BV-SSPA every centre had its own budget and management decisions concerning scientific resources, with the creation of the BV-SSPA both management and budget were centralized. Objectives. With this work we pretend to analyze if the results after these five years have reached the expectations from an economic point of view and determine if really we can offer a benefit to the Andalusian Professional and Society in general. We will demonstrate the following: - The BV-SSPA supposed a cost reduction. It meant cost-effectiveness. - It resulted in Economics of Scale, as we have every year more resources and services investing a minor proportional amount of money. - In terms of Efficiency it implemented more services than the System had before its creation, we a lower budget. Methods. The BV-SSPA was appointed the only intermediary for contracting electronic resources destined to the Andalusian Health System. This had some consequences which should be analyzed: - Hospitals were not allowed to subscribe any resources. - Services offered for the whole System. - A remote access system was created. - Tools to give more visibility to the Public Health System were developed. - Negotiations techniques changed as the BV-SSPA is stronger than individual hospitals. Results. - The amount of 2,431 electronic reviews, 8 data bases and other scientific information resources at the disposal of the Andalusian Health System Professionals and available worldwide requiring only an internet connection. Before the BV-SSPA, 5,267 titles were subscribed by hospital and 2,967 of them were subscribed repeatedly (by two or more hospitals), this represented more than 55%. The rationalization of the subscription investment has been reached. - The establishment of several important scientific services for the whole territory of Andalusia, not only big hospitals. - The use of appropriate tools through a Web 2.0 and Social Media to be acknowledged by most National Health Professionals. Conclusions. It has been demonstrated that the BV-SSPA has become the Central Unit for purchasing, offering librarian services and a reference for users in terms of knowledge management, but from the point of view of business it has also obtained the following results: - Cost-Effectiveness: Its budget for subscriptions is lower than the hospital former one in a 30% and now more electronic resources are available. - Economics of Scale: Near 95,000 health professionals can access this Virtual Library in 2010. Before its creation Professionals for small hospital and Primary Care centres were not able to access to scientific information subscribed by big hospitals. - Efficiency Besides the central electronic purchasing, services were created for the System, without increasing the expenses: - Remote access to all the library resources independent of the user’s location. The BV-SSPA usage increased in a 147% in 2008, when it was installed. - The Document Supply Service implemented in 2009. - The Institutional Repository which contains the whole intellectual, scientific production generated by the Andalusian Public Health Professionals as a result of their healthcare, research or managing activity. - The creation of an application developed by the BV-SSPA to study the Andalusian Health System Scientific Production. - The visibility of the Andalusian Health System reached thanks to the BV-SSPA, through the numerous events in which it participates and organizes such as the 2nd. European National Digital Libraries of Health Conferences and the National Conference of Health Science Information and Documentation held in Cadiz in 2010; and its profile in social media where it can be contacted by citizens and health professionals all over the world. - Negotiation with electronic resource suppliers is much more advantageous as the BV-SSPA is stronger to deal with them thanks to its consolidated budget, its managing independence and its visibility.

Boost converter

In this project, we want to implement a theoretical typology of a converter, the Boost converter, which is also named “Step-up converter”. We also want to bring it to the practical area, where we could work and obtain a useful service, particularly our objective is to obtain a power supply for a notebook. We will give the possibility to work, charge etc. our device in the car and obtain another work station

Study of a measles outbreak in Granada with preventive measures applied by the courts, Spain, 2010 to 2011.

Measles had practically been eliminated in Granada since the systematic vaccination of children with two doses introduced in 1984. However, in 2009 the disease returned in the form of small outbreaks. This study describes the measles outbreak that occurred in Granada from October 2010 to August 2011 and the measures imposed to control it. Information was sourced from the records of the Andalusian epidemiological surveillance system. A total of 308 cases were recorded, representing an incidence rate of 33.6 cases per 100,000 inhabitants. The first wave of the epidemic took place in Granada city, with the majority of cases occurring among families who lived in the Albaycín neighbourhood and were opposed to vaccination for ideological and/or religious reasons. The initial cases were in unvaccinated children aged 1 to 13 years. The outbreak later spread throughout the province. To control the outbreak, the vaccination schedule for the exposed children was brought up to date. The Regional Ministry of Health decided to take legal action in order to ensure vaccination of those in the initial nucleus of the outbreak.

