Spanish Recommendations Research Articles

Probabilistic assessment of climate-related impacts and risks in ports

Port activities are crucial for sustained, long-term economic growth, serving as the primary nodes for importing and exporting goods within global supply chains. Given their coastal locations, ports are inherently exposed to climate hazards, such as waves and extreme sea levels, requiring large investments in resilient infrastructure. This study introduces an innovative methodology for assessing climate-related impacts and risks in ports, applicable to both existing and new constructions. This approach aims to facilitate climate-informed decision-making and enhance the management of coastal structures and ports under high uncertainty. The methodology’s novelty resides in: (1) the development of a port-specific risk framework capable of estimating impacts from both extreme events and daily conditions; (2) the integration of the latest advancements in nearshore climate hazard modeling; (3) the application of high-resolution tools for accurately simulating wave propagation towards harbor basins and the interaction between waves and structures; (4) the probabilistic determination of failure modes and operational shutdowns susceptible to climate conditions; and (5) the estimation of economic losses resulting from diminished operational capacity, in addition to the degradation of reliability and functionality in port infrastructures. Formulated within the Intergovernmental Panel on Climate Change (IPCC) risk framework and anchored in established Spanish Recommendations for Maritime Works (ROM Program), this methodology has been applied to a complex, state-owned, newly-built outer port in the Mediterranean Sea. Preliminary findings suggest that, over the course of a 50-year lifespan, climate-related risks could lead to cumulative losses nearing 10 million euros for such infrastructure. Nevertheless, in scenarios marked by extreme events, potential losses could escalate to as much as 100 million euros, despite their occurrence being relatively rare (with a probability of only 0.1%). It stresses the significant uncertainties encountered when evaluating climate-related risks for critical infrastructure, including ports, and highlights the critical need for advanced methodologies to accurately understand these risks.

Estimation of radiation doses due to groundwater intake at a volcanic island: Tenerife (Canary Islands, Spain)

The main source of drinking water in the volcanic island of Tenerife (Canary Islands, Spain) is groundwater (ca. 80%), which is extracted through an extremely dense network of galleries and wells (with a total cumulative length of about 1600 km). This is a singular feature compared to mainland territories, where surface water is the main source of drinking water. In addition, in volcanic contexts, radionuclide concentration activity can increase because of enhanced water-rock reactions due to thermal anomalies and carbon dioxide-enriched groundwater. Natural radioactivity in groundwater from this island was measured on 74 samples from galleries, wells and water channels. Gross alpha, gross beta and gross beta without potassium activity concentrations were in the range of <0.001–1.22 Bq/L, 0.127–3.46 Bq/L and <0.010–1.44 Bq/L, respectively. A complete radiological characterization was determined in 42 groundwater samples in which gross alpha and/or gross beta without potassium activity concentrations exceeded the WHO and Spanish recommendations. Average radionuclide activity concentrations decreased in the order: 234 U, 238 U, 210 Pb, 235 U, 230 Th, 210 Po, 232 Th, 226 Ra. The contribution of groundwater to the total annual effective dose from all measured radionuclides for each age group was 56 ± 8 μSv/year (1–2 years), 44 ± 6 μSv/year (2–7 years), 35 ± 4 μSv/year (7–12 years), 32 ± 3 μSv/year (12–17 years) and 31 ± 4 μSv/year (>17 years). These values are below the 100 μSv/year reference level of the effective dose recommended by WHO. • Gross alpha/beta, 40 K and remainder beta were measured on 74 groundwater samples. • A complete radiological characterization of 42 groundwater samples was performed. • The total annual effective ingestion doses were determined for 5 age groups. • The contribution of each radionuclide to the assessed doses was calculated.

