Un modelo de educación trilingüe. El sistema educativo del Valle de Áran. Descripción, actitudes y perspectivas

La comarca del Valle de Arán se encuentra situada en el extremo noroccidental de la provincia de Lleida, en plenos Pirineos. En las últimas décadas, este territorio se encuentra inmerso en un proceso de transformación cultural. La situación viene marcada por varios aspectos: a) un fuerte incremento de población, proveniente principalmente de la inmigración; b) la coexistecia en el territorio de tres lenguas oficiales: el occitano-aranés, como lengua propia de la comarca, el catalán y el castellano, y c) una situación de contacto entre lenguas y culturas bastante diferenciadas. El artículo presenta el proceso de transformación que ha sufrido el sistema educativo en el Valle de Arán en los últimos 20 años, caracterizado principalmente por el paso de un modelo de educación monolingüe a un modelo de educación trilingüe.

Densidade de plantio na produtividade e nos teores de nutrientes nas folhas e frutos da bananeira cv. Thap Maeo

O objetivo deste estudo foi avaliar o efeito da densidade de plantio na produtividade, tempo de colheita e teores dos nutrientes nas folhas e nos frutos de bananeira cv. Thap Maeo (AAB) cultivada em Manaus (AM). O delineamento experimental foi o de blocos casualizados, com três repetições. Os tratamentos foram constituídos pelos fatores: três densidades de plantio (1.111; 1.667 e 3.333 plantas ha-1) e duas épocas de colheita (primeiro e segundo ciclos). Os resultados do primeiro e segundo ciclos mostraram incremento significativo da produtividade, com aumento da densidade de plantio. O tempo médio para colheita dos cachos foi menor na densidade de 1.111 plantas ha-1 (1º ciclo, 338 e 2º ciclo, 401 dias). Na média das densidades e independentemente do ciclo, os teores de macronutrientes nos frutos apresentaram a ordem de: K>N>P>Mg>Ca=S, enquanto a dos micronutrientes foi: 1º ciclo - Cl>Fe>Mn=B>Zn>Cu e 2º ciclo - Cl>Fe>Zn>B=Mn>Cu.

Implementación de una herramienta de metabúsqueda : MetaLib y SFX

L'article presenta les característiques i funcionalitats principals de les eines MetaLib i SFX, programaris per a la gestió i accés als recursos electrònics. S'analitzen els programaris citant els diferents tipus de funcionalitats, i la gestió i el manteniment. El procés s'emmarca en l'experiència de la Universitat Oberta de Catalunya, membre del CBUC, i se n'expliquen la configuració, els reptes i les dificultats que es van produir durant la implementació dels sistemes.

Soodakattilan energiatehokkuuden ja -taseen laskenta

Tämä diplomityö on tehty UPM-Kymmene Oy:n Tervasaaren tehtaalle. Työn tavoitteena oli määrittää soodakattilan energiatase. Määritellyn taseen avulla voitiin tutkia kattilan energiatehokkuutta. Soodakattilan savukaasupuolen ja vesihöyrypiirin energiataseet mallinnettiin taulukkolaskentaohjelmaan. Lähtöarvojen selvittämiseksi suoritettiin yksi mittausjakso. Laskettujen savukaasupuolen ja vesihöyrypiirin tasetulosten ero oli vain 0,4 % hyödyksi saatavien lämpöenergioiden suhteen. Savukaasupuolen energiataseessa käytettiin polttoaineiden tehollisia lämpöarvoja. Lisäksi lipeän määritettyä tehollista lämpöarvoa korjattiin erillisellä kertoimella. Kattilan energiatehokkuuden tarkasteluun valittiin muuttujiksi poltettavan lipeän laatu ja lipeän kuiva-aine sekä nuohoushöyrymäärä ja ilmakerroin. Lasketuista tuloksista voitiin havaita, että siirryttäessä nykyisestä polttolipeän poltosta pelkään sulfaattipohjaisen lipeän polttoon, saavutetaan säästöjä 2,33…3,10 milj.€/a. Myös nuohoushöyrymäärän ja ilmakertoimen muutoksilla todettiin saavutettavan säästöjä.

