Magnitud y frecuencia del transporte fluvial de sedimento en una cuenca mediterránea semihúmeda

Este trabajo examina la magnitud y la frecuencia del transporte de sedimento (material disuelto, sedimento en suspensión y carga de fondo) en la cuenca de la riera de Arbúcies (Cordilleras Costeras Catalanas), a partir de los caudales diarios del periodo 1967-1992 y de las muestras de agua y sedimento obtenidas durante los años 1991 y 1992. Los resultados indican que el transporte en disolución es más uniforme en el tiempo que el transporte de material sólido, tanto en suspensión como de fondo. Los cálculos muestran que la carga sólida total depende sobre todo de crecidas frecuentes y de magnitud moderada, correspondientes al nivel de cauce lleno (bankfull). Cabe señalar, en este sentido, que los caudales bankfull suceden el 2,2% del tiempo y transportan el 56% del sedimento en suspensión y el 31% de la carga de fondo total anual. El caudal efectivo para el transporte de sedimento en este río es, por tanto, un suceso relativamente frecuente y de idéntica magnitud al caudal geomorfológicamente dominante o bankfull.

Extension des prestations de type "équipe mobile" aux foyers socio-éducatifs: projet pilote dans le canton de Vaud [Extension of mobile team services to socio-educational home: pilot project in the Vaud canton].

L'objectif principal de ce projet d'extension des prestations, de type Antenne d'intervention dans le milieu pour enfants et adolescents (AIMEA) aux foyers socio-éducatifs pour l'ensemble du canton de Vaud, vise à décloisonner les champs socio-éducatifs et pédopsychiatriques. 64 patients ont fait l'objet d'une évaluation au cours de la phase pilote (après une année de fonctionnement). De plus, une enquête de satisfaction a été effectuée soit à la fin du suivi, soit à la fin de la phase pilote de ce projet (au 31.12.2012). Cette expérience très positive, relevée par une grande majorité des acteurs impliqués dans la prise en charge socio-éducative et pédopsychiatrique des mineurs, suscite un désir d'extension des prestations de type équipe mobile à d'autres structures ou à d'autres types de situations. The main objective of this project about mobile team service extension to the socio-educational home of the whole Vaud canton targets to decompartmentalize the socio-educational and youth-psychiatry domains. 64 patient were assessed during this pilot phase (after one-year functioning). In addition, a satisfaction survey was done either at the end of the follow up or at the end of the pilot phase of the project (31.12.2012). This experience was very positive as highlighted by the vast majority of the person involved in the socio-educational and youth-psychiatric domains taking care of youth. A desire of extension of mobile team service to other institutional structure or other situations was expressed.

[Place of volunteers in home care setting for taking care of individuals with Alzheimer's disease related dementia: Qualitative survey in a specialized unit] Place du bénévolat en EHPAD dans la prise en charge des personnes atteintes de la maladie d'Alzheimer ou démences apparentées : enquête qualitative dans une unité protégée.

Objectifs En EHPAD, selon les recommandations de la Haute Autorité de santé (HAS), la prise en charge non médicamenteuse des troubles psychocomportementaux associés à la maladie d'Alzheimer ou aux syndromes apparentés, implique une réorganisation, une formation spécifique du personnel et du temps. Se pose ici la question du rôle des bénévoles dans cette prise en charge. Matériels et méthodes Enquête descriptive à partir de questionnaires distribués aux différents intervenants (bénévoles, professionnels de santé et aidants familiaux) d'une unité protégée de l'EHPAD de la clinique du Diaconat (Colmar, France) et spécifiquement élaborés pour évaluer leur vécu de l'expérience de bénévolat dans la prise en charge des résidents souffrant d'une maladie d'Alzheimer ou d'un syndrome apparenté. Résultats Sur les 101 questionnaires qui ont été remplis, 85,7 % des aidants, 60 % des bénévoles et 42,1 % des professionnels constataient des bénéfices pour eux-mêmes. Les professionnels et les aidants avaient confiance dans l'intervention des bénévoles. Cependant, les bénévoles semblaient manquer de compétence pour le soutien des aidants et dans les techniques de communication avec les résidents. Les points essentiels pour permettre un fonctionnement harmonieux entre les différents intervenants étaient de bien définir préalablement le rôle de bénévoles et d'en informer les autres intervenants, de former les bénévoles à ce rôle et de favoriser la communication entre les bénévoles et les professionnels. Conclusion Cette enquête montre que les bénévoles ont une place aux côtés des équipes soignantes pour participer à la prise en charge non médicamenteuse des personnes atteintes de maladie d'Alzheimer ou syndromes apparentés. Ils ont une position singulière et jouent un rôle complémentaire de celui des soignants et des aidants. Objectives According to the recommendation of the French High Authority of Health (HAS), the non-pharmaceutical management of psycho-behavioural disorders associated with Alzheimer's disease or related disorders in a nursing home, involves reorganization an specific training for staff members and time. This raises the question of the role of volunteering in this approach. Materials and methods A descriptive survey using questionnaires distributed to various stakeholders (volunteers, healthcare professionals and caregivers) of a protected unit of the nursing home of the Diaconat clinic (Colmar, France) and specifically designed to assess their experience of the volunteering in supporting residents suffering from Alzheimer's diseases or related disorders. Results Of the 101 questionnaires that were filled in, 85.7% of caregivers, 60% of volunteers and 42.1% of professionals recorded benefits for themselves. Professionals and informal carers had confidence in the intervention of volunteers. However, volunteers seemed to lack skills to support informal caregivers and specific knowledge about the technique of communicating with residents. The key points to favor harmonious collaborations between the different stakeholders were: to properly define the role of volunteers and to inform other stakeholders about this role previously, and to specifically educate themselves in this task and to promote communication between volunteers and all other professionals. Conclusion This study shows that volunteers have a place alongside medical teams to participate in the non-pharmaceutical treatment for people with Alzheimer's disease or related syndromes. They have a unique position and play a complementary role to that of carers and informal caregivers.

