El recurs del buit en la pintura de Ma Yuan

Peer-reviewed

ESTRO-HERO survey: Guidelines for equipment and staffing of radiotherapy facilities in the European countries: Final results of the ESTRO-HERO survey

Background and purpose: In planning to meet evidence based needs for radiotherapy, guidelines for the provision of capital and human resources are central if access, quality and safety are not to be compromised. A component of the ESTRO-HERO (Health Economics in Radiation Oncology) project is to document the current availability and content of guidelines for radiotherapy in Europe. Materials and methods: An 84 part questionnaire was distributed to the European countries through their national scientific and professional radiotherapy societies with 30 items relating to the availability of guidelines for equipment and staffing and selected operational issues. Twenty-nine countries provided full or partial evaluable responses. Results: The availability of guidelines across Europe is far from uniform. The metrics used for capital and human resources are variable. There seem to have been no major changes in the availability or specifics of guidelines over the ten-year period since the QUARTS study with the exception of the recent expansion of RTT staffing models. Where comparison is possible it appears that staffing for radiation oncologists, medical physicists and particularly RTTs tend to exceed guidelines suggesting developments in clinical radiotherapy are moving faster than guideline updating. Conclusion: The efficient provision of safe, high quality radiotherapy services would benefit from the availability of well-structured guidelines for capital and human resources, based on agreed upon metrics, which could be linked to detailed estimates of need

ESTRO-HERO survey: Radiotherapy equipment and departments in the European countries: Final results from the ESTRO-HERO survey

Background: Documenting the distribution of radiotherapy departments and the availability of radiotherapy equipment in the European countries is an important part of HERO the ESTRO Health Economics in Radiation Oncology project. HERO has the overall aim to develop a knowledge base of the provision of radiotherapy in Europe and build a model for health economic evaluation of radiation treatments at the European level. The aim of the current report is to describe the distribution of radiotherapy equipment in European countries. Methods: An 84-item questionnaire was sent out to European countries, principally through their national societies. The current report includes a detailed analysis of radiotherapy departments and equipment (questionnaire items 2629), analyzed in relation to the annual number of treatment courses and the socio-economic status of the countries. The analysis is based on validated responses from 28 of the 40 European countries defined by the European Cancer Observatory (ECO). Results: A large variation between countries was found for most parameters studied. There were 2192 linear accelerators, 96 dedicated stereotactic machines, and 77 cobalt machines reported in the 27 countries where this information was available. A total of 12 countries had at least one cobalt machine in use. There was a median of 0.5 simulator per MV unit (range 0.31.5) and 1.4 (range 0.44.4) simulators per department. Of the 874 simulators, a total of 654 (75%) were capable of 3D imaging (CT-scanner or CBCToption). The number of MV machines (cobalt, linear accelerators, and dedicated stereotactic machines) per million inhabitants ranged from 1.4 to 9.5 (median 5.3) and the average number of MV machines per department from 0.9 to 8.2 (median 2.6). The average number of treatment courses per year per MV machine varied from 262 to 1061 (median 419). While 69% of MV units were capable of IMRT only 49% were equipped for image guidance (IGRT). There was a clear relation between socio-economic status, as measured by GNI per capita, and availability of radiotherapy equipment in the countries. In many low income countries in Southern and Central-Eastern Europe there was very limited access to radiotherapy and especially to equipment for IMRT or IGRT. Conclusions: The European average number of MV machines per million inhabitants and per department is now better in line with QUARTS recommendations from 2005, but the survey also showed a significant heterogeneity in the access to modern radiotherapy equipment in Europe. High income countries especially in Northern-Western Europe are well-served with radiotherapy resources, other countries are facing important shortages of both equipment in general and especially machines capable of delivering high precision conformal treatments (IMRT, IGRT)

ESTRO-HERO survey: Radiotherapy staffing in the European countries: Final results from the ESTRO-HERO survey

