Patient Satisfaction in the Spanish National Health Service: Partial Least Squares Structural Equation Modeling

The aim of this article was to determine which key indicators influence patient satisfaction with the Spanish NHS to provide useful information for policy decision-making. A total of 33 variables for each of the 17 Spanish autonomous communities were collected from the statistical portal of the Spanish Ministry of Health, Social Services, and Equality between 2005 and 2016. A cross-sectional study was applied using Partial Least Squares to a Structural Equation Model (PLS-SEM). The influence of expenditures, resource allocation, and safety were hypothesized about patient satisfaction. Gross Domestic Product (GDP) and life expectancy were used as control variables. Moreover, the influence of resource allocation on use was tested. The model explained 57.1% of patient satisfaction with the Spanish NHS. It was positively influenced mainly by resource allocation and expenditures, followed by safety and life expectancy. Additionally, resources directly influenced the level of use. The number of hospital beds, hemodialysis equipment, rate of adverse drug reactions, and expenditure positively influenced patient satisfaction. In contrast, the number of posts in day hospitals, the hospital infection rate, and the percentage of pharmacy spending negatively influenced patient satisfaction

Promoviendo una escuela inclusiva : efectos obtenidos tras la aplicación de las V Jornadas de sensibilización con el autismo

Treball Final de Grau en Mestre o Mestra d'Educació Primària. Codi: MP1040. Curs acadèmic 2014-2015En el presente trabajo se procede a analizar, desde una perspectiva organizativa y curricular, la percepción y predisposición que muestran los principales agentes educativos que conforman el proceso del C.E.I.P Eleuterio Pérez hacia la inclusión, centro situado en la localidad de La Vall de Uxó. Para dar respuesta al objetivo planteado, en colaboración con todo el equipo del aula CyL, hemos desarrollado unas jornadas de sensibilización determinadas por un proceso de investigación – acción, donde el enfoque de recolección y análisis de datos se ha definido como mixto, en el cual se integran técnicas cualitativas (grupo de discusión) y cuantitativas (cuestionarios de reflexión). Un aspecto clave a destacar es que, esta propuesta, no ha ido dirigida únicamente a los alumnos y alumnas, sino también a todo el profesorado, así como a los padres y madres que configuran esta escuela, de forma que todos se sintieran implicados en este propósito que es el de conseguir una escuela inclusiva. Una vez llevado a cabo este programa de sensibilización, los resultados muestran que la aplicación de estas jornadas acentúa el conocimiento y la empatía hacia aquellos alumnos y alumnas que presentan necesidades educativas especiales y que en consecuencia, acuden regularmente al aula CyL que dispone este centro. Aunque las jornadas de sensibilización han sido aplicadas a todos los ámbitos del centro escolar, tanto infantil como primaria, el ámbito de estudio que he desarrollado ha estado centrado exclusivamente en el sector de educación primaria, etapa en la que he estado presente como estudiante de prácticas. En definitiva, este trabajo permite no sólo obtener percepciones y necesidades hacia el proceso de inclusión educativa, sino que también se está en condiciones de buscar evidencias que permitan establecer la existencia de factores favorecedores del aprendizaje que impulsen el desarrollo de buenas prácticas educativas vinculadas con la atención a la diversidad del alumnado

Mediterranean Diet and food technology: sustainable strategies for a globalized world

[EN] Mediterranean Diet has been widely studied and its nutritional, healthy, and sustainable benefits have been recognized. However, in the last decades, globalization has brought about major changes in the developed world and a progressive deviation from the main Mediterranean patterns. Fresh food and traditional recipes continue to be valued and their beneficial effects on health are scientifically proven. Despite this, they have been largely replaced by fast and ...less nutritious food. Is it... possible to perform alternatives and procedures that help us to mitigate some deviations from the Mediterranean Diet, contributing to a more right, sustainable, and nutritious food system in a globalized world? This communication reinforces the idea that food technology and scientific advances must be properly applied to meet the challenges faced by Mediterranean countriesBetoret Valls, N.; Betoret Valls, ME. (2021). Mediterranean Diet and food technology: sustainable strategies for a globalized world. Agricultural Research & Technology. 26(3):1-3. https://doi.org/10.19081/ARTOAJ.2021.26.5563331326

Trophic ecology in marine ecosystems from the Balearic sea (Western Mediterranean)

