35 research outputs found
Extraction of silicon and aluminium from coal fly ash
No full textApplied SciencesChemical Engineering and of Materials ScienceApplied Thermodynamics and Phase Behaviou
Las obras del poeta mosen Ausias March : corregidas de los errores q[ue] tenian : sale con ellas el vocabulario de los vocablos en ellas contenidos ... / [compuesto por Ioan de Resa
No full textSign.: A-LL8, MM4. - Text en català, port. i prelim. en castellàEscut de G. Fernández de Córdoba a port.Registre i reclams. - Capll. xil. orn. als prels
Interpreting the world trade collapse
No full textWorld trade’s dramatic collapse from the end of 2008 was emblematic of a globally synchronised recession that threatened to become a depression and of a financial crisis painfully transmitted to the real economy. The extent of the fall in world trade relative to that in world GDP and the subsequent strength of the trade recovery so far suggests particular factors have been affecting global trade flows. This article considers the possible reasons for the pronounced fall and recovery in world trade relative to world GDP, focusing on UK export demand. At its core, the extraordinary decline in trade stemmed from the combination of a shock to global demand skewed towards highly tradable sectors and the ever-more globalised production process for these goods. The encouraging improvement in world trade from the second half of 2009 can also be attributed to some of these factors, as well as suggesting that permanent damage to the global marketplace may be less extensive than first feared.
Gut feelings in the diagnostic process of Spanish GPs: a focus group study
No full textObjectives: The gut feelings of doctors can act as triggers and modulators of the diagnostic process. This study explored the existence, significance, determinants and triggers of gut feelings among Spanish general practitioners. Design: Qualitative study using focus groups. Thematic content analysis. Setting: Primary healthcare centres in Majorca (Spain). Participants: 20 purposively sampled general practitioners working in Majorca. Results: General practitioners were aware of the existence of gut feelings in their diagnostic reasoning process and recognised 2 kinds of gut feelings: a sense of alarm and a sense of reassurance. A previous physician-patient relationship and the physician's experience had a strong perceived influence on the appearance of gut feelings. The physicians attached great significance to gut feelings, and considered them as a characteristic of the primary care working style and as a tool available in their diagnostic process. The physicians thought that the notion of gut feelings and their relevance can be transmitted to students and trainees. They tended to follow their gut feelings, although they were not sure of their accuracy. Conclusions: Spanish general practitioners in our study recognise the presence and role of gut feelings in their diagnostic reasoning process. Future research should examine the diagnostic accuracy of gut feelings and how to teach about gut feelings in the training of general practitioners
Cross-cultural translation and validation of the ‘gut feelings’ questionnaire into Spanish and Catalan
No full textBackground: The gut feelings questionnaire (GFQ) is the only tool developed to assess the presence of a ‘sense of alarm’ or a ‘sense of reassurance’ in the diagnostic process of general practitioners (GPs). It was created in Dutch and English and has validated versions in French, German and Polish. Objectives: To obtain a cross-cultural translation of the GFQ into Spanish and Catalan and to assess the structural properties of the translated versions. Methods: A six-step procedure including forward and backward translations, consensus, and cultural and linguistic validation was performed for both languages. Internal consistency, factor structure, and content validity were assessed. Results: Internal consistency was high for both questionnaires (Cronbach’s alpha for GFQ-Spa = 0.94 and GFQ-Cat = 0.95). The principal component analysis identified one factor with the sense of alarm and the sense of reassurance as two opposites, explaining 76% of the total variance for the GFQ-Spa, and 77% for the GFQ-Cat. Conclusion: Spanish and Catalan versions of the GFQ were obtained. Both have been cross-culturally adapted and showed good structural properties.</p
Social conflict, growth and factor shares