Multidisciplinary care of patients with Myotonic Dystrophy type 1 (DM1) in South Aquitaine

DM1 is characterized by a multisystemic involvement. Our objective was to determine the proportion of adequate follow-up for each affected organ in DM1 patients based on the recently published American and Spanish recommendations. To this end, we conducted a descriptive cross-sectional survey by phone in adult, genetically proven DM1 patients followed in the two French neuromuscular centers of Bayonne and Hendaye located in South Aquitaine, France. The questionnaire selected the most stringent criteria of the two international recommendations for each item of follow-up. Seventy-three patients were included, 55% of which were women (mean age of 48 years) with an average number of 467 CTG repeats. The proportion of patients receiving clinical follow-up in accordance with the recommendations was 90% in cardiology, 60% in neurology, 68% in ophthalmology, 53% in physiotherapy, 23% in pneumology, and 12% in rehabilitation. The high rate of neurological, cardiological, and ophthalmological monitoring might be explained by a locally dense medical demography whereas low rate of respiratory follow up and rehabilitation may reflect an incomplete knowledge of both the disease and the questionnaire. These results should be carefully interpretated as cognitive status may influence such a declarative study. Our study nevertheless disclosed important disparities according to the recommended multidisciplinary follow-up criteria in this French cohort of adult DM1 patients. These results highlight the major role of a multidisciplinary care and monitoring in DM1.

P–161 Is enough the staff in your lab?

Abstract Study question Must be all the activity made in in vitro fertilization (IVF) laboratories keep in mind to size its staff? Summary answer To create a staff calculator based on number of cycles carry on, assisted reproduction techniques, quality controls, administration management, weekend duties, labour regulations and holidays. What is known already In a bibliographic search about staff in human reproduction labs there is no mention about de number of embryologists recommended for every cycle done. Only that it will be according to the workload. Other guidelines establish that every embryologist could assume 150 IVF cycles/year. However, here is a downward tendency in the work that an embryologist can assume. Alikani established a maximum of 100 cycles/year for every embryologist (Alikani et al, 2014). Study design, size, duration Seven senior embryologists working in different IVF centres, three public and 4 privates, take part lead in this Multicentre study during 2019 and 2020. We made a survey to create a calculator for staff using the mean time spent in every lab by each embryologist of the centre to do any IVF procedure and measured three times each one. Participants/materials, setting, methods Different lab procedures and activities related with quality control, time spent to do them, and witnessing were included in the survey. For the calculations it was considered an embryologist with a full-time contract working 1744 hours / year according to current labour agreement in Spain. The times included in the calculations for each task were those corresponding to the 95th percentile. For the calculation, the program used was Microsoft Office Excel. Main results and the role of chance In the IVF laboratory many gametes and embryos from different couples are manipulated daily. The maintenance of traceability could be affected by not having the right staff and lead to dramatic consequences for the patients and the centre. Workload or overload caused by non-suitable staff number also affects the embryologist having a direct impact on his health. The results of the survey carried out showed the time needed by embryologist to perform the different procedures necessary for an IVF treatment, being a classic IVF cycle (8.11 hours), also taking into account the time spent in managing documentation, preparing the cycle and databases. An ICSI with Time lapse needs 10.27 hours and an ICSI-PGD cycle 13.91 hours. To all off this, 1.81 hours should be added for every vitrification support needed and the time to control more than 200 critical steps, including equipment control and culture parameters. The time spent in semen analysis (including managing documentation, cycle preparation and databases) or intrauterine insemination with a partner sperm was 2.7 hours. For donor sperm an additional hour for the management involved is required. The time required to perform and cryopreserve a testicular biopsy and seminal cryopreservation was 4 and 3.7 hours, respectively. Limitations, reasons for caution The study was made taking account of Spanish regulations, quality standards and recommendations and should be adapted to the foreigner’s regulations. Wider implications of the findings: New advance staff calculator allows laboratories estimate minimum number of embryologist necessary for a particular public or private laboratory without compromise neither security nor success in their results. Nevertheless, we recommended a minimum of two qualified embryologists in every lab, whatever it was the workload. Trial registration number none

Flood management challenges in transitional environments: Assessing the effects of sea-level rise on compound flooding in the 21st century