Are there positive emotions in short-term dynamic psychotherapy or is it all Freude-less ?

Psychodynamic therapists are often suspicious of positive emotions and consider them to be nothing more than a form of denial or of another defense aiming to diminish painful or difficult affects. Positive emotions seem to exist only through the absence of negative emotions or as something that may happen outside of therapy. On the other hand, clinicians also agree that psychoanalytic work could not be successful without such positive emotions as interest, pleasure, surprise and creativity. Contemporary psychoanalytic thinking and new research findings in the area of relationship regulation are likely to give positive emotions an increasingly prominent place in dynamically oriented therapies. With today's emphasis on the therapeutic relationship and intersubjectivity, the time appears right to integrate positive emotions more formally into psychodynamic clinical theories.

Avaluació del projecte "Nightingale/Rossinyol": projecte de mentoria amb estudiants universitaris adreçat a alumnes d'origen estranger

La recerca que aquí es presenta es centra en tres objectius. Primerament, obtenir informació d’altres experiències de mentoria d’alumnat immigrat desenvolupades en altres països (Alemanya, Àustria, Eslovènia, Estats Units, Israel, Noruega, Suècia, Suïssa, etc.) amb l’objectiu d’elaborar un marc teòric sòlid que ajudi a argumentar científicament el projecte "Rossinyol". Aquest objectiu s’ha treballat mitjançant la recerca bibliogràfica i documental a nivell nacional, estatal i internacional. Posteriorment, realitzar una primera anàlisi dels ímputs que aporta el projecte Rossinyol al territori on es porta a terme. Mitjançant l’elaboració i passi d’una entrevista a mentors, mestres (dels mentorats) i enllaços territorials (persones del territori que es posen en contacte amb les escoles per seleccionar els mentorats –entre d’altres tasques-) s’ha analitzat: els punts forts i febles del projecte, els possibles efectes de la mentoria en el mentorat i el tipus de relacions que s’han establert entre els agents que participen en el projecte. Finalment, establir uns criteris d’avaluació que permetin donar pautes per desenvolupar aquest projecte –o projectes similars de mentoria- en altres llocs del nostre país. En aquest apartat del treball s’ha elaborat una proposta d’indicadors amb el conseqüent instrument per, en una fase posterior, recollir informació que permetin fer un seguiment acurat, objectiu i extens del projecte.

Use of mobile devices to answer online surveys: implications for research.

BACKGROUND: There is a growing use of mobile devices to access the Internet. We examined whether participants who used a mobile device to access a brief online survey were quicker to respond to the survey but also, less likely to complete it than participants using a traditional web browser. FINDINGS: Using data from a recently completed online intervention trial, we found that participants using mobile devices were quicker to access the survey but less likely to complete it compared to participants using a traditional web browser. More concerning, mobile device users were also less likely to respond to a request to complete a six week follow-up survey compared to those using traditional web browsers. CONCLUSIONS: With roughly a third of participants using mobile devices to answer an online survey in this study, the impact of mobile device usage on survey completion rates is a concern. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01521078.

Setting up a Common European Asylum System : Report on the application of existing instruments and proposals for the new system

The study assesses firstly the evaluation process of the first generation of asylum instruments while underlining the possibilities to improve it. It analyses secondly the asylum "acquis" regarding distribution of refugees between Member States, the eligibility for protection, the status of protected persons regarding detention and vulnerability, asylum procedures and the external dimension by formulating short-term recommendations of each area. Its last part is devoted to the long term evolution of the Common European Asylum System regarding the legal context including the accession of the EU to the Geneva Convention, the institutional perspectives including the new European Support Office, the jurisdictional perspective, the substantive perspective, the distributive perspective and the external perspective.

Human large granular lymphocytes contain an esterase activity usually considered as specific for the myeloid series.