Director de la tesis doctoral: Dr. Quetglas, A. (Antoni). Tutor de la tesis doctoral: Dr. Moyà, G. (Gabriel)Conservation of marine ecosystem structure and functioning is a priority target within the context of environmental management. For such a target is fundamental to know the array of predator-prey interactions as a basis to understand the food web structure and dynamics. In this Thesis, the trophic structure of deep-sea food webs off the Balearic Islands and the feeding ecology of different taxonomic groups playing a key role in the trophodynamics of marine ecosystems, were investigated. Chapter 3 studied the trophic networks based on stable isotope analysis (SIA). A relatively large food web (89 species) encompassing both the pelagic and the hyperbenthic compartment from two geographical areas with contrasting hydrographic conditions were analysed. Although the food webs extended up to 4 trophic levels, both in the pelagic and hyperbenthic compartment, most species occupied intermediate levels. The wide range of isotopic values found suggested a high partitioning rate of trophic resources. Food webs of the two study areas showed similar close benthopelagic coupling decreasing with depth, although some location variability was found likely due to different hydrodynamism. Chapter 4 investigated the trophic ecology of the most abundant demersal elasmobranchs from the continental shelf and slope using stomach content analysis (SCA). Results showed that batoids from the shelf preyed on decapod crustaceans and teleosts, whereas sharks from the slope fed upon mesopelagic prey. Diet overlap was found among most skates and between sharks from the upper and middle slope. Raja clavata and Galeus melastomus showed ontogenetic shifts in diet, whereas Scyliorhinus canicula diet changed both with size and depth. In Chapter 5 the diet and trophic ecology of the two co-generic squid species Loligo vulgaris and L. forbesii was examined for the first time in the Mediterranean. Although both species are piscivorous, the prey composition revealed a lack of diet overlap as a result of their bathymetric segregation. Both squids showed shifts in diet related to size and their reproduction period, but not to sex. The squid L. vulgaris displayed an ontogenetic shift in diet from small benthic prey to benthopelagic fish. During the reproduction period, L. vulgaris increased the consumption of the highly nutritive polychaetes, wherea the adults of L. forbesii carried out movements to deeper waters to feed on mesopelagic prey, which might help improving their individual body condition during such a period. Chapter 6 focused on the trophodynamics of the mesopelagic fishes, owing to its importance as prey in marine foodwebs. Food sources (δ13C) of zooplankton and mesopelagic fishes varied little over the spatial scales sampled but showed high seasonality, reflecting the intra-annual changes in species composition of the phytoplankton community. By contrast, spatio-temporal variations of trophic interactions (δ15N) were minimal. Important niche segregation was observed between the non-migratory stomiiforms and some of the extensive migratory myctophids. There was little evidence of ontogenetic shifts in diet of the species analyzed, except for Lampanyctus crocodilus. Finally, Chapter 7 performed a comparative analysis of the trophic ecology of deep-sea cephalopods and elasmobranchs. The main aim was to know how their feeding strategies affect the role they play in the structure and dynamics of trophic networks. The combination of SCA and SIA showed that cephalopods and elasmobranchs displayed different feeding strategies with a clear resource partitioning between and within taxa. Results also revealed that squid and shark species identified as benthopelagic feeders, play a key role in the transport of energy from midwater regions to the benthosEn el context de la gestió mediambiental és fonamental conèixer les interaccions predador-presa per poder entendre l'estructura i dinàmica dels ecosistemes marins. La present Tesi investiga l'estructura de les xarxes tròfiques d’aigües profundes del mar Balear i l'ecologia alimentària de diferents grups taxonòmics que juguen un paper clau en la trofodinàmica dels ecosistemes marins. El Capítol 3 investiga les xarxes tròfiques en base a l’anàlisi d’isòtops estables (AIE). Es va analitzar una cadena tròfica relativament llarga (89 espècies) cobrint els compartiments pelàgic i hiperbentònic en dues zones amb característiques hidrogràfiques diferents. Tot i que les cadenes tròfiques en els dos compartiments incloïen fins a 4 nivells tròfics, la majoria de les espècies es situaven en nivells intermedis. L’ampli rang de valors isotòpics trobat suggerí un alt nivell de partició dels recursos tròfics. Les cadenes tròfiques de les dues zones d'estudi van mostrar un acoblament bentopelàgic elevat i similar que va disminuir a l’estrat més profund, encara que amb alguna variació geogràfica, probablement atribuïda al seu diferent hidrodinamisme. El Capítol 4 investiga l'ecologia tròfica dels elasmobranquis demersals més abundants a la plataforma i talús a partir dels continguts estomacals (ACE). Els resultats van mostrar que els batoïdeus de la plataforma s'alimenten de crustacis decàpodes i teleostis, mentre que els taurons del talús mengen preses mesopelàgiques. Es va trobar solapament en la dieta de la majoria de les rajades i entre els taurons del talús mitjà i superior. Raja clavata i Galeus melastomus van mostrar canvis ontogènics en la seva dieta, mentre que la dieta de Scyliorhinus canicula va variar en funció de la talla i la profunditat. En el Capítol 5, la dieta i l'ecologia tròfica de dos calamars congenèrics, Loligo vulgaris i L. forbesii, va ser examinada per primera vegada a la Mediterrània. Les dues espècies son piscívores, però les preses van revelar