One of the main challenges facing decision-makers, particularly in highly modified transitional systems (i.e., coastal and inland waters, estuaries, river mouths, deltas, and coastal lagoons), is to determine whether current flood defenses will be sufficient throughout the 21st century. In case they are not, address the questions of where and when flood defenses will fail and how much. The methodology presented in this paper addresses the effects of the mean sea-level rise on flooding failures caused by the occurrence of multiple concomitants (compatible and simultaneous) forcing agents in channelized transitional systems throughout the 21st century. It analyzes the spatial and temporal evolution of overflowing failures and compares the crest height of flood defenses with the extreme total water level events expressed as a function of the return periods. The presented procedure then characterizes the mechanism responsible for flooding and identifies the channelized transitional system areas that should be protected at different temporal horizons. The results are converted into management maps, where the spatio-temporal variability and uncertainty of the results are analyzed to facilitate knowledge-based decision making and long-term adaptation planning. The application of the proposed method to the Guadalete estuary, a highly modified estuary representative of the coasts of southern Europe, indicates that: (1) the middle part of the estuary is the most sensitive to flooding due to the sea-level rise; (2) if no actions for mitigation are taken, the number of overflowing failures by the end-century will increase by a 2000% in the middle estuary as a consequence of the combination of the extremes of the astronomical tide and river discharge with the mean sea-level rise; (3) the extreme total water level events of 50-year return period in 2050 will be 1.8 m higher than the current crest height of the levees with a 95% confidence. Therefore, it is recommended that reliable methodologies such as the one proposed here be incorporated into the recommendations for the cost-optimization of the construction and maintenance of protection structures against sea-level rise, such as the Spanish Recommendations of Maritime Works (ROM Program).

204 Piglets exhibited similar performance when fed OH-methionine or DL-Methionine during the post-weaning period

Abstract This work aimed to compare piglet’s performance when fed DL-Methionine or Hydroxy-Methionine (OH-Met and OH-MetCa) at the requirements of sulfur amino acids (SAA) or above. 720 piglets (♀ large white*landrace x ♂ pietrain*duroc) were weaned at 28 days old (6.84 ± 1.07 kg) and randomly allocated to the experimental treatments for 42 days. The experiment was a factorial design with three Met sources (DL-Met, liquid OH-Met (acid form) or OH-MetCa under powder form) and two doses of SAA. Treatments were formulated to reach the adequate SID SAA/Lys ratio of 58% or exceeded the Spanish nutrient recommendations in SAA by 25% (0.79% SID SAA/Lys). Each treatment was replicated 12 times (6 pens of males and 6 pens of females). Growth performance was measured and data was analysed by mixed-effects models (R Core Team). The body weight was neither affected by SAA level, nor by the Met sources. The daily weight gain (DWG) was not affected by the dietary treatments from 0 to 21 days; whereas the feed conversion ratio (FCR) was significantly (P=0.01) improved when the SAA level was increased by 25% (1.272 and 1.184) due to the decreased feed intake (P=0.03). Significant interactions were found between the Sex and the SAA level for DWG (P = 0.04) and FCR (P = 0.03) from 0 to 21 days. From day 21 to 42 and from day 0 to 42, no performance criteria were different in all dietary treatments. For all criteria of performance, the three Met sources exhibited a similar response. These results confirmed that Met sources are equivalent in piglets.

COVID-19 in Spain: Transplantation in the midst of the pandemic.

Spain has been one of the most affected countries by the COVID‐19 outbreak. As of April 28, 2020, the number of confirmed cases is 210 773, including 102 548 patients recovered, more than 10 300 admitted to the ICU, and 23 822 deaths, with a global case fatality rate of 11.3%. From the perspective of donation and transplantation, the Spanish system first focused on safety issues, providing recommendations for donor evaluation and testing, and to rule out SARS‐CoV‐2 infection in potential recipients prior to transplantation. Since the country entered into an epidemiological scenario of sustained community transmission and saturation of intensive care, developing donation and transplantation procedures has become highly complex. Since the national state of alarm was declared in Spain on March 13, 2020, the mean number of donors has declined from 7.2 to 1.2 per day, and the mean number of transplants from 16.1 to 2.1 per day. Increased mortality on the waiting list may become a collateral damage of this terrible pandemic.

Dietary recommendations in Spain –affordability and environmental sustainability?