A cytochemical marker such as alpha-naphthyl acetate esterase (ANAE) has been found useful for the morphological identification of the subset of T lymphocytes having receptors for Fcμ (TM cells). ANAE reaction on TM cells gives a typical pattern of one to four positive spots, whereas this pattern is not found on T cells with receptors for Fcγ (TG cells). ANAE is abundant in monocytes but not detectable in granulocytes. Herein another type of esterase activity, naphthol-AS-D chloroacetate esterase (NCAE), is described; it is known to be abundant in granulocytes and was found to give a specific pattern of reactivity with the subpopulation of large granular lymphocytes (LGL). This pattern of fine granular staining was observed not only on LGL present in the TG cell subpopulation but also in LGL present in the non-T, non-B cells. Fractions of peripheral blood mononuclear cells which were ènriched up to 80% in LGL by Percoll discontinuous density gradient gave a similar percentage of specific NCAE pattern. In addition, among the different fractions from Percoll gradient, there was a good correlation (r = 0.94) between the number of NCAE-positive cells and the natural killer activity against the natural killer susceptible K562 target cells. It will be important to determine whether or not this enzymatic activity plays a role in the cytotoxic activities of LGL.

Relationship Between the Development of the Spinal Canal and the Etiopathogenesis of Lumbar Spinal Stenosis

INTRODUCTION: The presence of a pre-existing narrow spinal canal may have an important place in the ethiopathogenesis of lumbar spinal stenosis. By consequence the study of the development of the spinal canal is crucial. The first goal of this work is to do a comprehensive literature search and to give an essential view on the development of spinal canal and its depending factors studied until now. The second goal is to give some considerations and hypothesize new leads for clinically useful researches. MATERIALS AND METHODS: A bibliographical research was executed using different search engines: PubMed, Google Schoolar ©, Ovid ® and Web Of Science ©. Free sources and avaible from the University of Lausanne (UNIL) and Centre Hospitalier Universitaire Vaudois (CHUV) were used. At the end of the bibliographic researches 114 references were found, 85 were free access and just 41 were cited in this work. Most of the found references are in English or in French. RESULTS AND DISCUSSION: The spinal canal is principally limited by the vertebrae which have a mesodermal origin. The nervous (ectodermal) tissue significantly influences the growth of the canal. The most important structure participating in the spinal canal growth is the neurocentral synchondrosis in almost the entire vertebral column. The fusion of the half posterior arches seems to have less importance for the canal size. The growth is not homogeneous but, depends on the vertebral level. Timing, rate and growth potentials differ by regions. Especially in the case of the lumbar segment, there is a craniocaudal tendency which entails a greater post-natal catch-up growth for distal vertebrae. Trefoil-shape of the L5 canal is the consequence of a sagittal growth deficiency. The spinal canal shares some developmental characteristics with different structures and systems, especially with the central nervous system. It may be the consequence of the embryological origin. It is supposed that not all the related structures would be affected by a growth impairment because of the different catch-up potentials. Studies found that narrower spinal canals might be related with cardiovascular and gastrointestinal symptoms, lower thymic function, bone mineral content, dental hypoplasia and Harris' lines. Anthropometric correlations found at birth disappear during the pediatric age. All factors which can affect bone and nervous growth might be relevant. Genetic predispositions are the only factors that can never be changed but the real impact is to ascertain. During the antenatal period, all the elements determining a good supply of blood and oxygen may influence the vertebral canal development, for example smoking during pregnancy. Diet is a crucial factor having an impact on both antenatal and postnatal growth. Proteins intake is the only proved dietetic relationship found in the bibliographic research of this work. The mechanical effects due to locomotion changes are unknown. Socioeconomic situation has an impact on several influencing factors and it is difficult to study it owing to numerous bias. CONCLUSIONS: A correct growth of spinal canal is evidently relevant to prevent not-degenerative stenotic conditions. But a "congenital" narrower canal may aggravate degenerative stenosis. This concerns specific groups of patient. If the size of the canal is highly involved in the pathogenesis of common back pains, a hypothetical measure to prevent developmental impairments could have a not- negligible impact on the society. It would be interesting to study more about dietetic necessities for a good spinal canal development. Understanding the relationship between nervous tissues and vertebra it might be useful in identifying what is needed for the ideal development. Genetic importance and the post-natal influences of upright standing on the canal growth remain unsolved questions. All these tracks may have a double purpose: knowing if it is possible to decrease the incidence of narrower spinal canal and consequently finding possible preventive measures. The development of vertebral canal is a complex subject which ranges over a wide variety of fields. The knowledge of this subject is an indispensable tool to understand and hypothesize the influencing factors that might lead to stenotic conditions. Unfortunately, a lack of information makes difficult to have a complete and satisfactory interdisciplinary vision.