Capturing diagnosis-timing in ICD-coded hospital data: recommendations from the WHO ICD-11 topic advisory group on quality and safety.

PURPOSE: To develop a consensus opinion regarding capturing diagnosis-timing in coded hospital data. METHODS: As part of the World Health Organization International Classification of Diseases-11th Revision initiative, the Quality and Safety Topic Advisory Group is charged with enhancing the capture of quality and patient safety information in morbidity data sets. One such feature is a diagnosis-timing flag. The Group has undertaken a narrative literature review, scanned national experiences focusing on countries currently using timing flags, and held a series of meetings to derive formal recommendations regarding diagnosis-timing reporting. RESULTS: The completeness of diagnosis-timing reporting continues to improve with experience and use; studies indicate that it enhances risk-adjustment and may have a substantial impact on hospital performance estimates, especially for conditions/procedures that involve acutely ill patients. However, studies suggest that its reliability varies, is better for surgical than medical patients (kappa in hip fracture patients of 0.7-1.0 versus kappa in pneumonia of 0.2-0.6) and is dependent on coder training and setting. It may allow simpler and more precise specification of quality indicators. CONCLUSIONS: As the evidence indicates that a diagnosis-timing flag improves the ability of routinely collected, coded hospital data to support outcomes research and the development of quality and safety indicators, the Group recommends that a classification of 'arising after admission' (yes/no), with permitted designations of 'unknown or clinically undetermined', will facilitate coding while providing flexibility when there is uncertainty. Clear coding standards and guidelines with ongoing coder education will be necessary to ensure reliability of the diagnosis-timing flag.

Epidemiology and outcome of fungemia in a cancer Cohort of the Infectious Diseases Group (IDG) of the European Organization for Research and Treatment of Cancer (EORTC 65031).

BACKGROUND: Anti-cancer treatment and the cancer population have evolved since the last European Organisation for Research and Treatment of Cancer (EORTC) fungemia survey, and there are few recent large epidemiological studies. METHODS: This was a prospective cohort study including 145 030 admissions of patients with cancer from 13 EORTC centers. Incidence, clinical characteristics, and outcome of fungemia were analyzed. RESULTS: Fungemia occurred in 333 (0.23%; 95% confidence interval [CI], .21-.26) patients, ranging from 0.15% in patients with solid tumors to 1.55% in hematopoietic stem cell transplantation recipients. In 297 evaluable patients age ranged from 17 to 88 years (median 56 years), 144 (48%) patients were female, 165 (56%) had solid tumors, and 140 (47%) had hematological malignancies. Fungemia including polymicrobial infection was due to: Candida spp. in 267 (90%), C. albicans in 128 (48%), and other Candida spp. in 145 (54%) patients. Favorable overall response was achieved in 113 (46.5%) patients by week 2. After 4 weeks, the survival rate was 64% (95% CI, 59%-70%) and was not significantly different between Candida spp. Multivariable logistic regression identified baseline septic shock (odds ratio [OR] 3.04, 95% CI, 1.22-7.58) and tachypnoea as poor prognostic factors (OR 2.95, 95% CI, 1.66-5.24), while antifungal prophylaxis prior to fungemia (OR 0.20, 95% CI, .06-.62) and remission of underlying cancer (OR, 0.18; 95% CI, .06-.50) were protective. CONCLUSIONS: Fungemia, mostly due to Candida spp., was rare in cancer patients from EORTC centers but was associated with substantial mortality. Antifungal prophylaxis and remission of cancer predicted better survival.

Clinical Development Strategies and Outcomes in First-in-Human Trials of Monoclonal Antibodies.