Global food demand is increasing due to population growth and dietary transitions, resulting from rising incomes, are associated with increased prevalence of non-communicable diseases. Improving the sustainability of the food sector is also critical for achieving the Sustainable Development Goals. This study assesses for the first time the greenhouse gases emissions (Carbon Footprint – CF), the water footprint (WF) and the cost of three omnivorous diets recommended in Spain due to their health benefits: the Mediterranean diet (MD), the Southern European Atlantic diet (SEAD) and the Spanish dietary guidelines (NAOS). Analysis was conducted using standard Life Cycle Assessment and WF methods together with current Spanish food price data.The dietary energy recommendation of the SEAD is greater than that of MD and NAOS (11 and 15% respectively), and SEAD also has greater animal source food content than the other two diets. SEAD has a concomitantly higher CF, WF and cost scores in comparison with MD (+30%, +23% and +21% respectively) and NAOS (+15%, +9% and +21% respectively). Adjusting recommendations to meet the suggested Spanish adult dietary energy of 2228 kcal∙capita−1∙day−1 changed the environmental profiles of the diets and the NAOS has the highest environmental impact. However, the isocaloric diets had approximately the same cost. Analysis of the WF of the diets identified the major contribution of precipitation (the green WF) to the overall WF (88% of the total) and the significant contribution of animal-source foods to dietary WF. Regardless of the dietary scenario, better scores were identified for the Spanish recommendations analysed than those reported for other healthy diets identified in Europe. Differences in the recommended intake levels of certain food groups, cooking techniques and the origin of food products are behind these results.Environmental indicators should be considered alongside nutrition and health metrics when defining national dietary guidelines. Supporting citizens to follow healthy and environmentally-friendly dietary recommendations through, among other things, information campaigns and nutritional education programmes is essential.It is recommended the incorporation not only of health, but also of environmental indicators of these dietary options in the national dietary guidelines, as well as implementation of information campaigns and nutritional education programs among citizens to promote their adhesion since balanced dietary habits rich on plant-based products and low on animal-based ones involve multiple health and environmental benefits.

Total fat and fatty acid intakes and food sources in Mediterranean older adults requires education to improve health

The proportion of fat has increased at the expense of carbohydrates in the past years, and we aimed to assess total fat and fatty acids intake and their food sources among Mediterranean older adults and compare them to national and international recommendations. This study was conducted in 211 participants to determine lipid and fatty acid intake using a Spanish food database. The mean daily intake of lipids was 68.6g/d (standard deviation [SD]: 24.6; 34.4%, SD: 7.0 of total energy consumed). Men, younger participants, and those with higher education ingested more lipids than their peers. Fatty acids were ingested as follows (expressed as percentage of total energy intake): monounsaturated fatty acids (MUFA) (16.7%, SD: 4.1), saturated fatty acids (SFA) (9.6%, SD: 2.6), and polyunsaturated fatty acids (PUFA) (5.0%, SD: 1.7). Oils and seeds were the highest contributors in the intake of lipids (38.8%, SD: 16.0), MUFA (53.9%, SD: 18.7), and PUFA (33.0%, SD: 16.4). The total fat intake (34.4%, SD: 7.0) was within the range of International and Spanish recommendations among Mediterranean older adults; however, the intake of fatty acids did not abide by the international (PUFA) and Spanish recommendations (SFA, MUFA). α-Linoleic acid, eicosapentaenoic acid, and docosahexaenoic acid intake were lower than recommendations, but cholesterol intake (243.9mg, SD: 140.4) was within the range of recommendations. Therefore, public health campaigns are needed to encourage older adults to decrease SFA intake and increase adherence to the Mediterranean diet pattern for a better health.

Summary of Spanish recommendations on intensive care to facilitate organ donation.

With the aim of consolidating recommendations about the practice of initiating or continuing intensive care to facilitate organ donation (ICOD), an ad hoc working group was established, comprising 10 intensivists designated by the Spanish Society of Intensive Care and Coronary Units (SEMICYUC) and the Spanish National Transplant Organization (ONT). Consensus was reached in all recommendations through a deliberative process. After a public consultation, the final recommendations were institutionally adopted by SEMICYUC, ONT, and the Transplant Committee of the National Health-Care System. This article reports on the resulting recommendations on ICOD for patients with a devastating brain injury for whom the decision has been made not to apply any medical or surgical treatment with a curative purpose on the grounds of futility. Emphasis is made on the systematic referral of these patients to donor coordinators, the proper assessment of the likelihood of brain death and medical suitability, and on transparency in communication with the patient's family. The legal and ethical aspects of ICOD are addressed. ICOD is considered a legitimate practice that offers more patients the opportunity of donating their organs upon their death and helps to increase the availability of organs for transplantation.