Les douze points-clés de la rééducation après une prothèse totale de genou [The 12 keypoints for rehabilitation after total knee arthroplasty].

The rehabilitation process after total knee arthroplasty (TKA) relies more and more on the family doctor. Many factors contribute to this development: the constantly increasing number of TKA performed, the reduced length of stay at the hospital and the rehabilitation process after TKA requiring care for 3 to 4 months. After this time, it is also of major importance to encourage patients to take up physical activities in order to limit the negative effects of sedentarity. The goal of this paper is to give family doctors an overview of the current knowledge in the area of rehabilitation after TKA for physicians.

Killing by lung cancer or by diabetes? The trade-off between smoking and obesity

As the prevalence of smoking has decreased to below 20%, health practitioners interest has shifted towards theprevalence of obesity, and reducing it is one of the major health challenges in decades to come. In this paper westudy the impact that the final product of the anti-smoking campaign, that is, smokers quitting the habit, had onaverage weight in the population. To these ends, we use data from the Behavioral Risk Factors Surveillance System,a large series of independent representative cross-sectional surveys. We construct a synthetic panel that allows us tocontrol for unobserved heterogeneity and we exploit the exogenous changes in taxes and regulations to instrumentthe endogenous decision to give up the habit of smoking. Our estimates, are very close to estimates issued in the 90sby the US Department of Health, and indicate that a 10% decrease in the incidence of smoking leads to an averageweight increase of 2.2 to 3 pounds, depending on choice of specification. In addition, we find evidence that the effectovershoots in the short run, although a significant part remains even after two years. However, when we split thesample between men and women, we only find a significant effect for men. Finally, the implicit elasticity of quittingsmoking to the probability of becoming obese is calculated at 0.58. This implies that the net benefit from reducingthe incidence of smoking by 1% is positive even though the cost to society is $0.6 billions.

Les adénocarcinomes kystiques de la glande lacrymale [Cystic adenocarcinomas of the lacrymal gland]

Adenoid cystic carcinoma of the lacrimal gland. BACKGROUND: Adenoid cystic carcinoma is the most frequent epithelial tumour of the lacrimal gland. It represents 1.6 % of the orbital tumours. The aim of this study is to present a series of such patients who were followed up in our clinic and to discuss their clinical management in order to achieve a better life prognosis. MATERIALS AND METHODS: The cases we followed up in our department were presented, the treatment modalities were discussed, and conclusions were drawn. RESULTS: Six patients with this pathology were examined, 3 men and 3 women, aged 31 to 69 years. A large excision was performed in 5 patients (exenteration alone or extended exenteration with complementary radiotherapy) and in 1 patient with excision of the tumour followed by radiotherapy. One patient died due to carcinoma six years after the first surgery. The median follow-up period of our cases is 25 months. CONCLUSION: Adenoid cystic carcinoma of the lacrimal gland is a malignant tumour with a reserved prognosis. Various treatments were proposed to improve the mortality rate of the disease. At present radical surgery with or without complementary therapy seems to give the best chances of healing, at least with short or mid-term follow-up.