Effect Estimation of an Innovative Nursing Intervention to Improve Delirium among Home-Dwelling Older Adults: A Randomized Controlled Pilot Trial.

AIMS: Estimating the effect of a nursing intervention in home-dwelling older adults on the occurrence and course of delirium and concomitant cognitive and functional impairment. METHODS: A randomized clinical pilot trial using a before/after design was conducted with older patients discharged from hospital who had a medical prescription to receive home care. A total of 51 patients were randomized into the experimental group (EG) and 52 patients into the control group (CG). Besides usual home care, nursing interventions were offered by a geriatric nurse specialist to the EG at 48 h, 72 h, 7 days, 14 days, and 21 days after discharge. All patients were monitored for symptoms of delirium using the Confusion Assessment Method. Cognitive and functional statuses were measured with the Mini-Mental State Examination and the Katz and Lawton Index. RESULTS: No statistical differences with regard to symptoms of delirium (p = 0.085), cognitive impairment (p = 0.151), and functional status (p = 0.235) were found between the EG and CG at study entry and at 1 month. After adjustment, statistical differences were found in favor of the EG for symptoms of delirium (p = 0.046), cognitive impairment (p = 0.015), and functional status (p = 0.033). CONCLUSION: Nursing interventions to detect delirium at home are feasible and accepted. The nursing interventions produced a promising effect to improve delirium.

Salivary cotinine concentrations in daily smokers in Barcelona, Spain: a cross-sectional study

Background: Characterizing and comparing the determinant of cotinine concentrations in different populations should facilitate a better understanding of smoking patterns and addiction. This study describes and characterizes determinants of salivary cotinine concentration in a sample of Spanish adult daily smoker men and women. Methods: A cross-sectional study was carried out between March 2004 and December 2005 in a representative sample of 1245 people from the general population of Barcelona, Spain. A standard questionnaire was used to gather information on active tobacco smoking and passive exposure, and a saliva specimen was obtained to determine salivary cotinine concentration. Two hundred and eleven adult smokers (>16 years old) with complete data were included in the analysis. Determinants of cotinine concentrations were assessed using linear regression models. Results: Salivary cotinine concentration was associated with the reported number of cigarettes smoked in the previous 24 hours (R2 = 0.339; p < 0.05). The inclusion of a quadratic component for number of cigarettes smoked in the regression analyses resulted in an improvement of the fit (R2 = 0.386; p < 0.05). Cotinine concentration differed significantly by sex, with men having higher levels. Conclusion: This study shows that salivary cotinine concentration is significantly associated with the number of cigarettes smoked and sex, but not with other smoking-related variables.

La institucionalització o l'educació de l'home com a problema

És molt estrany plantejar-se especular sobre la relació entre l'educació/ educador i el procés d'institucionalització, sobretot perquè es gairebé impossible que aquesta es pugui donar fora de la pròpia institució, o fora d'alguna institució, sigui quin sigui l'àmbit al qual es vulgui assignar. A més d'estrany és paradoxal, doncs és la pròpia institució la que disposa la producció de discursos que atenen a la seva definició, renovació, projecció i fins i tot deixa espai a la producció crítica. L'efecte d'aquestes capacitats ens assenyala una primera constatació: el procés d'institucionalització incrementa hist6ricament el seu desplegament sobre la superfície social i amb aix6 l'abast de les seves influencies.