PROBABILISTIC ASSESSMENT OF PORT OPERABILITY UNDER CLIMATE CHANGE

Harbors are strategic infrastructures within the local, regional and global economy. The objective of a harbor is to guarantee the safety, serviceability and exploitation of all activities, for each element, and in all project phases. Within this context, Level III Verification Method is recommended for the probabilistic evaluation of failure modes and operational stoppage modes (downtime) of maritime structures; and the Spanish Recommendations for Maritime Structures (ROM) proposes a simulation method based on the Monte Carlo technique. On the other hand, ports are susceptible to impacts from climate change driven processes, like sea level rise (SLR) or changes in waves and storm surges. These impacts could reduce the functionality of ports and therefore negatively affect the effectiveness of supply chain network. In this work, we focus on a very long-term probabilistic assessment of the port operability due to wave agitation inside the port including the potential effects of climate change.

Evaluation of Current Organ Packaging and Storage Patterns Between Brazilian Renal Transplant Teams

Introduction In Brazil, technique of cold static storage of organs for transplantation is determined by a Brazilian Health Regulatory Agency’s guideline, based on the American and Spanish recommendations. Our hypothesis is this standardization is incomplete and unclear what can generate lack of uniformity among the teams’ practices. The present study aims to evaluate the compliance of the transplantation teams with the static cold storage standards and whether there is uniformity between the teams in the unwritten aspects. Methods An electronic form was e-mailed to all kidney transplantation teams in the country. The analysed variables were: transport container type; contents of the organ’s coating package (written in the standard) and volume of the container; ice format; ice filling in container; organ preservation solution; way of coated organ storage in the container; presence of temperature control in the container (not written in the standards). All variables were categorical and the chi-square test was used to evaluate whether the distribution of the observed responses met the expected pattern. The level of significance was p <0.05. Results Twenty-seven renal transplant teams answered the questionnaire, which represents 2,625 kidney transplants per year (2015), 47.31% of the country's total. It was in accordance to the expected distribution among the teams (p> 0.05): transport container type (styrofoam-0%, thermal box −100%, p> 0.05). It was not in conformity to the expected distribution (P <0.05): volume of the container (9L-18.5%, 34L-70.4%, 50L-11.1%, p <0.001), ice filling in the container (yes-70.3%, no-29.7%, p=0.034), organ preservation solution (Euro Collins™37.5%, IGL™-22.2%, SPS™-14.8%, Custodiol™-25.9%, p = 0.037), ice format (crushed-25.9%, cubes-74.1%, p=0.012), contents of the organ’s coating package (organ only-14.8%, organ preservation solution-74.1%, saline-11.1%, p <0.01), way of coated organ storage in the container (direct in contact with the ice- 66.7%, packed in plastic pot-22.2%, packed in metal box-11.1%, p <0.01), presence of temperature control in the container (yes-22.2%, no-77.8%, p = 0.004). Conclusions Most teams are not completely in accordance with the Brazilian packaging recommendations. On the other hand, the aspects not written in standards, presented an uneven distribution. Future studies may assess whether these technical differences have an impact on the outcome of the transplants performed. Dr. Valter Duro Garcia - Conselheiro Consultivo da Associação Brasileira de Transplante de Órgãos (ABTO). Central Estadual de Transplantes de Rondônia (GCETRO). Secretaria Municipal de Saúde de Porto Velho (SEMUSA-PVH). Programa Institucional de Bolsas de Iniciação Científica (PIBIC)/Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPQ).

Anthropometric Status and Nutritional Intake in Children (6-9 Years) in Valencia (Spain): The ANIVA Study.