PURPOSE: We conducted a comprehensive review of the design, implementation, and outcome of first-in-human (FIH) trials of monoclonal antibodies (mAbs) to clearly determine early clinical development strategies for this class of compounds. METHODS: We performed a PubMed search using appropriate terms to identify reports of FIH trials of mAbs published in peer-reviewed journals between January 2000 and April 2013. RESULTS: A total of 82 publications describing FIH trials were selected for analysis. Only 27 articles (33%) reported the criteria used for selecting the starting dose (SD). Dose escalation was performed using rule-based methods in 66 trials (80%). The median number of planned dose levels was five (range, two to 13). The median of the ratio between the highest planned dose and the SD was 27 (range, two to 3,333). Although in 56 studies (68%) at least one grade 3 or 4 toxicity event was reported, no dose-limiting toxicity was observed in 47 trials (57%). The highest planned dose was reached in all trials, but the maximum-tolerated dose (MTD) was defined in only 13 studies (16%). The median of the ratio between MTD and SD was eight (range, four to 1,000). The recommended phase II dose was indicated in 34 studies (41%), but in 25 (73%) of these trials, this dose was chosen without considering toxicity as the main selection criterion. CONCLUSION: This literature review highlights the broad design heterogeneity of FIH trials testing mAbs. Because of the limited observed toxicity, the MTD was infrequently reached, and therefore, the recommended phase II dose for subsequent clinical trials was only tentatively defined.

Self-reported nonadherence to antiretroviral therapy as a predictor of viral failure and mortality

OBJECTIVE: To determine the effect of nonadherence to antiretroviral therapy (ART) on virologic failure and mortality in naive individuals starting ART. DESIGN: Prospective observational cohort study. METHODS: Eligible individuals enrolled in the Swiss HIV Cohort Study, started ART between 2003 and 2012, and provided adherence data on at least one biannual clinical visit. Adherence was defined as missed doses (none, one, two, or more than two) and percentage adherence (>95, 90-95, and <90) in the previous 4 weeks. Inverse probability weighting of marginal structural models was used to estimate the effect of nonadherence on viral failure (HIV-1 viral load >500 copies/ml) and mortality. RESULTS: Of 3150 individuals followed for a median 4.7 years, 480 (15.2%) experienced viral failure and 104 (3.3%) died, 1155 (36.6%) reported missing one dose, 414 (13.1%) two doses and, 333 (10.6%) more than two doses of ART. The risk of viral failure increased with each missed dose (one dose: hazard ratio [HR] 1.15, 95% confidence interval 0.79-1.67; two doses: 2.15, 1.31-3.53; more than two doses: 5.21, 2.96-9.18). The risk of death increased with more than two missed doses (HR 4.87, 2.21-10.73). Missing one to two doses of ART increased the risk of viral failure in those starting once-daily (HR 1.67, 1.11-2.50) compared with those starting twice-daily regimens (HR 0.99, 0.64-1.54, interaction P = 0.09). Consistent results were found for percentage adherence. CONCLUSION: Self-report of two or more missed doses of ART is associated with an increased risk of both viral failure and death. A simple adherence question helps identify patients at risk for negative clinical outcomes and offers opportunities for intervention.

Evolution of the Helvetic shelf (Switzerland) during the Barremian-early Aptian : paleoenvironmental, paleogeographic and paleoceanographic controlling factors

