Leaching performance of concrete eco-blocks: Towards zero-waste in precast concrete plants.

This work presents a case study of waste incorporation, where precast concrete block rejects were reincorporated into the production of new recycled concrete blocks which stands for a technically and environmentally viable alternative to natural aggregates. This study therefore evaluated the technical feasibility, first, and the leaching performance, after, of recycled vibro-compacted dry mixed concrete blocks using different percentages of substitution of recycled aggregates (RA) coming from precast concrete block rejects in order to identify those that presented a better technical performance. According to the results, concrete blocks with a 20% of RA incorporation presented an optimum physic-mechanical behaviour.

Risk assessment by percolation leaching tests of extensive green roofs with fine fraction of mixed recycled aggregates from construction and demolition waste.

Extensive green roofs are urban construction systems that provide thermal regulation and sound proofing for the buildings involved, in addition to providing an urban heat island mitigation or water retention. On the other hand, policies towards reduction of energy consumption, a circular economy and sustainability are core in the European Union. Motivated by this, an experimental study was carried out to evaluate the environmental risk assessment according to release levels of polluting elements on leachates of different green roof substrate mixtures based on recycled aggregates from construction and demolition waste through (i) the performance in laboratory of two procedures: compliance and percolation tests and (ii) an upscaled experimental leaching test for long-term on-site prediction.

Nominal group technique: a brainstorming tool for identifying areas to improve pain management in hospitalized patients.

Background: Pain management in hospitalized patients remains a priority area for improvement; effective strategies for consensus development are needed to prioritize interventions.

Objective: To identify challenges, barriers, and perspectives of healthcare providers in managing pain among hospitalized patients.

Design: Qualitative and quantitative group consensus using a brainstorming technique for quality improvement-the nominal group technique (NGT).

The Dreyfus model of clinical problem-solving skills acquisition: a critical perspective.

Context: The Dreyfus model describes how individuals progress through various levels in their acquisition of skills and subsumes ideas with regard to how individuals learn. Such a model is being accepted almost without debate from physicians to explain the 'acquisition' of clinical skills.

Objectives: This paper reviews such a model, discusses several controversial points, clarifies what kind of knowledge the model is about, and examines its coherence in terms of problem-solving skills.

Validity versus feasibility for quality of care indicators: expert panel results from the MI-Plus study.

Background: In the choice and definition of quality of care indicators, there may be an inherent tension between feasibility, generally enhanced by simplicity, and validity, generally enhanced by accounting for clinical complexity.

Objective: To study the process of developing quality indicators using an expert panel and analyze the tension between feasibility and validity.

Design And Participants: A multidisciplinary panel of 12 expert physicians was engaged in two rounds of modified Delphi process to refine and choose a smaller subset from 36 indicators; these were developed by a research team studying the quality of care in ambulatory post-myocardial infarction patients with co-morbidities.

Attitudes and Views of Medical Students toward Science and Pseudoscience.

Objectives: To know opinions, attitudes and interest of medical students toward science and pseudoscience.

Design: A questionnaire was administered to 124 medical students of the San Marcos University in Lima, Peru.

Results: 173 students were surveyed.

Epistemological Beliefs and Knowledge among Physicians: A Questionnaire Survey.

Background: All sciences share a common underlying epistemological domain, which gives grounds to and characterizes their nature and actions. Insofar as physicians depend on scientific knowledge, it would be helpful to assess their knowledge regarding some theoretical foundations of science.

Objectives: 1.