l'absència de solapament tròfic degut a la seva segregació batimètrica. Tots dos calamars van mostrar canvis en la dieta relacionats amb la talla i amb la reproducció, però no amb el sexe. Amb l’augment de la talla, la dieta de L. vulgaris va canviar de petites preses bentòniques a peixos bentopelàgics. Durant la reproducció, L. vulgaris va incrementar la ingesta de poliquets, mentre que els adults de L. forbesii van desplaçar-se a aigües més profundes per alimentar-se de preses mesopelàgiques, la qual cosa podria ajudar a millorar la condició individual durant aquest període. Capítol 6 es centra en la trofodinàmica dels peixos mesopelàgics, per la seva importància com a preses en les xarxes tròfiques marines. Les fonts d'aliment (δ13C), tant del zooplàncton com dels peixos mesopelàgics, va mostrar lleugeres variacions en l'escala espaial mostrejada, però en canvi mostrà una gran estacionalitat, reflectint els canvis intra-anuals en la composició específica del fitoplàncton. No obstant això, les variacions espai-temporals de les relacions tròfiques (δ15N) foren mínimes. Es va observar una important segregació del nínxol tròfic entre els stomiiformes no migradors i alguns dels mictòfids altament migradors. Les espècies analitzades no van mostrar canvis ontogènics en la dieta, excepte en el cas de Lampanyctus crocodilus. Per finalitzar, el Capítol 7 portà a terme un anàlisi comparatiu de l'ecologia tròfica dels cefalòpodes i dels elasmobranquis del talús. La combinació d’ACE i AIE va permetre investigar les seves estratègies alimentàries, les relacions tròfiques, el solapament de dietes i els canvis ontogènics en la seva alimentació. Els cefalòpodes i els elasmobranquis van mostrar diferents estratègies alimentàries i una clara partició dels recursos alimentaris a nivell inter i intra-taxonòmic. Els resultats van desvelar que els calamars i els elasmobranquis categoritzats com a consumidors bentopelàgics, juguen un paper clau en el transport d’energia des de les capes superficials fins a la zona bentònica del talúsEn el contexto de la gestión medioambiental es fundamental conocer las interacciones predador-presa para poder entender la estructura y dinámicas de los ecosistemas marinos. En la presente Tesis se investiga la estructura de las redes tróficas de aguas profundas del Mar Balear y la ecología alimentaria de diferentes taxones que juegan un papel clave en la trofodinámica de los ecosistemas marinos. El Capítulo 3 investiga las redes tróficas en base al análisis de los isótopos estables (AIE). Se analizó una cadena trófica relativamente larga (89 especies) abarcando los compartimentos pelágico e hiperbentónico en dos zonas con diferentes características hidrográficas. A pesar de que las cadenas tróficas en ambos compartimentos incluían hasta 4 niveles tróficos, la mayoría de las especies se situaban en niveles intermedios. El amplio rango de valores isotópicos encontrado sugirió un alto nivel de partición de los recursos tróficos. Las cadenas tróficas de las dos zonas de estudio mostraron un acoplamiento bentopelágico elevado y similar, que disminuyó en el estrato más profundo, aunque con alguna variación geográfica, probablemente atribuida a su diferente hidrodinamismo. El Capítulo 4 investiga la ecología trófica de los elasmobranquios demersales más abundantes de la plataforma y el talud a partir del análisis de contenidos estomacales (ACE). Los resultados mostraron que los batoideos de la plataforma se alimentan de crustáceos decápodos y teleósteos, mientras que los tiburones del talud basan su dieta en presas mesopelágicas. Se encontró solapamiento en la dieta de la mayoría de rayas y entre los tiburones del talud medio y superior. Raja clavata y Galeus melastomus mostraron cambios ontogénicos en su dieta, mientras que la dieta de Scyliorhinus canicula varió en función tanto de la talla como de la profundidad. En el Capítulo 5, la dieta y ecología trófica de dos calamares congenéricos, Loligo vulgaris y L. forbesii, fue examinada por primera vez en el Mediterráneo. Aunque ambas especies son piscívoras, sus presas desvelaron la ausencia de solapamiento trófico debido a su segregación batimétrica. Ambos calamares mostraron cambios en la dieta relacionados con la talla y la reproducción, pero no con el sexo. Con el aumento de la talla, la dieta de L. vulgaris cambió de presas bentónicas a peces bentopelágicos. Durante la reproducción, L. vulgaris incrementó la ingesta de poliquetos, mientras que los adultos de L. forbesii se alimentaron de presas mesopelágicas, lo que ayudaría a mejorar su condición individual durante dicho período. El Capítulo 6 se centra en la trofodinámica de los peces mesopelágicos, debido a su importancia en las redes tróficas marinas. Las fuentes de alimento (δ13C), tanto del zooplancton como de los peces mesopelágicos, mostró ligeras variaciones en la escala espacial muestreada, pero una gran estacionalidad, reflejando cambios intra-anuales en la comunidad del fitoplancton. No obstante, las variaciones espacio-temporales de las relaciones tróficas (δ15N) fueron mínimas. Se observó una importante segregación del nicho trófico entre los stomiiformes no migradores y algunos de los mictófidos migradores. Las especies analizadas no mostraron cambios ontogénicos en la dieta, excepto en el caso de Lampanyctus crocodilus. Para finalizar, el Capítulo 7 llevó a cabo un análisis comparativo de la ecología trófica de los cefalópodos y los elasmobranquios del talud. La combinación de los datos de ACE y AIE permitió constatar diferentes estrategias alimentarias y una clara partición de los recursos alimentarios a nivel inter e intra-taxonómico. Los resultados revelaron que los calamares y los tiburones identificados como consumidores bentopelágicos, juegan un papel clave en el transporte de energía desde las capas superficiales hasta la zona bentónica del talu

