Andreu Sala i l'arribada del barroc a Catalunya

Andreu Sala és l’escultor que millor patentitza la introducció de l’estètica i l’univers conceptual i espiritual de l’alt-barroc romà a Catalunya. En aquest treball s’intentarà donar llum a l’univers documental que amaga amb recel les poques notícies referides a l’escultor i també aportar noves hipòtesis i arguments per tal de forjar una idea més clarivident de la vida i obra de l’imaginaire Andreu Sala

L’Inventari de recursos turístics a l’àmbit local: metodologia per a l’inventari dels recursos naturals i culturals per a la Carta Europea de Turisme Sostenible al Parc Natural del Montseny

El present projecte neix de la proposta facilitada per l’Oficina del Parc Natural del Montseny en relació a les accions a portar a terme dins els compromisos de la Carta Europea de Turisme Sostenible (CETS) al parc durant els anys 2011-2015. Es dissenya una metodologia a portar a terme per a l’elaboració de l’inventariat dels recursos turístics, naturals i culturals, dins dels municipis que engloben el territori de la Carta. Així mateix, aquest projecte pretén ser una eina útil, no només per a la catalogació dels recursos, sinó també per a la jerarquització d’aquests en termes de potencial turístic

Unidireccionalitat i bidireccionalitat en les xarxes socials dels museus catalans

L’objectiu general d’aquest treball és analitzar les xarxes socials dels museus catalans registrats per a veure si les utilitzen com a un canal de comunicació unidireccional o bidireccional

Estat de la qüestió sobre la romanització en l'àmbit rural de l'illa de Menorca : revisió crítica de les investigacions

Estat de la qüestió de les investigacions que s'han portat a terme sobre la continuïtat d'ocupació en els poblats talaiòtics durant l'època romana a Menorca. S'estudia la continuïtat en relació al procés de romanització que va patir l'illa

Treball final de màster

Desenvolupament d’una unitat didàctica dissenyada per al centre d’educació secundària IES Ramon Turró i Darder de Malgrat de Mar que està basada principalment en corrents i teories psicopedagògiques com els processos de la piràmide o taxonomia de Bloom i la teoria de l’aprenentatge significatiu de David Ausubel. Per portar a terme les activitats de la unitat didàctica, des de les inicials fins a les de síntesi, s’han seguit els processos de la piràmide o taxonomia de Bloom en la qual es van superant i es va augmentant el nivell de dificultat de les activitats de l’alumnat fins a aconseguir arribar a nivells de reflexió i de creació per part dels alumnes. Per una altra banda, es destacaria la teoria de l’aprenentatge significatiu de David Ausubel en la qual els nous coneixements es van incorporant en l’alumne a partir d’una sèrie de passos i d’aspectes que s’han de tenir en compte. En relació amb la piràmide de Bloom, l’alumnat rep una informació que desconeixia fins aquell moment i que ha relacionat amb els coneixements que ja portava incorporats. Perquè els diferents passos es puguin desenvolupar cal que per part del docent es produeixi un guiatge i unes explicacions a partir d’uns materials que han d’adequar-se a les capacitats dels alumnes

Formació a professionals de l'àmbit de l'atenció i la protecció a la infància: eines de treball per a la capacitació parental

Els serveis i equips d’atenció a la infància i a l’adolescència tenen per objectiu assegurar el benestar i l’adequat desenvolupament dels infants en el sí de la família. L’objectiu principal d’aquest projecte es concreta en donar eines i estratègies als professionals de l’àmbit d’atenció i protecció als infants que permetin la millora de les seves intervencions amb el conjunt de la família (pràctica professional)

El suïcidi a Catalunya : una mirada teòrica i estadística

Endinsar-se en l’estudi de les tipologies i les estadístiques de suïcidis implica posarsobre la taula una problemàtica que durant els últims anys ha estat tabú fora delsarticles científics, ja que es tenia por que parlar d’aquest tema en mitjans decomunicació podria fomentar l’aparició de més suïcidis.Aquest article pretén realitzar una mirada estadística i comparativa del suïcidi aCatalunya els darrers dos anys i a la província de Girona els darrers 10 anys. Laintenció es desvetllar certs interrogants que, per manca d’informació, no estant al’abast de molta gent, com podrien ser: Quin gènere es suïcida més, homes o dones?A quina edat o franja d’edat hi ha més suïcidis? Aquestes dades són percentualmentiguals a tot arreu?Amb aquesta finalitat, i per intentar donar resposta a aquestes qüestions realitzaremun visió objectiva, comparativa i concreta dels resultats obtinguts, tenint present queés tan sols una fotografia determinada d’una població

