State of emergency medicine in Spain

Spain has universal public health care coverage. Emergency care provisions are offered to patients in different modalities and levels according to the characteristics of the medical complaint: at primary care centers (PCC), in an extrahospital setting by emergency medical services (EMS) and at hospital emergency departments (ED). We have more than 3,000 PCCs, which are run by family doctors (general practitioners) and pediatricians. On average, there is 1 PCC for every 15,000 to 20,000 inhabitants, and every family doctor is in charge of 1,500 to 2,000 citizens, although less populated zones tend to have lower ratios. Doctors spend part of their duty time in providing emergency care to their own patients. While not fully devoted to emergency medicine (EM) practice, they do manage minor emergencies. However, Spanish EMSs contribute hugely to guarantee population coverage in all situations. These EMS are run by EM technicians (EMT), nurses and doctors, who usually work exclusively in the emergency arena. EDs dealt with more than 25 million consultations in 2008, which implies, on average, that one out of two Spaniards visited an ED during this time. They are usually equipped with a wide range of diagnostic tools, most including ultrasonography and computerized tomography scans. The academic and training background of doctors working in the ED varies: nearly half lack any structured specialty residence training, but many have done specific master or postgraduate studies within the EM field. The demand for emergency care has grown at an annual rate of over 4% during the last decade. This percentage, which was greater than the 2% population increase during the same period, has outpaced the growth in ED capacity. Therefore, Spanish EDs become overcrowded when the system exerts minimal stress. Despite the high EM caseload and the potential severity of the conditions, training in EM is still unregulated in Spain. However, in April 2009 the Spanish Minister of Health announced the imminent approval of an EM specialty, allowing the first EM resident to officially start in 2011. Spanish emergency physicians look forward to the final approval, which will complete the modernization of emergency health care provision in Spain

Coupled RELAP/PARCS Full Plant Model Assessment of a Cooling Transient in Trillo Nuclear Power Plant (NUREG/IA-0255)

This report presents the methodology to change from a 0-D kinetics core in a RELAP5/Mod3.3 full plant model of Trillo NPP to a coupled RELAP5/PARCS 3-D core. The coupled plant model is assessed against a real cooling transient that deformed the core power axial profile. The coupled steady state core model was adjusted to a CASMO/SIMULATE calculation by condensing the cross-sections with the SIMTAB methodology. The need of information exchange between RELAP and PARCS during the transient was the reason for two modifications of the coupling between both codes. The CASMO/SIMULATE calculation of the initial core conditions correspondent to the date of the transient was performed by Iberdrola Ingeniería. The SIMTAB methodology used to build the PARCS input file, the automated tools for core input files mapping and the RELAP/PARCS modifications of control rod and boron content were performed by the Nuclear Engineering Group belonging to the Institute for Industrial, Radiophysical and Environmental Safety (ISIRYM) at the Universitat Politècnica de València (UPV). The modifications to the RELAP5 full plant model to couple the 3-D PARCS core, the steady-state adjustments of PDDs, and the transient calculation and analysis were performed by the Thermo-Hydraulic group of Almaraz-Trillo NPPs. The results of the transient show an almost perfect agreement with plant data for all the compared variables. The comparison of in-core parameters evolution with plant data is also very good and the 3-D simulation allows to perform a more detailed analysis of core behaviour. This report was prepared by the Thermo-Hydraulic group of Almaraz-Trillo NPPs (CNAT), with the help of the Polytechnic University of Valencia. The Asociación Española de la Industria Eléctrica (UNESA, Electric Industry Association of Spain) and Almaraz-Trillo NPPs AIE sponsored this work.Martínez Murillo, J.; Novo, M.; Miró Herrero, R.; Barrachina Celda, TM.; Verdú Martín, GJ. (2011). Coupled RELAP/PARCS Full Plant Model Assessment of a Cooling Transient in Trillo Nuclear Power Plant (NUREG/IA-0255). U.S. Nuclear Regulatory Commission. http://hdl.handle.net/10251/58956