The aim of our study was to assess nutritional intake and anthropometric statuses in schoolchildren to subsequently determine nutritional adequacy with Spanish Dietary Reference Intake (DRIs). The ANIVA study, a descriptive cross-sectional study, was conducted in 710 schoolchildren (6–9 years) in 2013–2014 in Valencia (Spain). Children’s dietary intake was measured using 3-day food records, completed by parents. Anthropometric measures (weight and height) were measured according to international standards, and BMI-for-age was calculated and converted into z-scores by WHO-Anthro for age and sex. Nutrient adequacy was assessed using DRI based on estimated average requirement (EAR) or adequate intake (AI). Pearson’s chi-square and Student’s t-test were employed. Of our study group (47.61% boys, 52.39% girls), 53.1% were normoweight and the weight of 46.9% was inadequate; of these, 38.6% had excess body weight (19.6% overweight and 19.0% obesity). We found intakes were lower for biotin, fiber, fluoride, vitamin D (p < 0.016), zinc, iodine, vitamin E, folic acid, calcium and iron (p < 0.017), and higher for lipids, proteins and cholesterol. Our results identify better nutritional adequacy to Spanish recommendations in overweight children. Our findings suggest that nutritional intervention and educational strategies are needed to promote healthy eating in these children and nutritional adequacies.

Fat intake in children with autism spectrum disorder in the Mediterranean region (Valencia, Spain)

Objective: Children with autism spectrum disorder (ASD) have been found to have alterations in dietary fat intake and fat quality. The fat intakes of the foods consumed by children with and without ASD were compared, and the deficiency and excess of these nutrients were examined. Methods: In a matched case–control study, 3-day food diaries were completed by 105 children with ASD and 495 typically developing (TD) 6- to 9-year-old children in Valencia (Spain). We used the probabilistic approach and estimated average requirement cut-point to evaluate the risk of inadequate nutrients intakes. These were compared between groups and with Spanish recommendations using linear and logistic regression, respectively. Results: Groups did not differ significantly in age, total dietary intake, Healthy Eating Index, or food variety score. Children with ASD had lower saturated fatty acids (SFAs) and ω-3 polyunsaturated fatty acids (PUFAs) intakes, but their total PUFAs and (PUFAs + monounsaturated fatty acids (MUFAs)/SFAs, PUFAs/SFAs intakes and ω-6/ω-3 ratios were higher than TD children. The total fat and cholesterol intakes of both groups were slightly above Spanish recommendations. Both groups had low ω-6 intakes, very low ω-3 intakes, and high ω-6/ω-3 ratios. Conclusion: Further research is required to clarify associations between ASD symptomatology, fat-eating patterns and health status.

Durability of recycled aggregate concrete designed with the Equivalent Mortar Volume (EMV) method: Validation under the Spanish context and its adaptation to Bolomey methodology

Some durability properties are analyzed in concretes made with a novel method for recycled aggregates concrete (RAC) proportioning, in order to validate it under the Spanish context. Two types of concrete mixes were elaborated; one following the guidelines of the named method, and other based on an adaptation of the method to Bolomey methodology. Two types of recycled concrete aggregates (RCA) were used. RCA replacement for natural aggregates (NA) ranged from 20% to 100%. The 20% was chosen in order to comply with Spanish recommendations. Water penetration under pressure, water absorption and chlorides attack were the studied properties. It is verified that the new method and the developed adaptation results in concrete mixes of better or similar properties to those of the natural aggregates concrete (NAC) and the conventional RAC, saving important amounts of cement.

Estrategias para mejorar el valor nutricional de los menús ofertados en residencias públicas para personas mayores

In developed countries, elderly people are considered a group of high risk for possible nutritional imbalances, particularly if they are institutionalized. In the present study, the nutritional value of the meals offered by public nursing homes for the elderly in province of Murcia (Spain) was assessed, to compare the results with Spanish recommendations and to propose possible strategies for improving the nutritional status of the residents. We studied 252 meals offered by six nursing homes, evaluating the energy and macronutrient contents, caloric profile, fat quality and cholesterol and fiber contents. The results were compared with Spanish recommendations for elderly people, and recommendations for a balanced and Mediterranean diet. The average energy content of the meals widely fulfilled the amounts of Recommended Dietary Intake for the elderly population. The caloric profile was adequate as regards proteins, low in carbohydrates and high in lipids. The fat quality was adequate, the cholesterol content was higher and the fiber content lower that the recommended amounts. Among possible strategies to improve the nutritional value of the meals, could be a reduction in the fat and cholesterol contents and an increase in carbohydrate and fiber contents, by replacing some red meat dishes by legumes, bread and refined cereals by wholemeal foods, and fat full dairy products by low fat equivalents.