Background: The ESTRO Health Economics in Radiation Oncology (HERO) project has the overall aim to develop a knowledge base of the provision of radiotherapy in Europe and build a model for health economic evaluation of radiation treatments at the European level. The first milestone was to assess the availability of radiotherapy resources within Europe. This paper presents the personnel data collected in the ESTRO HERO database. Materials and methods: An 84-item questionnaire was sent out to European countries, through their national scientific and professional radiotherapy societies. The current report includes a detailed analysis of radiotherapy staffing (questionnaire items 4760), analysed in relation to the annual number of treatment courses and the socio-economic status of the countries. The analysis was conducted between February and July 2014, and is based on validated responses from 24 of the 40 European countries defined by the European Cancer Observatory (ECO). Results: A large variation between countries was found for most parameters studied. Averages and ranges for personnel numbers per million inhabitants are 12.8 (2.530.9) for radiation oncologists, 7.6 (019.7) for medical physicists, 3.5 (012.6) for dosimetrists, 26.6 (1.978) for RTTs and 14.8 (0.461.0) for radiotherapy nurses. The combined average for physicists and dosimetrists is 9.8 per million inhabitants and 36.9 for RTT and nurses. Radiation oncologists on average treat 208.9 courses per year (range: 99.9348.8), physicists and dosimetrists conjointly treat 303.3 courses (range: 85757.7) and RTT and nurses 76.8 (range: 25.7156.8). In countries with higher GNI per capita, all personnel categories treat fewer courses per annum than in less affluent countries. This relationship is most evident for RTTs and nurses. Different clusters of countries can be distinguished on the basis of available personnel resources and socio-economic status. Conclusions: The average personnel figures in Europe are now consistent with, or even more favourable than the QUARTS recommendations, probably reflecting a combination of better availability as such, in parallel with the current use of more complex treatments than a decade ago. A considerable variation in available personnel and delivered courses per year however persists among the highest and lowest staffing levels. This not only reflects the variation in cancer incidence and socio-economic determinants, but also the stage in technology adoption along with treatment complexity and the different professional roles and responsibilities within each country. Our data underpin the need for accurate prediction models and long-term education and training programmes

Core communication components along the cancer care process: the perspective of breast cancer patients

This study sought to assess the impact of health care professional (HCP) communication on breast cancer patients across the acute care process as perceived by patients. Methodological approach was based on eight focus groups conducted with a sample of patients (n ¼ 37) drawn from 15 Spanish Regions; thematic analysis was undertaken using the National Cancer Institute (NCI) framework of HCP communication as the theoretical basis. Relevant results of this study were the identification of four main communication components: (1) reassurance in coping with uncertainty after symptom detection and prompt access until confirmed diagnosis; (2) fostering involvement before delivering treatments, by anticipating information on practical and emotional illness-related issues; (3) guidance on the different therapeutic options, through use of clinical scenarios; and, (4) eliciting the feeling of emotional exhaustion after ending treatments and addressing the management of potential treatment-related effects. These communication-related components highlighted the need for a comprehensive approach in this area of cancer care

Efectos de la aplicación de biosólidos en plantaciones de especies leñosas para restauración de canteras de caliza mediterráneas

Los programas de restauración de las canteras de caliza situadas en el macizo del Garraf (sudoeste de la cordillera Litoral catalana) contemplan la plantación de especies leñosas autóctonas como medida para mitigar el impacto visual y para optimizar la restauración ecológica tras la explotación del recurso mineral. Las condiciones ambientales de partida poco favorables (elevadas pendientes y substratos poco fértiles) pueden ser limitantes para la instalación y evolución de leñosas, de forma que la adición de compost puede ser una vía para mejorar su rendimiento. En este trabajo evaluamos el efecto de la aplicación extensiva de compost en plantaciones de cuatro especies de árboles y arbustos de un año de edad en parcelas sembradas con distintas mezclas de herbáceas. Como resultado principal se observó que en las parcelas con compost la supervivencia de Pinus halepensis y Rhamnus alaternus fue menor, aunque el crecimiento de las cuatro especies ensayadas fue superior. Las leñosas presentaron una supervivencia superior en las parcelas sembradas con herbáceas autóctonas, que habían desarrollado menor cobertura, respecto a las siembras con herbáceas comerciales, con mayor cubierta.