Prototyping low-cost and flexible vehicle diagnostic systems

Diagnostic systems are software and hardware-based equipment that interoperate with an external monitored system. Traditionally, they have been expensive equipment running test algorithms to monitor physical properties of, e.g., vehicles, or civil infrastructure equipment, among others. As computer hardware is increasingly powerful (whereas its cost and size is decreasing) and communication software becomes easier to program and more run-time efficient, new scenarios are enabled that yield to lower cost monitoring solutions. This paper presents a low cost approach towards the development of a diagnostic systems relying on a modular component-based approach and running on a resource limited embedded computer. Results on a prototype implementation are shown that validate the presented design, its flexibility, performance, and communication latency.This work has been partly funded by the project REM4VSS (TIN2011-28339) and M2C2 (TIN2014-56158-C4-3-P), funded by the Spanish Ministry of Economy and Competitivenes

A novel enzymatic approach to nanocrystalline cellulose preparation

In this work, conditions for an enzymatic pretreatment prior to NCC isolation from cotton linter were assessed. Different cellulase doses and reaction times were studied within an experimental design and NCC were obtained. At optimal enzymatic conditions (20U, 2 h), a total yield greater than 80% was achieved and the necessary enzymatic treatment time was reduced 90%. Different intensities of enzymatic treatments led to proportional decreases in fiber length and viscosity and also were inversely proportional to the amount of released oligosaccharides. These differences within fibers lead to quantitative differences in NCC: increase in acid hydrolysis yield, reduction of NCC surface charge and crystallinity increase. Benefits produced by enzymatic treatments did not have influence over other NCC characteristics such as their sulfur content (˜1%), size (˜200 nm), zeta potential (˜-50 mV) or degree of polymerization (˜200). Evidence presented in this work would reduce the use of harsh sulfuric acid generating a cleaner stream of profitable oligosaccharidesPostprint (author's final draft

Cellulose oxidation by Laccase-TEMPO treatments

In this work, laccase-TEMPO (Lac-T) treatments were applied to bleached commercial dissolving pulp in order to introduce carbonyl and carboxyl groups, which were found to improve dry and wet strength-related properties. Also the solubility behavior towards xanthate reactions was assessed. The effect of a refining step (R) before the oxidative treatment, the absence or presence of oxygen pressure, TEMPO dose (2 or 8% oven dried pulp) and reaction time (8 or 20 h) were thoroughly examined. Treatments conducted in the presence of oxygen pressure exhibited greater amount of functional groups. Introducing a pre-refining treatment resulted in similar functional groups but higher wet strength was achieved. Specifically, a high W/D strength ratio was observed, indicating that wet strength-related property was satisfactorily developed. Besides the fact that all Lac-T treatments caused severe cellulose degradation, no fiber strength loss was detected. In fact, all oxidized samples presented higher Wet Zero-Span Tensile Strength, mainly in R+ Lac-T (O2) sample, which suggested the formation of hemiacetal linkages between the new introduced aldehyde groups and available free hydroxyl groups resulting from fibrillationPostprint (author's final draft