Spanish recommendations on economic evaluation of health technologies

The economic evaluation of health technologies has become a major tool in health policy in Europe for prioritizing the allocation of health resources and the approval of new technologies. The objective of this proposal was to develop guidelines for the economic evaluation of health technologies in Spain. A group of researchers specialized in economic evaluation of health technologies developed the document reported here, following the initiative of other countries in this framework, to provide recommendations for the standardization of methodology applicable to economic evaluation of health technologies in Spain. Recommendations appear under 17 headings or sections. In each case, the recommended requirements to be satisfied by economic evaluation of health technologies are provided. Each recommendation is followed by a commentary providing justification and compares and contrasts the proposals with other available alternatives. The economic evaluation of health technologies should have a role in assessing health technologies, providing useful information for decision making regarding their adoption, and they should be transparent and based on scientific evidence.

Monitoring heavy metal contents in food and hair in a sample of young Spanish subjects

For most people the main route of exposure to the toxic elements is through the diet. Consequently, information concerning dietary intake is of the utmost importance in being able to assess risks to human health. The goal of this study was to intend to assess the usefulness of hair as a biomonitor of the mineral status in young adults. Daily intakes of selected toxic and essential mineral elements were evaluated using a food frequency questionnaire. In addition, the levels of these same elements in hair samples were measured by inductively coupled plasma mass spectrometry and inductively coupled plasma atomic emission spectrometry. The contents of the essential elements in the study population were all well above Spanish recommendations for adult males and females. The estimated intakes of toxic elements were appreciably below the respective PTWIs, indicating that these intake levels do not pose a health concern for this group. Significant differences in hair metal levels were observed between the men and the women, who were in the same age group. Interestingly, no correlation was found between trace element intakes and the corresponding levels in the hair. In conclusion, hair is only limited usefulness as a means of estimating the nutritional status of the essential and toxic elements considered.

Considerações sobre prova de carga em estruturas de concreto

Um dos testes mais eficientes para verificar a segurança de uma estrutura já concluída é uma prova de carga. Quando existem dúvidas quanto à estabilidade de uma estrutura, devido a fatores, entre outros, como qualidade dos materiais de construção, utilização ou manutenção inadequada ou até mesmo uma nova utilização da edificação, diferente daquela inicialmente prevista no projeto, uma prova de carga é recomendada. Esse trabalho visa a apresentar os critérios mais importantes que devem ser considerados em uma prova de carga. Avalia procedimentos das normas brasileira (NBR 9607-1986), americana (ACI 318-2002), australiana (AS 3600-2001) e recomendações espanhola (EHE-1998) e européia (Rilem TBS-2 -1984). Destaca aspectos como a obrigatoriedade de uma prova de carga, intensidade do carregamento a ser aplicado, análise dos resultados e critérios de aceitação estipulados pelas referidas normas e recomendações.

Using sediment quality guidelines for dredged material management in commercial ports from Spain

Dredged material contamination was assessed in different commercial ports from Spain: Port of Cádiz and Huelva, South West; Bilbao and Pasajes, North; Cartagena and Barcelona, East; Coruña, North West. Sediment from different locations of these ports was sampled and was characterized following the Spanish recommendations for dredged material management. This characterization included grain size distribution, organic matter content and concentration of the chemical compounds included in the list of pollutants and hazardous substances (As, Cd, Cu, Cr, Hg, Ni, Pb and Zn; PCB congeners IUPAC number 28, 52, 101, 118, 138, 153 and 180; PAHs were also analyzed). The results were compared to the limit values of Spanish Action Levels that define the different categories for assessment and management. A set of empirically derived sediment quality guidelines (SQG) was used to assess the possible toxicity of the dredged materials and to improve the use of the chemical approach to characterize dredged material for its management.