No full textStandard growth theory is based on atomistic agents with no strategic interactions among them. In contrast, we model growth as resulting from a one-off, strategic game between workers and owners of capital (capitalists) on factor shares, in an otherwise standard AK growth model. The resulting distribution of income between factors further determines the marginal revenue product of capital and the rate of growth. We analyse the properties of four equilibria: competitive, Stackelberg equilibrium, a hybrid non-cooperative regime, and cooperative (Nash) solution. We show that our model provides a potentially richer view of the growth process than comparable models, and endogenises a key aspect of the social contract.social conflict; factor shares; growth; catching up with the Joneses
Prospective observational study on the prevalence and diagnostic value of general practitioners' gut feelings for cancer and serious diseases
No full textAbstract: Background General practitioners (GPs) have recognized the presence of gut feelings in their diagnostic process. However, little is known about the frequency or determinants of gut feelings or the diagnostic value of gut feelings for cancer and other serious diseases. Objective To assess the prevalence of gut feelings in general practice, examine their determinants and impact on patient management, and measure their diagnostic value for cancer and other serious diseases. Design This prospective observational study was performed using the Gut Feelings Questionnaire (GFQ). Participants Participants included 155 GPs and 1487 of their patients, from four Spanish provinces. Main Measures Sociodemographic data from patients and GPs; the reasoning style of GPs; the characteristics of the consultation; the presence and kind of gut feeling; the patient's subsequent contacts with the health system; and new cancer and serious disease diagnoses reported at 2 and 6 months post-consultation. Key Results GPs experienced a gut feeling during 97% of the consultations: a sense of reassurance in 75% of consultations and a sense of alarm in 22% of consultations. A sense of alarm was felt at higher frequency given an older patient, the presence of at least one cancer-associated symptom, or a non-urban setting. GPs took diagnostic action more frequently after a sense of alarm. After 2 months, the sense of alarm had a sensitivity of 59% for cancer and other serious diseases (95% CI 47-71), a specificity of 79% (95% CI 77-82), a positive predictive value of 12% (95% CI 9-16), and a negative predictive value of 98% (95% CI 86-98). Conclusions Gut feelings are consistently present in primary care medicine, and they play a substantial role in a GP's clinical reasoning and timely diagnosis of serious disease. The sense of alarm must be taken seriously and used to support diagnostic evaluation in patients with a new reason for encounter
A new approach to model geomaterials with heterogeneous properties in thermo-hydro-mechanical coupled problems
No full textThe main objective of this article is to present a new approach to model coupled thermo-hydro-mechanical problems considering geomaterials with heterogeneous properties. This approach has been implemented in the software CODE_BRIGHT and it provides the possibility of considering geomaterials with a spatially correlated heterogeneous field of porosity, following a normal distribution. This spatial correlation can be isotropic or anisotropic. An important feature of this approach is that material properties such as intrinsic permeability, thermal conductivity, diffusivity, retention curve, elastic modulus or cohesion are defined as a function of porosity and, thus, they become heterogeneous with spatial correlation and, eventually, anisotropic. A validation exercise and other basic numerical examples have been carried out to illustrate the possibilities of the proposed approach. The results, which have been compared with a homogeneous case, show that considering heterogeneous fields can be relevant in different modelling problems, especially coupled thermo-hydro-mechanical problems.This research was supported by the CODE_BRIGHT Project (CIMNE, International Centre for Numerical Methods in Engineering) and by the DECOVALEX Project. The second author was supported by a CSC scholarship (No. 202008390058). The CODE_BRIGHT project is funded by a Consortium composed by SKB (Sweden), Posiva (Finland), GRS (Germany) and ANDRA (France). DECOVALEX is an international research project comprising participants from industry, government and academia, focusing on development of understanding, models and codes in complex coupled problems in sub-surface geological and engineering applications; DECOVALEX-2023 is the current phase of the project. The authors appreciate and thank the DECOVALEX-2023 Funding Organisations ANDRA, BASE, BGE, BGR, CAS, CNSC, COVRA, US DOE, ENRESA, ENSI, JAEA, KAERI, NWMO, NWS, SÚRAO, SSM and Taipower for their financial and technical support of the work described in this paper. The statements made in the paper are, however, solely those of the authors and do not necessarily reflect those of the Funding Organisations. Special thanks to I.P. Damians for facilitating the original numerical model used in his work (Damians et al., 2020), in which one of the models presented in this article has been based.Peer ReviewedPostprint (published version
