Forecasting the need for medical specialists in Spain: application of a system dynamics model

[EN] Background: Spain has gone from a surplus to a shortage of medical doctors in very few years. Medium and long-term planning for health professionals has become a high priority for health authorities. Methods: We created a supply and demand/need simulation model for 43 medical specialties using system dynamics. The model includes demographic, education and labour market variables. Several scenarios were defined. Variables controllable by health planners can be set as parameters to simulate different scenarios. The model calculates the supply and the deficit or surplus. Experts set the ratio of specialists needed per 1000 inhabitants with a Delphi method. Results: In the scenario of the baseline model with moderate population growth, the deficit of medical specialists will grow from 2% at present (2800 specialists) to 14.3% in 2025 (almost 21 000). The specialties with the greatest medium-term shortages are Anesthesiology, Orthopedic and Traumatic Surgery, Pediatric Surgery, Plastic Aesthetic and Reparatory Surgery, Family and Community Medicine, Pediatrics, Radiology, and Urology. Conclusions: The model suggests the need to increase the number of students admitted to medical school. Training itineraries should be redesigned to facilitate mobility among specialties. In the meantime, the need to make more flexible the supply in the short term is being filled by the immigration of physicians from new members of the European Union and from Latin America.

An assessment of the concentrations of pharmaceutical compounds in wastewater treatment plants on the island of Gran Canaria(Spain)

[EN] An assessment of the concentrations of thirteen different therapeutic pharmaceutical compounds was conducted on water samples obtained from different wastewater treatment plants (WWTPs) using solid phase extraction and high- and ultra-high-performance liquid chromatography with mass spectrometry detection (HPLC-MS/MS and UHPLC-MS/MS), was carried out. The target compounds included ketoprofen and naproxen (anti-inflammatories), bezafibrate (lipid-regulating), carbamazepine (anticonvulsant), metamizole (analgesic), atenolol (?-blocker), paraxanthine (stimulant), fluoxetine (antidepressant), and levofloxacin, norfloxacin, ciprofloxacin, enrofloxacin and sarafloxacin (fluoroquinolone antibiotics). The relative standard deviations obtained in method were below 11%, while the detection and quantification limits were in the range of 0.3 ? 97.4 ng·L-1 and 1.1 ? 324.7 ng·L-1, respectively. The water samples were collected from two different WWTPs located on the island of Gran Canaria in Spain over a period of one year. The first WWTP (denoted as WWTP1) used conventional activated sludge for the treatment of wastewater, while the other plant (WWTP2) employed a membrane bioreactor system for wastewater treatment. Most of the pharmaceutical compounds detected in this study during the sampling periods were found to have concentrations ranging between 0.02 and 34.81 ?g·L-1.

CLIL materials in Secondary Education: focusing on the language of instruction in the subject area of Mathematics

[EN]Applying a CLIL methodological approach marks a shift in emphasis from language learning based on linguistic form and grammatical progression to a more ‘language acquisition’ one which takes account language functions. In this article we will study the elements of the “language of instruction” of the area of Maths in Secondary Education, by focusing on the analysis of the communicative functions, and the lexical and the cultural items present in the textbook in use. Our aim is to present the CLIL teacher with the linguistic and didactic implications that he or she should take into consideration when implementing the bilingual syllabuses with their students. In order to do that, we will present our conclusions emphasizing the need for coordination in different content areas, linguistic and communicative contents, between the foreign language teacher and the CLIL subject one.

Sedimentology and tectonic history of late Archaean sedimentary successions in Zimbabwe

ZusammenfassungSpätarchaische Sedimentgesteine (ca. 2,65 Milliarden Jahre alt) wurden in Grünsteingürteln des Simbabwe Kratons untersucht. In dem Belingwe Grünsteingürtel ist granitoides Grundgebirge von einer allochthonen Einheit aus vulkanischen Gesteinen und Vorlandbeckensedimenten überlagert. Die sedimentäre Abfolge besteht aus Flachwasserkalken und Turbiditen. Unterschiedliche Faziestypen der Kalksteine sind in sedimentäre Verflachungszyklen angeordnet. Eustatische Meeresspiegelschwankungen werden als Ursache der zyklischen Sedimentation angenommen. Sedimentologische, geochemische und strukturelle Analysen zeigen die Bedeutung horizontal-tektonischer Prozesse für die Entstehung dieses Grünsteingürtels an.Sedimentgesteine des Midlands Grünsteingürtels lagern zwischen ozeanischen, mafischen Vulkaniten und kontinentalen, granitoiden Gneisen. Die Art der Abfolge sedimentärer Fazies, beginnend mit Turbiditen und überlagert von flachmarinen Schelfsedimenten und alluvialen Ablagerungen, sowie geologische und geochemische Hinweise aus den benachbarten Gesteinsserien lassen auf Ablagerung während der Kollision zwischen einem ozeanischen Plateau/Inselbogen und einem kontinentalen Krustenfragmentes schließen.In dem Bindura-Shamva Grünsteingürtel können zwei Sedimentgesteinseinheiten unterschieden werden, eine alluvial—flachmarine Abfolge und eine tiefmarin—fluviatile Abfolge. Extensionstektonik verursachte wahrscheinlich die Bildung des Sedimentbeckens. Die spätere Phase der Beckenbildung war jedoch ähnlich jener in modernen Vorlandbecken.Schichtparallele Eisensteinhorizonte sind häufig entlang von Sediment-Vulkanit-Kontakten zu finden. Diese Gesteine werden als silifizierte und von Sulfiden imprägnierte Scherzonen interpretiert. Syntektonische hydrothermale Alteration von Gesteinen entlang der Störungszonen führte zur Bildung dieser 'tektonischen Eisensteine'.