Carbon footprint in Higher Education Institutions: a literature review and prospects for future research

Higher Education Institutions (HEI) or universities, as organisations engaged in education, research and community services, play an important role in promoting sustainable development. Therefore, they are increasingly linked to the initiative of calculating their carbon footprint (CF), which is a tool to assess sustainability from the perspective of greenhouse gas (GHG) emissions. The aim of this study is to carry out a systematic review of the current situation of CF assessment in academic institutions by analysing different key elements, such as the time period, methodologies and practises, calculation tools, emission sources, emission factors and reduction plans. The review protocol considered articles published until March 2021. Of the articles reviewed, 35 are aimed specifically at calculating the CF of HEI, while the remaining articles consist of review, activity-specific CF assessment or GHG emission reduction articles. Clear differences have been identified when results are compared for the normalised CF (average of 2.67 t CO2e/student, ranging from 0.06 to 10.94) or the percentage of carbon offsetting, only considered in 14% of the studies and ranging from 0.09 to 18%. The main reason for this is the lack of standardisation as regards the time metric (year, semester), functional unit (student, employee, area) and data collection boundary (scope 1, 2, 3), the emissions sources and emission factors, mainly for scope 3 (water consumption and treatment, waste treatment, office, ICT and laboratory consumables, commuting and travel, construction materials, canteens, etc.), and the inclusion or not of the effect of carbon offset projects to offset the CF (aim of the project and absorption sources and factors). However, despite the differences, a reduction over time is clearly observed. Therefore, CF in HEI requires further improvements and solutions to a number of challenges, including the definition of representative emission sources, the creation of a robust emission factor database and the development of tools/methodologies that cover all the needs of this type of organisation

Carbon footprint assessment tool for universities: CO2UNV

Universities, as organisations engaged in education, research and community services, play an important role in promoting sustainability and should be an example of a sustainable organisation. The Carbon Foot- print (CF) is a very useful decision-making tool that allows organisations to measure and communicate the effect of their activities on the environment. To do so, it is necessary to have tools capable of calcu- lating, tracking and reporting their greenhouse gas (GHG) emissions, as well as guiding the actions for reducing and offsetting them. The aim of this article is to present a tool specifically designed to calcu- late the carbon footprint of universities, called CO2UNV. This tool is able to quantify the CO 2 equivalent (CO 2 e) emissions for scopes 1 (direct GHG emissions), 2 (electricity indirect GHG emissions) and 3 (other indirect GHG emissions), for a university as a whole and for the different buildings/units that it is made up of. It includes, by default, the typical emission sources of an education centre and their corresponding emission factors. However, it is totally adaptable to any other type of organisation thanks to the possibil- ity of including new emission sources and of updating all the emission factors (by default and new). It is also capable of evaluating the evolution of the CF over time, and the CO 2 e offsets achie ved by contribut- ing to offset projects. The results report includes input data and the graphical representation of results. Finally, CO2UNV is applied to calculate and offset the CF of the Universitat Jaume I (Spain), and the study concludes with its validation according to applicability and accuracy criteria.Funding for open access charge: CRUE-Universitat Jaume

Political Foundations of Universalistic Care Policy: Comparative Politics of Elderly Care Policy in Japan, the U.S., and Sweden

Two enzyme treatments involving xylanase (X) and laccase (L) were used jointly in an XLE sequence (where E denotes alkaline extraction) to bleach oxygen-delignified eucalyptus kraft pulp in the presence of 1-hydroxybenzotriazol (HBT) as mediator. The results of the XLE sequence were compared with those of an LE sequence. The application conditions for the laccase–mediator system were optimized by using a sequential statistical plan involving three variables (viz., the laccase and mediator doses, and the reaction time) with both sequences. The models used to predict the kappa number and brightness revealed that, once all accessible lignin was removed, the system altered other coloured compounds. The best conditions for the L stage involved a reduced mediator dose (0.5% odp). The xylanase pretreatment increased the accessibility of residual lignin and facilitated removal of hexenuronic acids. For a specific target brightness level of 70% ISO, the X pretreatment can save as much as 30% laccase and 80% mediator while shortening the reaction time by 45%.Peer ReviewedPostprint (published version