HIA Report to the Minister for Health on an evaluation and analysis of returns for 1 July 2011 to 30 June 2012 including advice

HIA Report to the Minister for Health The Department of health requested that the Health Insurance Authority provide a report to the Minister ‘in anticipation of the enactment of the health Insurance (Amendment) Bill 2012.” Click here to download PDF 8.87MB The Health Insurance (Amendment) Bill 2012 Link to the Minister’s Second Stage Speech to the Dáil on 14 November 2012          

Almost routine prophylactic cholecystectomy during laparoscopic gastric bypass is safe

Background Morbidly obese patients are at high risk to develop gallstones, and rapid weight loss after bariatric surgery further enhances this risk. The concept of prophylactic cholecystectomy during gastric bypass has been challenged recently because the risk may be lower than reported earlier and because cholecystectomy during laparoscopic gastric bypass may be more difficult and risky. <p>Methods A review of prospectively collected data on 772 patients who underwent laparoscopic primary gastric bypass between January 2000 and August 2007 was performed. The charts of patients operated before 2004 were retrospectively reviewed regarding preoperative echography and histopathological findings.</p> <p>Results Fifty-eight (7.5%) patients had had previous cholecystectomy. In the remaining patients, echography showed gallstones or sludge in 81 (11.3%). Cholecystectomy was performed at the time of gastric bypass in 665 patients (91.7%). Gallstones were found intraoperatively in 25 patients (3.9%), for a total prevalence of gallstones of 21.2%. The age of patients with gallstones was higher than that of gallstone-free patients (43.5 vs 38.7 years, p < 0.0001). Of the removed specimens, 81.8% showed abnormal histologic findings, mainly chronic cholecystitis and cholesterolosis. Cholecystectomy was associated with no procedure-related complication, prolonged duration of surgery by a mean of 19 min (4-45), and had no effect on the duration of hospital stay. Cholecystectomy was deemed too risky in 59 patients (8.3%) who were prescribed a 6-month course of ursodeoxycolic acid.</p> <p>Conclusion Concomitant cholecystectomy can be performed safely in most patients during laparoscopic gastric bypass and does not prolong hospital stay. As such, it is an acceptable form of prophylaxis against stones forming during rapid weight loss. Whether it is superior to chemical prophylaxis remains to be demonstrated in a large prospective randomized study.</p>

Molecular detection of human astrovirus in an urban sewage treatment plant in Rio de Janeiro, Brazil

The objective of this study was to evaluate the prevalence and dissemination of human astroviruses (HAstV) in the environment by analyzing urban sewage samples from a wastewater treatment plant in the city of Rio de Janeiro, Brazil. A one-year study was performed with a total of 48 raw and treated sewage composite samples, which were collected biweekly from an activated sludge plant. Virus particles were concentrated by the adsorption-elution method using negatively charged membranes associated to a Centriprep Concentrator® 50 (Nihon Millipore). HAstV were detected in 16.7% of the samples in raw and treated sewage by using both qualitative and quantitative reverse transcriptase-polymerase chain reactions (RT-PCR and qPCR, respectively). Positive untreated sewage sample exhibited mean values of 1.1 x 10(4) gEq/mL. The qPCR sensitivity was 18 gEq/reaction. Through utilization of qPCR, a HAstV recovery efficiency of 4.2% and 4.3% was demonstrated for raw and treated sewage samples, respectively. The presence of HAstV in both the raw and treated sewage samples demonstrated the dissemination of these viruses in the environment as well as viral permanence after sewage treatment. There was a reduction in the total and faecal coliform levels, indicating efficiency of the wastewater treatment plant.