Tacrolimus vs. Azathioprine in myasthenia gravis treatment: a multicenter, prospective, randomized, double blind, head to head clinical trial

Current evidences show that tacrolimus could be a good therapeutic option in patients non-responsive to first-line treatments and even it could become one of the first-line drugs for treating MG. Our study will try to determine the effectivity and safety of tacrolimus in 190 myasthenia gravis patients with suboptimal response to azathioprine: after 12 months of treatment they will be randomized to continue with azathioprine or they will be switched to tacrolimus. Patients will follow the allocated treatment during 14 months and the response will be assessed as well as adverse effectsPURPOSE: To compare azathioprine vs. tacrolimus effectivity and safety in MG patients with suboptimal response to azathioprine at 12 monthsDESIGN: A 14 months multicenter, prospective, randomized, double blind, head to head clinical trial

Intestinal microbiota in the adenoma progression to colorectal cancer: a cross-sectional study

Background: Colorectal cancer is a major health problem worldwide and many efforts have been done to delineate risk factors and develop screening strategies to reduce its incidence and mortality. Colorectal adenomas have been clearly considered preneoplastic lesions due to their potential malignant transformation via the adenoma-carcinoma sequence. Over the last years, intestinal microbiota has been studied in several diseases and it has been hypothesized that colonic microbiota could influence colorectal cancer pathogenesisObjective: The goal of this study is to analyse whether there is an association between the fecal microbiota profiling and the presence and progression of colorectal adenomas, detected in population undergoing colonoscopy, to better understand the role of intestinal microbiota in colorectal carcinogenesisDesign: A cross-sectional study in the Gastroenterology Department at Hospital Universitari Doctor Josep Trueta in Girona, in a period of time of two yearsParticipants: General population undergoing screening or diagnostic colonoscopy in the Digestive Endoscopy UnitOutcomes: Identification and characterization of intestinal microbiota in stool samples from healthy patients and patients with low and high risk colorectal adenomas

The influence of a certain volume of fluid in the lower tear meniscus on intraocular pressure measurements using the non-contact tonometer

Background: Intraocular pressure (IOP) is the pressure inside the eye that helps to maintain the integrity and the suitable form of the ocular globe. Precise and accurate measures of IOP are needed for the diagnosis as well as follow-up of glaucoma. In daily clinical practice, Goldmann applanation tonometer (GAT) and Non-contact tonometer (NCT) are the most common devices for measuring IOP. A close agreement between these methods has been showed, particularly in normotensive patients and a poor agreement, especially when IOP levels are above the normal range. Ophthalmologists have noticed a poor agreement between NCT and GAT, observing that by using NCT and after comparing with GAT, there is an overestimation of IOP readings, and particularly it occurs when the eyes are tearful. Previous studies investigate the effect of tears in Non-contact tonometer readings by the instillation of artificial tears, concluding in one of the studies that the variation was less than 1mmHg and not clinically significant, in contrast with another study which the increases were sadistically significant. Tear menisci are a thin strip of tear fluid located between the bulbar conjunctiva and the eyelid margins. We think that the overestimation of IOP readings using NCT could be due to the presence of a higher volume of tear in the lower tear meniscus which might cause an optical interference in the optoelectronic applanation monitoring system of this deviceObjectives: To research the influence of a certain volume of fluid in the lower tear meniscus on IOP measurements using the NCT in healthy eyes. Moreover, to investigate the agreement between IOP readings obtained by NCT and GAT in the presence and absence of this volume of fluidMethods: The study design will be transversal for diagnostic tests of repeated measures. We will study patients with no ocular pathology and IOP<21mmHg. It will consist in the measurement of IOP using NCT before and after the instillation of COLIRCUSÍ FLUOTEST, used as a volume of fluid in the lower tear meniscus, to observe if there will be differences using the paired t-test. Moreover, we will take IOP measures by GAT in order to know the agreement between these methods after and before the application of these eyedrops, using the ICC (intraclass correlation coefficient) and the Bland-Altmann method