Geofluid behaviour in successive extensional and compressional events: a case study from the southwestern end of the Vallès-Penedès Fault (Catalan Coastal Ranges, NE Spain)

The structural position of the Upper Jurassic-Lower Cretaceous carbonates located in the central part of the Catalan Coastal Ranges corresponds to the southwestern end of the Vallès-Penedès Fault. This fault was reactivated at different times during successive extensional and compressional events and several generations of fractures and cementations were formed.

Current status of pediatric home enteral nutrition in Spain: The importance of the NEPAD register

Home enteral nutrition (HEN) is a type of enteral nutrition (EN) which is becoming progressively more widespread in pediatrics due to the benefits it affords to patients, their families and to reducing hospital costs. However, the true extent of its use is unknown in Spain as the data-base set up for this purpose is still underused (Registro de Nutrición Enteral Pediátrica Ambulatoria y Domiciliaria -NEPAD-). More thorough registration of patients in the NEPAD online register will provide information about the characteristics of HEN in Spain: prevalence, diagnosis, the population sector being administered HEN, complications and developments. Likewise, forecast and planning of the necessary resources could be made while those in use could be analysed.

Efficacy and safety of once-daily aclidinium in chronic obstructive pulmonary disease

Background: The long-term efficacy and safety of aclidinium bromide, a novel, long-acting muscarinic antagonist, were investigated in patients with moderate to severe chronic obstructive pulmonary disease (COPD). Methods: In two double-blind, 52-week studies, ACCLAIM/COPD I (n = 843) and II (n = 804), patients were randomised to inhaled aclidinium 200 μg or placebo once-daily. Patients were required to have a postbronchodilator forced expiratory volume in 1 second (FEV1)/forced vital capacity ratio of ≤70% and FEV1 <80% of the predicted value. The primary endpoint was trough FEV1 at 12 and 28 weeks. Secondary endpoints were health status measured by St George"s Respiratory Questionnaire (SGRQ) and time to first moderate or severe COPD exacerbation. Results: At 12 and 28 weeks, aclidinium improved trough FEV1 versus placebo in ACCLAIM/COPD I (by 61 and 67 mL; both p < 0.001) and ACCLAIM/COPD II (by 63 and 59 mL; both p < 0.001). More patients had a SGRQ improvement ≥4 units at 52 weeks with aclidinium versus placebo in ACCLAIM/COPD I (48.1% versus 39.5%; p = 0.025) and ACCLAIM/COPD II (39.0% versus 32.8%; p = 0.074). The time to first exacerbation was significantly delayed by aclidinium in ACCLAIM/COPD II (hazard ratio [HR] 0.7; 95% confidence interval [CI] 0.55 to 0.92; p = 0.01), but not ACCLAIM/COPD I (HR 1.0; 95% CI 0.72 to 1.33; p = 0.9). Adverse events were minor in both studies. Conclusion: Aclidinium is effective and well tolerated in patients with moderate to severe COPD. Trial registration: ClinicalTrials.gov: NCT00363896 ACCLAIM/COPD I) and NCT00358436 (ACCLAIM/COPD II).

Implementing evidence-based patient and family education on oral anticoagulation therapy: a community-based participatory project.

AIMS AND OBJECTIVES: This study aimed at developing and implementing evidence-based patient and family education on oral anticoagulation therapy. BACKGROUND: The number of persons with chronic diseases who live at home is increasing. They have to manage multiple diseases and complex treatments. One such treatment is oral anticoagulation therapy, a high risk variable dose medication. Adherence to oral anticoagulation therapy is jeopardised by limited information about the medications, their risk and complications, the impact of individual daily routine and the limited inclusion of family members in education. Hence, improved and tailored education is essential for patients and families to manage oral anticoagulation therapy at home. DESIGN AND METHODS: A community-based participatory research design combined with the Precede-Proceed model was used including a systematic literature review, posteducation analysis, an online nurse survey, a documentation analysis and patient/family interviews. The study was conducted between April 2010-December 2012 at a department of general internal medicine in a teaching hospital in Switzerland. Participants were the department's nursing and medical professionals including the patients and their families. RESULTS: The evidence-based patient and family education on oral anticoagulation therapy emerged comprising a learning assessment, teaching units, clarification of responsibilities of nurse professionals and documentation guidelines. CONCLUSION AND CLINICAL RELEVANCE: The inclusion of the whole department has contributed to the development and implementation of this evidence-based patient family education on oral anticoagulation therapy, which encompasses local characteristics and patient preferences. This education is now being used throughout the department.

The Hercynian intrusive rocks of the Catalonian Coastal Ranges (NE Spain).