Anàlisi comparativa dels processos emergents sharon i anammox per al tractament d’aigües amb una alta càrrega de nitrogen

Estudi de tractaments innovadors en aigües residuals amb elevada concentració de nitrogen mitjançant la tecnologia ANAMMOX (Anaerobic Ammonium Oxidation) i SHARON i posterior anàlisi teòrica de la gestió dels fangs residuals d’una EDAR

Prescripción enfermera en el entorno de las urgencias y emergencias. Marco conceptual vs entorno legislado en España

The prescription, widely discussed and defined conceptually in recent years in an environment of widening the spectrum of responsibilities nurse, has capacity for integration and definition in the area of accident and emergency care and carried out over the patient urgently, about emergencies and life-long commitment. Be necessary to frame throughout the legal framework, following the amendment of the Twelfth Additional Provision of Law 29/2006 of guarantees and rational use of drugs and medical devices, can be waived and implementation required, provided under model and through the nursing process and method and as an exponent and endorsementn of science and advanced clinical practice, to join the idea of interdisciplinary professional consensus that the law posed by the preparation and implementation of standardized protocols, algorithms and / or clinical practice guidelines in the context of what has come to be called "collaborative standard prescription": Prescription to the nurse in certain clinical situations in terms of a performance protocol, agreed with multidisciplinary team care health of the population (Group Protocols), which can be considered an intermediate step in the evolution towards independent nurse prescribing, providing nurses experience of a prescription under these protocols and demonstrating their capabilities.

L’atribució legal de drets successoris al cònjuge i al convivent: bases per a una reforma

Se explora el fundamento y finalidad de las atribuciones legales mortis causa previstas para el cónyuge y el conviviente. Los beneficios viudales y sucesorios se analizan para aportar reflexiones que sirvan para afrontar una reforma de los mismos que sea capaz de ajustarles mejor técnica, familiar y socialmente.

Tractament fisicoquímic de les aigües i fangs d'un escorxador porcí

L’objectiu del present projecte és la proposta (disseny i estimació econòmica) d’un sistema de tractament de les aigües i els fangs generats a un escorxador porcí de Granollers. Per tal de portar a terme aquest estudi, es va realitzar una anàlisi de la situació prèvia a l’escorxador, del diagrama de flux de les instal·lacions existents, de les necessitats del sector, dels límits d’abocament fixats pel Reglament del Consorci del Besòs, i finalment de la caracterització de les aigües residuals generades (en quantitat i qualitat) així com dels fangs produïts. Arran d’aquesta anàlisi es va realitzar un estudi experimental d’optimització del tractament fisicoquímic, i en base als resultats es van generar diferents alternatives de tractament, es va simular el seu comportament, i es va fer una avaluació comparativa dels costos i rendiments estimats

Use of an isothermal microcalorimetry assay to characterize microbial oxalotrophic activity

Isothermal microcalorimetry (IMC) has been used in the past to monitor metabolic activities in living systems. A few studies have used it on ecological research. In this study, IMC was used to monitor oxalotrophic activity, a widespread bacterial metabolism found in the environment, and particularly in soils. Six model strains were inoculated in solid angle media with K-oxalate as the sole carbon source. Cupriavidus oxalaticus, Cupriavidus necator, and Streptomyces violaceoruber presented the highest activity (91, 40, and 55 μW, respectively) and a maximum growth rate (μmax h(-1) ) of 0.264, 0.185, and 0.199, respectively, among the strains tested. These three strains were selected to test the incidence of different oxalate sources (Ca, Cu, and Fe-oxalate salts) in the metabolic activity. The highest activity was obtained in Ca-oxalate for C. oxalaticus. Similar experiments were carried out with a model soil to test whether this approach can be used to measure oxalotrophic activity in field samples. Although measuring oxalotrophic activity in a soil was challenging, there was a clear effect of the amendment with oxalate on the metabolic activity measured in soil. The correlation between heat flow and growth suggests that IMC analysis is a powerful method to monitor bacterial oxalotrophic activity

