Dry torrefaction and continuous thermochemical conversion for upgrading agroforestry waste into eco-friendly energy carriers: Current progress and future prospect.

Agroforestry Waste (AW) is seen as a carbon neutral resource. However, the poor quality of AW reduced its potential application value. Even more unfortunately, chlorine in AW led to the formation of organic pollutants such as dioxins under higher temperatures. Alkali and alkaline earth metals (AAEMs) in ash may deepen the reaction degree. Co-pretreatment of dry torrefaction and de-ashing followed by thermochemical conversion is a promising technology, which can improve raw material quality, inhibit the release of organic pollutants and transform AW into eco-friendly energy carriers. In order to better understand the process, theoretical basis such as the structural characteristics, thermal properties and separation methods of structural components of AW are described in detail. In addition, dry torrefaction related reactors, process parameters, kinetic analysis models as well as the evaluation methods of torrefaction degree and environmental impact are systematically reviewed. The problem of ash accumulation caused by dry torrefaction can be well solved by de-ashing pretreatment. This paper provides a comprehensive discussion on the role of the two- and three-stage conversion technologies around dry torrefacion, de-ashing pretreatment and thermochemical conversion in products quality enhancement. Finally, the existing technical challenges, including suppression of gaseous pollutant release, harmless treatment and reuse of torrefaction liquid product (TPL) and reduction of torrefaction operating costs, are summarized and evaluated. The future research directions, such as vitrification of the reused TPL (after de-ashing or acid catalysis) and integration of oxidative torrefaction with thermochemical conversion technologies, are proposed.

Self-Concept Clarity and the Bodily Self: Malleability Across Modalities.

The self has fascinated scholars for centuries. Although theory suggests that the self-concept (cognitive self-understanding) and bodily self (pre-reflective awareness of one's body) are related, little work has examined this notion. To this end, in Study 1, participants reported on self-concept clarity (SCC) and completed the rubber hand illusion (RHI), a paradigm in which synchronous (vs. asynchronous) stimulation between a prosthetic hand and one's own hand leads one to "embody" the prosthetic hand. Whereas participants were equally susceptible to the RHI during synchronous stroking, low-SCC individuals were more vulnerable to the illusion during asynchronous stroking, when the effect is unwarranted. Conceptually replicating and extending this finding, in Study 2, low-SCC individuals were more susceptible to the body-swap illusion-the impression that another person's body is one's own. These findings suggest that a clear sense of self implies clarity and stability of both the self-concept and the bodily self.

Do integrated care structures foster processes of integration? A quasi-experimental study in frail elderly care from the professional perspective.

OBJECTIVE: This study explores the processes of integration that are assumed to underlie integrated care delivery. DESIGN: A quasi-experimental design with a control group was used; a new instrument was developed to measure integration from the professional perspective. SETTING AND PARTICIPANTS: Professionals from primary care practices and home-care organizations delivering care to the frail elderly in the Walcheren region of the Netherlands. INTERVENTION: An integrated care intervention specifically targeting frail elderly patients was implemented. MAIN OUTCOME MEASURES: Structural, cultural, social and strategic integration and satisfaction with integration. RESULTS: The intervention significantly improved structural, cultural and social integration, agreement on goals, interests, power and resources and satisfaction with integration. CONCLUSIONS: This study confirms that integrated care structures foster processes of integration among professionals. TRIAL REGISTRATION: Current Controlled Trials ISRCTN05748494.

Associations between level of services integration and nurses' workplace well-being.

BACKGROUND: To respond better to population needs, in recent years Quebec has invested in improving the integration of services and care pathways. Nurses are on the front lines of these transformation processes, which require them to adopt new clinical practices. This updating of practices can be a source of both satisfaction and stress. The aim of this study was to gain a better understanding of the relationship between the transformation processes underlying services integration and nurses' workplace well-being. METHOD: This study was based on a descriptive cross-sectional correlational design. The target population included all nurses working in four care pathways in a Quebec healthcare establishment: palliative oncology services, mental health services, autonomy support for the elderly, and chronic obstructive pulmonary disease. In all, 107 nurses took part in the study and completed a questionnaire sent to them. Hierarchical linear regression analyses were used to examine the relationship between level of integration, measured using the Development Model for Integrated Care; nurses' perceptions of organizational change, measured on four dimensions (challenge, responsibility, threat, control); and nurses' workplace well-being, measured on three dimensions (negative stress, positive stress, satisfaction), as defined by the Flexihealth model. RESULTS: Nurses in the palliative oncology care pathway, which was at a more advanced level of integration, presented a lower negative stress level and a higher positive stress level than did nurses in other care pathways. Their mean satisfaction score was also higher. More advanced integration was associated with nurses' feeling less threatened, as well as improved workplace well-being. The perception of threat appeared to be a significant mediating variable in the relationship between level of integration and well-being. CONCLUSION: The association observed between level of services integration and workplace well-being contributes to a better understanding of nurses' experiences in such situations. These results provide new perspectives on interventions that could be implemented to remedy the potential negative consequences of these types of transformations.

Impacto de los nomencladores nacionales geográficos en el Sistema Nacional de Salud / Impact of the national geographical codifiers in the National System of Health

Como parte del proceso de informatización del Sistema Nacional de Salud (SNS) en Cuba surge la necesidad de contar con una solución informática al menor costo posible para la gestión de la información de salud, de cara a todos los profesionales, técnicos y dirigentes que toman decisiones asistenciales, clínicas o de gestión en salud. La solución tiene que ser eficiente al permitir a los usuarios autorizados combinar la información de los diferentes módulos que componen el Sistema de Información para la Salud (SISalud) y desplegarse centralizadamente para acceder desde cualquier nivel del SNS. Para compartir la información con otros sistemas, el Registro Informatizado de Salud (RIS) sigue una arquitectura orientada a servicios y basada en componentes, formando parte de la estructura de SISalud. Como componentes del RIS se dispone en la actualidad de nomencladores nacionales geográficos, que gestionan de manera homogénea la información del Registro de Ubicación Geográfica, el Registro de Localidades del país y el Registro de las Áreas de Salud, incorporando así la fortaleza de los procesos definidos en el SNS y respetando los procedimientos oficiales que garanticen la confidencialidad de la información de salud. Se expone el impacto para el proceso de informatización del sector a partir de la etapa de piloto o censo. El Proyecto RIS contribuye a un objetivo nacional y sus resultados se generalizan a lo largo del país, produciendo cambios en la gestión de las unidades de salud, pues los recursos humanos deben capacitarse y elevar su cultura informacional(AU)

As part of the process of computerization of the National Health System (NHS) in Cuba there is the need for an IT solution at the lowest cost for the management of health information. The solution must be efficient to allow authorized users to combine information from different modules in the system for Health Information (SISalud) and must be deployed centrally for access from any level of the NHS. To share information with other systems, the Computerized Health Record (RIS) follows a service-oriented architecture and component-based, being part of SISalud structure. Currently available as components of the RIS are geographic nomenclatures, uniformly managing information on the Register of Geographical Location, the Locations Registry and the Registry of the Health Areas, incorporating the strength of the processes defined in the NHS and respecting formal procedures to ensure the confidentiality of health information. We discuss the impact on the sector computerization process from the pilot stage. The RIS project contributes to a national objective and results are generalized throughout the country, producing changes in the management of health units(AU).