Prevalence and diagnostic value of GPs' gut feelings for cancer and serious diseases : protocol for a prospective observational study of diagnostic validity
No full textAbstract: Introduction Cancer diagnosis in primary care is an important challenge for general practitioners (GPs) due to the relatively low frequency of any single type of cancer and the heterogeneous signs and symptoms that can be present. In addition to analytical reasoning, GPs may become aware of gut feelings (GFs) as they suspect that a patient may have cancer or another serious disease. We aimed to investigate the prevalence and the predictive value of GFs for the diagnosis of cancer and serious diseases. Methods and analysis Prospective observational study of diagnostic validity. Participation will be offered to GPs from Majorca and Zaragoza (Spain). They will recruit all patients with a new reason for encounter during one or two workdays. GPs will complete the Gut Feelings Questionnaire (GFQ). Variables regarding patient, GP and consultation will be collected. Two and 6 months after the first visit, incident diagnoses of cancer or other serious diseases, diagnostic tests performed, referrals and new visits will be recorded. Analysis will include a descriptive analysis of the variables and prevalence of GFs, and the sensitivity, specificity, predictive values and likelihood ratios of the GFs (sense of alarm and sense of reassurance) for diagnosing cancer and other serious diseases, as measured with the GFQ. Ethics and dissemination The study has obtained approval from the Majorcan Primary Care Research Committee and from the Balearic Islands Ethical Committee, with reference number IB 3210/16 PI. The results may help GPs to make more accurate decisions about which patients need further examinations to rule out or to confirm a diagnosis of cancer or a serious disease, and which ones do not. The results will be published as part of the PhD project of the first author and in open access journals, and will be presented at medical conferences
Barriers to and discourses about breast cancer prevention among immigrant women in Spain: a qualitative study
No full textObjectives: To identify knowledge, barriers and discourses about breast cancer screening in Spain among female immigrants from low-income countries and native Spanish women from a low socioeconomic class. Design: Qualitative interview study with thematic analysis interpreted using cultural mediators. Setting Mallorca, Spain. Participants: Thirty-six in-depth interviews, using cultural mediators, of immigrant women living in Mallorca who were 50-69years old and were from Maghreb, Sub-Saharan Africa, Eastern Europe, Latin America, China or were native to Spain and from a low socioeconomic class. Results: We analysed the interviews to assess breast cancer perceptions and beliefs, discourses about breast cancer prevention and barriers to accessing breast cancer prevention programmes. Although the women reported an association of breast cancer with death, they acknowledged the effectiveness of early detection. They also exhibited reluctance to talk about cancer. Discourses about cancer prevention tended to be proactive or fatalistic, depending on the woman's country of origin. For all women, fear of results and lack of time were barriers that limited participation in breast cancer prevention programmes. Language barriers, frequent changes of residence and fear due to status as an irregular (undocumented) immigrant were barriers specific to immigrant women. Conclusions: The culture of origin affects whether an immigrant has a fatalistic or proactive approach toward breast cancer screening. Immigrants from low-income countries and Spanish natives from a low socioeconomic class experience barriers in access to breast cancer screening. Frequently changing homes is also a barrier for immigrant women.This study was financed with a grant from the Ministry of Health, Carlos III Institute (ISCIII), PI08/90628. It also received the support of the Health Promotion and Preventive Activities-Primary Health Care Network (redIAPP), sustained by the Ministry of Health, ISCIII and cofinanced by ERDF funds (RETIC RD06/0018, RD12/0005/0011, RD16/0007). This project was also supported by the Balearic Islands Health Research Institute (IdISBa)