Jornada de Camp de l'Arròs 2016

Nous reptes estan forçant el cultiu de l’arròs a situar-se al capdavant en les noves tecnologies per tal de donar resposta a aquests reptes. L’objectiu d’aquesta jornada és oferir als assistents noves propostes de millora, alternatives de maneig i un debat entre tècnics i arrossers. Es visitaran els assajos desenvolupats per l’IRTA a la pròpia finca, també es presentaran noves línies de recerca i, en col·laboració amb empreses del sector, es mostraran les novetats en varietats, adobs i fitosanitaris. Com sempre us convidem a participar en aquesta jornada arrossera, la jornada de tots, i esperem que us sigui ben profitosa

Potato consumption does not increase blood pressure or incident hypertension in 2 cohorts of Spanish adults

5 TablasBackground: Potatoes have a high glycemic load but also antioxidants, vitamins, and minerals. It is unclear what mechanisms are involved in relation to their effect on blood pressure (BP) and hypertension. Objectives: This study aimed to assess the association between potato consumption, BP changes, and the risk of hypertension in 2 Spanish populations. Methods: Separate analyses were performed in PREDIMED (PREvención con DIeta MEDiterránea), a multicenter nutrition intervention trial of adults aged 55-80 y, and the SUN (Seguimiento Universidad de Navarra) project, a prospective cohort made up of university graduates and educated adults with ages (means±SDs) of 42.7±13.3 y for men and 35.1± 10.7 y for women. In PREDIMED, generalized estimating equations adjusted for lifestyle and dietary characteristics were used to assess changes in BP across quintiles of total potato consumption during a 4-y follow-up. Controlled BP values (systolic BP < 140 mm Hg and diastolic BP < 90 mm Hg) during follow-up were also assessed. For SUN, multivariateadjusted HRs for incident hypertension during a mean 6.7-y follow-up were calculated. Results: In PREDIMED, the total potato intake was 81.9 ± 40.6 g/d. No overall differences in systolic or diastolic BP changes were detected based on consumption of potatoes. For total potatoes, the mean difference in change between quintile 5 (highest intake) and quintile 1 (lowest intake) in systolic BP after multivariate adjustment was 20.90 mm Hg (95% CI: -2.56, 0.76 mm Hg; P-trend = 0.1) and for diastolic BP was 20.02 mm Hg (95% CI: -0.93, 0.89 mm Hg; P-trend = 0.8). In SUN, the total potato consumption was 52.7 ± 33.6 g/d, and no significant association between potato consumption and hypertension incidence was observed in the fully adjusted HR for total potato consumption (quintile 5 compared with quintile 1: 0.98; 95% CI: 0.80, 1.19; P-trend = 0.8). Conclusions: Potato consumption is not associated with changes over 4 y in blood pressure among older adults in Spain or with the risk of hypertension among Spanish adults.Supported by the official funding agency for biomedical research of the Spanish Government, Instituto de Salud Carlos III through grants provided to research networks specifically developed for the trial (RTIC G03/140, to RE; RTIC RD 06/0045, to MAM-G) and through Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERobn), and by grants from Centro Nacional de Investigaciones Cardiovasculares (CNIC 06/2007), Fondo de Investigación Sanitaria–Fondo Europeo de Desarrollo Regional [Proyecto de Investigación (PI) 04-2239, PI 05/2584, CP06/00100, PI07/0240, PI07/1138, PI07/0954, PI 07/0473, PI10/01407, PI10/02658, PI11/01647, P11/02505 and PI13/00462], Ministerio de Ciencia e Innovación [Recursos y teconologia agroalimentarias (AGL)-2009-13906-C02 and AGL2010-22319-C03 and AGL2013-49083-C3-1-R], Fundación Mapfre 2010, the Consejería de Salud de la Junta de Andalucía (PI0105/2007), the Public Health Division of the Department of Health of the Autonomous Government of Catalonia, Generalitat Valenciana [Generalitat Valenciana Ayuda Complementaria (GVACOMP) 06109, GVACOMP2010-181, GVACOMP2011-151], Conselleria de Sanitat y AP; Atención Primaria (CS) 2010-AP-111 and CS2011-AP-042, and Regional Government of Navarra (P27/2011)