The Early Cretaceous has experienced the development of large shallow-water carbonate platform in tropical and subtropical regions, favoured by exceptionally warm climatic conditions, optimal trophic conditions and a suitable tectonic and paleogeographic context. This period was also characterized by shorter intervals, in which the widespread deposition of marine sediments enriched in organic matter occurred ("oceanic anoxic episodes": OAE). This study focuses on the Barremian- Aptian interval, during which the Urgonian platform developed throughout the northern Tethyan passive margin. Due to the Alpine orogeny, sediments belonging to this platform - named locally Schrattenkalk Formation, are presently outcropping in the Helvetic Alps. This study aims to reconstruct the paleogeographic evolution of the Helvetic platform, and to define the environmental and oceanographic factors, which influenced its development. Several key episodes in the life of this platform have been identified: - The installation of the platform, covering hemipelagic sediments of the Drusberg Member, near the limit between the early and late Barremian. - The temporary change of carbonate production type during the basal Aptian, with the deposition of the Rawil Member. - And finally the definitive interruption of photozoan carbonate platform sedimentation in the study area, during the early Aptian. The sedimentological, biostratigraphical and chemostratigraphic (8I3C) data lead to the sequential subdivision of eleven sections and one core, located throughout the different Helvetic nappes of Switzerland. The sequence stratigraphie framework, initially defined for the Urgonian carbonate platform of the Vercors area (SE France), is confirmed in the Helvetic nappes, where the same number of sequences was observed. Many similarities between these two areas are put forward in this work. The sequence stratigraphie framework helped to highlight the installation of a bioclastic body, included in the Schrattenkalk Formation, since the middle Early Barremian (sequence B2). The age of the installation of the rudist-rich limestone, which corresponds to the Urgonian facies sensu stricto, is attributed to the late Barremian (maximum flooding surface of the sequence B3). This age coincides with the one determined in other northern Tethyan areas for the installation of the Urgonian platform. The results of this study show a strong tectonic control of the platform architecture, with the presence of syn-sedimentary faults in a perpendicular position to the progradation direction of the platform. The presence of these faults was highlighted by the study of the evolution of the microfacies distribution and by thickness variations in different areas. Sea level fluctuations also played an important role in the various life phases of the platform. Three major falls in sea level have been identified. A significant emersion of the proximal domain has been observed, involving an important drop of the relative sea level, leading to the exposure of the Drusberg Member hemipelagic series. A second major drop in sea level is identified near the Barremian-Aptian boundary, and a third is registered on the top of the Upper Schrattenkalk Member on the whole platform; it is associated with a karst affecting the underlying limestones to a depth of over 20 meters. This observation sheds new light on the conditions linked to the demise of Urgonian platform, which was strongly influenced by this phase of emersion.

Impact of Aldosterone Antagonists on Sudden Cardiac Death Prevention in Heart Failure and Post-Myocardial Infarction Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

BACKGROUND AND OBJECTIVES: Sudden cardiac death (SCD) is a severe burden of modern medicine. Aldosterone antagonist is publicized as effective in reducing mortality in patients with heart failure (HF) or post myocardial infarction (MI). Our study aimed to assess the efficacy of AAs on mortality including SCD, hospitalization admission and several common adverse effects. METHODS: We searched Embase, PubMed, Web of Science, Cochrane library and clinicaltrial.gov for randomized controlled trials (RCTs) assigning AAs in patients with HF or post MI through May 2015. The comparator included standard medication or placebo, or both. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Event rates were compared using a random effects model. Prospective RCTs of AAs with durations of at least 8 weeks were selected if they included at least one of the following outcomes: SCD, all-cause/cardiovascular mortality, all-cause/cardiovascular hospitalization and common side effects (hyperkalemia, renal function degradation and gynecomastia). RESULTS: Data from 19,333 patients enrolled in 25 trials were included. In patients with HF, this treatment significantly reduced the risk of SCD by 19% (RR 0.81; 95% CI, 0.67-0.98; p = 0.03); all-cause mortality by 19% (RR 0.81; 95% CI, 0.74-0.88, p<0.00001) and cardiovascular death by 21% (RR 0.79; 95% CI, 0.70-0.89, p<0.00001). In patients with post-MI, the matching reduced risks were 20% (RR 0.80; 95% CI, 0.66-0.98; p = 0.03), 15% (RR 0.85; 95% CI, 0.76-0.95, p = 0.003) and 17% (RR 0.83; 95% CI, 0.74-0.94, p = 0.003), respectively. Concerning both subgroups, the relative risks respectively decreased by 19% (RR 0.81; 95% CI, 0.71-0.92; p = 0.002) for SCD, 18% (RR 0.82; 95% CI, 0.77-0.88, p < 0.0001) for all-cause mortality and 20% (RR 0.80; 95% CI, 0.74-0.87, p < 0.0001) for cardiovascular mortality in patients treated with AAs. As well, hospitalizations were significantly reduced, while common adverse effects were significantly increased. CONCLUSION: Aldosterone antagonists appear to be effective in reducing SCD and other mortality events, compared with placebo or standard medication in patients with HF and/or after a MI.

Is Switzerland doing enough regarding the prevention of syphilis, gonorrhea and chlamydia infections ?