Xarxa digital multimèdia de pantalles i kioscs interactius

Internet s’ha alçat en poc temps com el mitjà més utilitzat pels turistes per a planificar, organitzar i comprar un viatge, és per això que es proposa donar les mateixes facilitats en el destí. La Publicitat Dinàmica o “Digital Signage” és un nou servei de comunicació que consisteix en un conjunt de tecnologies i aplicacions informàtiques que permeten emetre missatges multimèdia i comunicar-se així d’una manera innovadora amb el públic objectiu de cada empresa, si s’afegeix un sistema independent, multimèdia i interactiu que pot utilitzar-se per a proporcionar informació i/o permetre la realització de transaccions es potencia al màxim el servei. D’aquesta manera es proposa crear una Xarxa Digital Multimèdia de Kioscs Interactius recolzats amb una pantalla de plasma per a la tecnologia Digital Signage. La ubicació escollida estratègicament és en un dels punts de major afluència turística, tal com l’entrada dels hotels. Així es tracta de crear circuits tancats en àrees geogràfiques on es troben els principals nuclis turístics de Mallorca. La possibilitat d’accedir a segments de població altament interessants per al producte o servei es multiplica al ser una manera fàcil, eficaç i altament suggestiva de promocionar el què es pretén. Un avantatge és la simplicitat de la infraestructura tecnològica que es necessita, el dispositiu mitjançant el qual es visualitzaran els missatges serà una pantalla de plasma convencional, i un terminal de punt de venda instal.lat en un lloc de pas. Cada mòdul està connectat a la xarxa ADSL mitjançant un servidor local a Internet. La connexió a la xarxa és imprescindible per a que el manteniment i actualització dels continguts es puguin efectuar remotament. L’objectiu principal d’aquest treball és estudiar la viabilitat de la implantació de la xarxa, mitjançant la realització d’un estudi de mercat on s’analitzen els grups claus per a la implantació: els hotelers, la indústria turística i el Govern Balear. S’identifiquen els beneficis que aportarà al nou servei i les repercussions que tendrà la seva instal.lació. Entre els resultats més destacats d’aquest estudi cal remarcar l’acceptació que ha tengut la idea entre els hotelers entrevistats i la resposta positiva de la indústria turística. Es reconeix: una millora de la imatge del sector, l’ús com a eina de promoció turística pel Govern, i la contribució a la sostenibilitat econòmica pel fet que augmenta la competitivitat de les empreses i això millora la qualitat del servei.

Iowa Efficiency Review Report to Governor Chet Culver and Lieutenant Governor Patty Judge, December 18,2009

Public Works is pleased to present the following Iowa Efficiency Review Report to Governor Chet Culver and Lieutenant Governor Patty Judge. This report is the product of a collaboration between our consulting team and very dedicated Iowa state employees who worked with us to share ideas and cost‐saving proposals under very difficult circumstances caused by the national financial crisis that is affecting state budgets throughout the country. For example, during the course of this review, Iowa departments were also asked to develop across‐the‐board cuts to achieve immediate reductions in state spending. It is a credit to Iowa state government that departmental staff continued to work on this Efficiency Review Report despite these challenges of also having to develop across‐the‐board budget cuts to achieve a balanced budget. We hope that these ideas will set the stage for further future budget improvements from achieving efficiencies, eliminating outdated practices, increasing the use of information technology solutions and finding new sources of non‐tax funding. The Efficiency Review Team faced a second challenge. Statewide Efficiency Reviews usually take from nine to 12 months to complete. In Iowa, we worked with dedicated department staff to complete our work in less than 4 months. The Governor challenged all of us to work intensely and to give him our best thinking on efficiency proposals so that he could act as quickly as possible to position state government for success over the next several years.

In Service to Iowa : Public Library Standards, 5th edition, 2010

The Standards and Accreditation program exists to encourage the ongoing development of high quality public library services in Iowa. In Service to Iowa: Public Library Standards is the manual for the State Library of Iowa’s standards program. It was first published in 1985 and was updated in 1989, 1997, 2004, and now in 2010. Iowa’s voluntary public library standards program was established to give public libraries a tool to identify strengths and areas for improvement. It is also used to document the condition of public library service in Iowa, to distribute Direct State Aid funding, and to meet statutory requirements. In 2010, the Iowa Commission of Libraries appointed the Public Library Standards Advisory Task Force to revise In Service to Iowa. The Task Force included members representing libraries from different size categories, the Iowa Commission of Libraries, Library Service Area staff, and State Library staff. All members support and stress the importance of the accreditation process and thank the Iowa public library community for its assistance.