The effect on prices of the attributes of holiday hotels: a hedonic prices approach

This article examines the effect on price of different characteristics of holiday hotels in the sun-and-beach segment. The effect on price is estimated under the hedonic function perspective by means of random effect models, known also as mixed or panel models. Some 82,000 prices were gathered between 1991 and 1998 from tour operator catalogues. The study reveals huge price differences between 4-star hotels and the rest, coupled with practically no difference between 1-star and 2-star hotels. Other attributes with a significant effect on price are town, hotel size, distance to the beach and availability of parking place. The results can assist hotel managers in shaping pricing and investment strategies

A broadband leptonic model for gamma-ray emitting microquasars

Observational and theoretical studies point to microquasars (MQs) as possible counterparts of a significant fraction of the unidentified gamma-ray sources detected so far. At present, a proper scenario to explain the emission beyond soft X-rays from these objects is not known, nor what the precise connection is between the radio and the high-energy radiation. We develop a new model where the MQ jet is dynamically dominated by cold protons and radiatively dominated by relativistic leptons. The matter content and power of the jet are both related with the accretion process. The magnetic field is assumed to be close to equipartition, although it is attached to and dominated by the jet matter. For the relativistic particles in the jet, their maximum energy depends on both the acceleration efficiency and the energy losses. The model takes into account the interaction of the relativistic jet particles with the magnetic field and all the photon and matter fields. Such interaction produces significant amounts of radiation from radio to very high energies through synchrotron, relativistic Bremsstrahlung, and inverse Compton (IC) processes. Variability of the emission produced by changes in the accretion process (e.g. via orbital eccentricity) is also expected. The effects of the gamma-ray absorption by the external photon fields on the gamma-ray spectrum have been taken into account, revealing clear spectral features that might be observed. This model is consistent to the accretion scenario, energy conservation laws, and current observational knowledge, and can provide deeper physical information of the source when tested against multiwavelength data.

Forma i apmliació de l'escola Sant Joan a Montgat

Award-winning

Projecte modificat per a les obres de nova construcció 1 línia de l'Escola l'Olivar de Castellnou de Bages

Award-winning

Los determinantes sociales del pensamiento: ni anomalismo ni funcionalización

El principal objetivo del presente trabajo es indagar si las habituales tentativas por descifrarel pensamiento desde un punto de vista sociológico, a pesar de su vehemente compromisoantirreduccionista, podrían aceptar en último término la reducción de ideas, argumentos y doctrinasa sus presuntos determinantes sociales. En una primera etapa analizamos el ¿sociologismoanómalo¿ de Martin Kusch, señalamos algunas de sus lagunas, y establecemos que la panopliaconceptual en losofía de la mente es fértilmente aplicable al ámbito racional-social. A continuaciónconsideramos el funcionalismo reduccionista de Jaegwon Kim, nos centramos en latesis de que los estados intencionales de la mente, al contrario de lo que ocurre con los qualia,son causalmente funcionalizables, e intentamos establecer sus posibles repercusiones en la interpretaciónsocial del pensamiento. La aplicación de la metodología funcionalista al horizonteracional-social, de todos modos, parece venir desmentida por la evidencia, ya que las propiedadesdel pensamiento equiparables a los qualia son de hecho eminentemente funcionalizablesen la medida que fundamentan la efectividad social de los recursos gurativos y retóricos. Enun sentido análogo, la obra de Hans Blumenberg demuestra que los inescrutables ingredientes gurativos de todo pensamiento que él denomina ¿metáforas absolutas¿ son tan decisivos paracualquier proceso abstractivo que los conceptos nunca llegan a agotar su alcance determinador.Con lo cual los conceptos y las ideas más generales, antes considerados del todo funcionalizables,ahora dependen de algunas metáforas básicas, aun cuando por analogía con los qualia selas creía inmunes a toda funcionalización. Por tanto parece que la reducción no puede resolverlas di cultades que plantean los presuntos ¿determinantes sociales del pensamiento¿. Al mismotiempo, y con rmando así algunos emergentismos, los aspectos causal-funcionales del ámbitoracional-social dan la impresión de ser inconciliables con la enigmática estructura causal queponen de mani esto las aproximaciones losó cas al problema mente-cuerpo.

Temporalidad finita y diferencia ontológica

Este trabaio se propone esclarecer la tensión entre el momento finitista y el momentoontológico en la doctina del primer Heidegger. Constata que la finitud expresa la referencia recíproca del ser v el ente en la diferencia ontológica, ayudando a unificar los modos alternativos (el én-cubrimiento y el des-en-ubrimiento) de la verdad. Así revoca una bifurcación que la propia finitud propiciaba. La unidad de la verdad y la no-verdad, en suma, parece descansar sobre la eventualidad de una «nada» liberada de la onticidad. Por otra parte, la finitud y el ontologismo solicitan una metodología basada en la «circularidad». La fundamentación del ente por el ser no se encuentra en condiciones de excluir la