Impacte de l’aplicació de fangs de depuradora en un sòl agrícola

L'elevada quantitat d'aigües residuals generades per la societat actual i el posterior procés de depuració per tal d'eliminar els contaminants de l'aigua, provoca un gran volum de fangs que tradicionalment es duien en un abocador controlat o, pitjor encara, a les zones litorals on es dipositaven directament al mar. La reutilització dels fangs, obtinguts com a subproducte del tractament de les aigües residuals en les EDAR, com a adob biològic en camps agrícoles, és una de les opcions més utilitzades per a la seva gestió. Aquesta, pot ser una bona opció sempre i quan no suposi un risc per la salut, donat que el contingut al fang d'alguns contaminants pot ser elevat i l'acumulació excessiva per exemple d'elements potencialment tòxics (PTE) pot suposar un risc pels sòls i les plantes amb els problemes que això pot ocasionar. Encara que els fangs normalment presenten continguts en PTE inferiors als valors límit establerts per la normativa europea, la seva aplicació reiterada pot suposar un risc d'acumulació dels metalls en el sòl i, depenent de la seva mobilitat, també en les plantes. En aquest projecte, ens centrem en l'estudi de la mobilitat i biodisponibilitat dels metalls en els sòls on s'han cultivat cereals d'hivern, concretament ordi. Els fangs aportats en aquesta experiència són procedents de l'EDAR de Palamós, on reben un tractament de digestió anaeròbia. S'avalua tan el contingut pseudototal de PTE en el sòl, amb l'ajuda d'una digestió al microones, com el contingut de metall biodisponible. A continuació, es determinarà la concentració dels PTE en els extractes mitjançant l'ICP-AES o ICP-MS, depenent de la concentració d'aquests.El projecte es centra en l'avaluació del possible impacte de l'aplicació continuada de biosòlids en sòls agrícoles. Des d'un punt de vista operacional, l'estudi es portarà a terme en parcel•les experimentals situades a l'Estació Experimental Mas Badia, on es porten aplicant fangs de depuradora de manera reiterada durant 12 anys, amb l'objectiu de valorar l'interès agrícola i la incidència agronòmica de l’aplicació de fangs de depuradora en diferents cultius, a mig i a llarg termini

Selected Information About County Jails and Adult Detention Facilities in Iowa, 2003

During the 2002 session of the Iowa General Assembly, Senate File 2278 was enacted, establishing a new Section 356.36A within the Iowa Code. Subsequently, House File 2623 was enacted, which served to make a minor amendment to Senate File 2278. The Governor subsequently signed the amended legislation into law. The final version of the new Section 356.36A required that the Iowa Department of Human Rights, Division of Criminal and Juvenile Justice Planning and Statistical Analysis Center (CJJP) prepare a report for the Legislature “analyzing the confinement and detention needs of jails and facilities established pursuant to chapters 356 and 356A.

A foundation for strategic agenda voting

We offer complete characterizations of the equilibrium outcomesof two prominent agenda voting institutions that are widely used in the democraticworld: the amendment, also known as the Anglo-American procedure,and the successive, or equivalently the Euro-Latin procedure. Our axiomaticapproach provides a proper understanding of these voting institutions, and allowscomparisons between them, and with other voting procedures.

Evaluating Spanish pension expenditure under alternativa reform scenario

In this paper we evaluate the quantitative impact that a number ofalternative reform scenarios may have on the total expenditure for publicpensions in Spain. Our quantitative findings can be summarized in twosentences. For all the reforms considered, the financial impact of themechanical effect (change in benefits) is order of magnitudes larger thanthe behavioral impact or change in behavior. For the two Spanish reforms,we find once again that their effect on the outstanding liability of theSpanish Social Security System is essentially negligible: neither themechanical nor the behavioral effects amount to much for the 1997 reform,and amount to very little for the 2002 amendment.