The hercynian outcrops of the Catalonian Coastal Ranges (NE Spain) consist mainly of Lower Permian-Upper Carboniferous, post-tectonic, epizona1 granitoid intrusions which form a typical applutonic calc-alkaline suite ranging from mafic hornblende gabbros and ultramafic olivine homblendites throught on alites and granodioritcs to leucogranites. This suite displays major andtrace-element characteristics and Sr isotope ratios similar to volcanic arc and post-collision magmatism oceanic lithosphere and to have been modified by contamination and is therefore believed to have formed above subducted with melts from the crust

Daily precipitation concentration across Europe 1971-2010

Daily Precipitation Concentration Index (CI) was used in this paper to investigate the statistical structure of daily precipitation across Europe based on 530 daily rainfall series for the period 1971-2010. Annual CI shows a North- West to South-East gradient (excluding Turkey and Greece). The same gradient is also observed in winter, spring and autumn, while in summer the gradient is North-South. Highest annual and seasonal daily concentrations of rainfall were detected in the western Mediterranean basin, mainly along Spanish and French coastlands. Latitude and distance from the sea seems to play a major role on spatial CI distribution; at subregional scale also relief plays an important role. The Mann-Kendall test did not identify uniform significant pattern in temporal trend across Europe for 1971-2010 period. The only broad areas with increasing annual and seasonal CI values are located in northern and south-western France and northern coastlands of the Iberian Peninsula. This findings suggest that daily precipitation distribution has not significantly changed during the 1971-2010 over Europe.

Laajakaistaliitynnät - xDSL-tekniikat ja muut vaihtoehdot

Tietoliikenteen suuria linjoja ovat mm. siirtonopeuksien kasvu, IP-tekniikan yleistyminen ja Internet-liitäntöjen kautta käytettävien palvelujen valtaisa lisääntyminen. Kotien verkkoliitännöissä eräänä haasteena on vielä tarjota kohtuullisilla kustannuksilla suuri liikennöintikapasiteetti, mikä voidaan tehdä usealla eri tavalla. Kotien laajakaistaiseen tulevaisuuteen johtaakin useita polkuja, joita tässä diplomityössä on kartoitettu. Työssä on esitelty erilaisia kotitalouksiin soveltuvia nopeita langallisia ja langattomia liitäntätekniikoita. Painopiste on nykyisessä valtavirrassa, kuparikaapelia käyttävässä xDSL-tekniikkaperheessä ja niihin pohjautuvissa verkoissa mukaan lukien ATM-pohjaiset runkoverkot Käytännön liitäntöjen laatua ja toimivuutta on selvitetty mittaamalla perinteistä ADSL-liitäntää sekä uudempaa tekniikkaa edustavaa SHDSL-liitäntää. Liittymiä mitattiin sekä xDSL-mittarilla että spektrianalysaattorilla. Mittauksissa kiinnitettiin huomiota kupariparien toimintaan, kuormituksen ja häiriöiden vaikutukseen sekä liittymän toimintaan käyttäjän kannalta. Mittauksissa todettiin, että kuparikaapeli sietää hyvin häiriöitä myös uusien tekniikoiden käytössä. Tulevaisuutta kartoitettiin haastattelututkimuksella, josta työhön on koostettu operaattoreiden, konsulttien ja käyttäjien näkemyksiä laajakaistaliitäntöjen ja niiden kautta saatavien palveluiden kehittymisestä. Tehty tutkimus osoittaa, että ADSL-tekniikka hyödyntää hyvin sille varattuja taajuusalueita. SHDSL-tekniikassa voidaan lähettää ja vastaanottaa suuria datamääriä molempiin suuntiin.

Hercynian Metamorphism in the Catalonian Coastal Ranges

Paleozoic rocks in the Catalonian Coastal Ranges are in their largestpart affectedby alow-tovery-low grade Hercynian metamorphism. Amphibolite facies conditions are only found in restricted areas such as the southwestern part of the Guilleries massif where upper amphibolite facies conditions are reached. Metamorphic grade increases from top to bottom of the Paleozoic stratigraphic sequence and the metamorphic peak is diachronous, being progressively older in the lower grade metamorphic zones. The isograd pattern, mineral assemblages, mineral chemistry and preserved reaction textures are consistent with a low pressure metamorphism possibly evolving from a previous Barrovian type event. The metamorphic climax in the high grade zone was reached after the seconddeformational phase. Calculatedpeak P-Tconditions are 620-640 OC and around 3.5 Kb . A latter episode of decompression from the maximum conditions to 1-2 Kb, with an associated temperature decrease to 530-550 OC, is recognized. The intrusion of late Hercynian granitoids produced contact metamorphic aureoles where the pyroxene-hornfels facies is locally reached.