Sexually transmitted infections are a major problem for medicine and for public health services worldwide. More than 30 sexually transmittable pathogenic micro-organisms are known, including bacteria, viruses, fungi, protozoa and ectoparasites. According to estimates from the World Health Organisation more than 333 million of bacterial sexually transmitted infections occur worldwide per year. Sexually transmitted infections, by their nature, affect individuals, within partnerships and larger sexual networks, and in turn populations. This report focuses on three bacterial sexually transmitted infections in Switzerland that are Chlamydia trachomatis, Neisseria gonorrhea and Treponema pallidum (syphilis) in Switzerland. The prevalence of these infections has been increasing alarmingly for a decade. All three infections can be asymptomatic and their diagnosis and treatment can therefore occur too late or worse not at all, even though treatments are available. This is an important problem as untreated sexually transmitted infections may cause complications such as ascending infections, infertility, ectopic pregnancies and serious long-term neurological sequels. The consequences of these infections should not be underestimated. They constitute a significant public health burden as well as serious financial burden. The increases in chlamydia, syphilis and gonorrhea infections have also been observed in many European countries. Countries, where rising numbers of sexually transmitted infections have been observed, have reacted in different ways. Some have developed clinical guidelines or implemented screening programs, while others are still in their observational phase. The aim of this mémoire is to assess whether Switzerland is doing enough regarding the prevention of chlamydial, syphilis and gonorrheal infections. After first describing the infections, surveillance systems of sexually transmitted infections are assessed, then the epidemiological trends of these three infections are described, and finally the prevention measures implemented in Switzerland to respond to the increasing number of infections are described. The reaction of the United Kingdom to the same problem is reported for comparison. [Author, p. 7]

Regressiomenetelmien vertailu männiköiden läpimittajakaumien ennustamiseksi ojitusalueilla

Seloste artikkelista: Siipilehto, J., Sarkkola, S. & Mehtätalo, L. 2007. Comparing regression estimation techniques when predicting diameter distributions of Scots pine on drained peatlands. Silva Fennica 4 (2): 333-349.

La participació de les províncies a la Unió Europea. Estudi comparat dels casos de Barcelona, Estocolm, Hannover, Lódz i Roma

L’actual context de crisi econòmica en què es troben molts dels països europeus sembla haver accelerat el debat territorial. Per una banda, alguns governs dels Estats membres han proposat unes reformes en la direcció de racionalitzar (i/o suprimir) els nombrosos nivells de govern que existeixen al llarg de la geografia europea. Per l’altra, la Unió Europea (UE) segueix apostant per una major participació dels ens territorials en les diferents fases del procés de presa de decisions comunitari. El present treball tracta de descriure i observar el paper dels governs locals intermedis en el procés de presa de decisions europeu amb l’objectiu de d’analitzar l’impacte del procés d’integració europea sobre el context territorial. La pregunta de recerca s'ha centrat en entendre com i de quina manera els ens locals intermedis poden participar e influir a la presa de decisions europea. La metodologia de l’estudi es basa en una anàlisi comparativa que inclou cinc autoritats locals intermèdies de cinc Estats membres: la Diputació de Barcelona (Espanya), el Landkreis d’Hannover (Alemanya), el powiat de Łódź (Polònia), la provincia de Roma (Itàlia) i el lan d’Estocolm (Suècia).

Pilarização de esmectita brasileira para fins catalíticos. Emprego de argila pilarizada na alquilação de benzeno com 1-dodeceno

Al-pillared clay was prepared with a Brazilian bentonite from the Campina Grande region (Paraíba, BRAZIL). It was intercalated at 298 K, during 48 hours, with a solution containing [Al3+] = 0.10 mol/L and molar ratio OH/Al = 2.0 prepared at 333 K, and was calcined at 773K. The catalytic activity was evaluated by alkylation of benzene with 1-dodecene. The characterization methods were: X-ray fluorescence and diffraction analysis; 27Al, 29Si and 23Na MAS NMR and textural analysis by N2 adsorption. The thermal stability of the natural clay was improved by the pillaring procedure, as well as the catalytic activity. The intercalated clay presented the highest initial rate of reaction among the systems tested.