Effect of irrigation water on the incidence of Salmonella spp. on lettuces produced by urban agriculture and sold on the markets in Dakar, Senegal

The aim of our survey was to assess the effect of irrigation water of the microbiological quality on the production chain of lettuce in the Dakar area. Microbiological analysis showed that 35% of irrigation water was contaminated by Salmonella spp. between the two water-types used for irrigation (groundwater and wastewater), no significant difference (p>0.05) in their degree of contamination was found. The incidence of different types of irrigation water on the contamination rate of lettuces from the farm (Pikine and Patte d'Oie) was not different either (p>0.05). However, the contamination rate of lettuce from markets of Dalifort and Grand-Yoff that were supplied by the area of Patte d'Oie was greater than those of Sham and Zinc supplied by Pikine (p<0.05). Comparison of serotypes of Salmonella isolated from irrigation water and lettuce showed that irrigation water may affect the microbiological quality of lettuce. Manures, frequently used as organic amendment in cultivating lettuce are another potential source of contamination. These results showed that lettuce may constitute effective vectors for the transmission of pathogens to consumers. Extensive treatment of the used wastewater and/or composting of manure could considerably reduce these risks.

Improving rainwater-use in Cabo Verde drylands by reducing runoff

Dryland agriculture in Cabo Verde copes with steep slopes, inadequate practices, irregular intense rain, recurrent droughts, high runoff rates, severe soil erosion and declining fertility, leading to the inefficient use of rainwater. Maize and beans occupy N80% of the arable land in low-input, low-yielding subsistence farming. Three collaborative field trialswere conducted in different agroecological zones to evaluate the effects ofwater-conservation techniques (mulching of crop residue, a soil surfactant and pigeon-pea hedges) combinedwith organic amendments (compost and animal or green manure) on runoff and soil loss. During the 2011 and 2012 rainy seasons, three treatments and one control (traditional practice) were applied to 44- and 24-m2 field plots. A local maize variety and two types of beanswere planted. Runoff and suspended sedimentswere collected and quantified after each daily erosive rainfall. Runoff occurred for rainfalls≥50mm(slope b10%, loamy Kastanozem),≥60mm(slope≤23%, silt–clay–loam Regosol) and≥40mm(slope≤37%, sandy loam Cambisol). Runoffwas significantly reduced only with themulch treatment on the slope N10% and in the treatment of surfactant with organic amendment on the slope b10%. Soil loss reached 16.6, 5.1, 6.6 and 0.4 Mg ha−1 on the Regosol (≤23% slope) for the control, surfactant, pigeon-pea and mulch/pigeon-pea (with organic amendment) treatments, respectively; 3.2, 0.9, 1.3 and 0.1 Mg ha−1 on the Cambisol (≤37% slope) and b0. 2Mg ha−1 for all treatments and control on the Kastanozem(b10% slope). Erosion was highly positively correlated with runoff. Mulch with pigeon-pea combinedwith an organic amendment significantly reduced runoff and erosion fromagricultural fields on steep slopes, contributing to improved use of rainwater at the plot level. Sustainable land management techniques, such as mulching with pigeon-pea hedges and an organic amendment, should be advocated and promoted for the semiarid hillsides of Cabo Verde prone to erosion to increase rainwater-use and to prevent further soil degradation.

Assessment of microbial community structure changes by amplified ribosomal DNA restriction analysis (ARDRA)

Amplified ribosomal DNA restriction analysis (ARDRA) is a simple method based on restriction endonuclease digestion of the amplified bacterial 16S rDNA. In this study we have evaluated the suitability of this method to detect differences in activated sludge bacterial communities fed on domestic or industrial wastewater, and subject to different operational conditions. The ability of ARDRA to detect these differences has been tested in modified Ludzack-Ettinger (MLE) configurations. Samples from three activated sludge wastewater treatment plants (WWTPs) with the MLE configuration were collected for both oxic and anoxic reactors, and ARDRA patterns using double enzyme digestions AluI+MspI were obtained. A matrix of Dice similarity coefficients was calculated and used to compare these restriction patterns. Differences in the community structure due to influent characteristics and temperature could be observed, but not between the oxic and anoxic reactors of each of the three MLE configurations. Other possible applications of ARDRA for detecting and monitoring changes in activated sludge systems are also discussed