Talking through walls: a history of the murals in Northern Ireland

This dissertation examines how some fundamental events of the history of Ireland emerge through the art of the mural. It is divided into three chapters. The first chapter opens with a brief presentation of the mural as a form of art with a semiotic and sociological function, with a particular focus on the socio-political importance it has had and still has today in Ireland, where murals are a significant means of expressing ideals, protest and commemoration. A part of this chapter also provides data about the number of murals and their location, with a particular focus on the two cities of Belfast and Derry. This first chapter ends with the presentation of an initiative put forth by the Arts Council of Northern Ireland, called "Building Peace through the Arts: Re-Imaging Communities", and questions its implementation on the Irish soil. The second chapter provides a history of the murals in Northern Ireland, from the Unionist's early depictions of King Billy in occasion of the 12 July annual celebrations to the Republican response. This will be supported by an explanation of the two events that triggered the start of the mural painting for both factions: the Battle of the Boyne for the Loyalists and the 1981 hunger strike for the Republicans. In the third and last chapter of this dissertation, a key of the main themes, symbols, acronyms and dominant colours which can be found in Loyalist and Republican murals is provided. Furthermore, one mural for each faction is looked at more closely, with an analysis of the symbols which are present in it.

Dynamics of inorganic carbon and carbonate saturation in the Gulf of Cádiz (SW Spain)

The study of inorganic carbon chemistry of the coastal ocean is conducted in the Gulf of Cádiz (GoC). Here we describe observations obtained during 4 sampling cruises in March, June, September and November 2015. The primary data set consists of state-of-the-art measurements of the keystone parameters of the marine CO2 system: Total Alkalinity (TA), pH, dissolved inorganic carbon (DIC). We have then calculated aragonite and calcite saturation state. The distribution of inorganic carbon system parameters in the north eastern shelf of the Gulf of Cádiz showed temporal and spatial variability. River input, mixing, primary production, respiration and remineralization were factors that controlled such distributions. Data related to carbonate saturation of calcite and aragonite reveal the occurrence of a supersaturated water; in any case, both species increased with distance and decreased with depth. The carbon system parameters present a different behaviour close to the coast to offshore ad at deeper water. In this area six water masses are clearly identified by their different chemical properties: Surface Atlantic Water, North Atlantic Central Water (NACW) and Mediterranean Water (MOW). Moreover, with this work the measurement of calcium in seawater is optimize, allowing a better quantification for future work of the saturation state of CaCO3.

A history of frequent dental care reduces the risk of tooth loss but not periodontitis in older subjects

OBJECTIVES: Information on the significance of dental care in older adults is limited. We hypothesized that regular dental visits has an effect on the number of remaining teeth and periodontal conditions in older subjects. MATERIALS AND METHODS: 1020 randomly selected individuals age 60 - 96 from the Swedish National Study on Aging and Care Blekinge received a comprehensive oral health examination. RESULTS: Dentate women and men had, on average 18.4 teeth (SD +7.6,) and 18.9 teeth (SD + 7.5) respectively (NS). In the youngest group (60 and 66 years old) with less than one dental visit per year, 37% had >20 teeth, compared with 73% among those with at least annual visits. Among the old-old, comparable figures were 1.8 % and 37% respectively. Across age groups, bleeding on probing was 23 %.When adjusting for age, and number of teeth GLM univariate analysis failed to demonstrate an effect of dental visit frequency on alveolar bone loss (p = 0.18), the number of periapical lesions (p = 0.65), or the number of endodontically treated teeth ( p = 0.41). Frequent dental visitors had more teeth than infrequent visitors (p = 0.001). CONCLUSIONS: Tooth loss and alveolar bone loss severity increase with age. Individuals with regular dental visits retained more teeth but the frequency of dental visits had no impact on plaque deposits, gingival inflammation, or alveolar bone levels.