Efficacy of methotrexate to prevent postoperative recurrence of Crohn's disease

BACKGROUND: endoscopic postoperative recurrence (POR) of Crohn’s disease (CD) is the presence of lesions in previously unaffected intestinal segments and occurs in up to 85% of patients one year after bowel resection. Patients at low risk for POR can either remain untreated until lesions recur or receive immediate prevention after surgery with mesalazine, azathioprine (AZA) and/or metronidazole, although with moderate benefit. Out of the postoperative setting, methotrexate (MTX) has been shown to be efficacious for induction and maintenance of remission and has been established as the second-line immunosuppressant for patients with CD unresponsive or intolerant to AZA.AIMS: to determine the efficacy and safety of MTX to prevent endoscopic and clinical POR at 24 weeks after surgery in low risk patientsMETHODS: the study consists on a multicenter, randomized, double-blind and placebo-controlled clinical trial that will enroll 132 patients at low risk for POR (non-smokers, first intestinal resection, non-penetrating behavior). Patients will be randomized to receive subcutaneous MTX at doses of 25 mg/week or an identical placebo, for 24 weeks. Endoscopic and clinical assessment of POR will be performed after 24 weeks (6 months) of treatment. The main outcome is endoscopic POR, defined as a Rutgeerts score of >i2, and secondary outcomes include clinical POR, defined as >i2 lesions plus a Crohn’s Disease Activity Index (CDAI) >150, and description of adverse events

Reliability of intraoperative ultrasound in margin status assessment in women undergoing breast conserving surgery

Background: Effective treatment for breast cancer requires accurate preoperative planning, developing and implementing a consistent definition of margin clearance, and using tools that provide detailed real-time intraoperative information on margin status. Intraoperative ultrasound (IOUS) may fulfil these requirements and may offer few advantages that other preoperative localization and intraoperative margin assessment techniques may notPurpose: The goal of the present work is to determine how accurate the intraoperative ultrasound should be to acquire complete surgical excision with negative histological margins in patients undergoing Breast Conservative SurgeryDesign: A diagnostic test study with a cross-sectional design carried out in a tertiary referral hospital in Girona within a Breast Pathology UnitParticipants: Women diagnosed with breast cancer undergoing a Breast Conservative Surgery in the Breast Pathology Unit at Hospital Universitari de Girona Dr. Josep Trueta

Targeted vs. standard treatment against Helicobacter pylori: safety assessment clinical trial

Helicobacter pylori (H. pylori) is a gram negative bacteria that represents a considerable global burden in the world and is related to many gastrointestinal diseases (peptic ulcer, gastric MALT lymphoma or gastric cancer). Currently the triple standard therapy is less used as there is an increase of the clarithromycin resistance. Therefore patients have to receive several lines of treatment with the consequence of adverse events and the possibility to interrupt the treatment. This is why the main objective is to determine if making a culture and antibiogram to do a targeted treatment cause less adverse events with the same eradication than making an empirical treatment to eradicate H. pylori. The secondary objective is to determine the prevalence of resistance to clarithromycin in the province of GironaThis is a multicentre clinical trial without blinding; patients are selected by non-probabilistic sampling, with a total sample of 868 patients randomized in two equal groups of 434 patients in each group. The study will last 2 years. The endpoints will be to evaluate the adverse events and eradication of each group of patients. Also it will be evaluated the resistance to clarithromycin

TCDI vs TCD for stroke risk prevention in children with sickle cell anemia: a cross-sectional study

Children with sickle cell anemia (SCA) are at increased risk of stroke. Elevated blood-flow velocities in the middle cerebral artery detected by Transcranial Doppler (TCD) are a good predictor of stroke risk in these children. Velocities obtained by TCD are measured by using a specific parameter, the time-averaged mean of the maximum velocity (TAMM). Children with TAMM velocities ≥200 cm/sec are at high risk of stroke, and transfusions as primary prevention might be done. Transcranial Doppler-imaging (TCDI) is now widely available and it allows the visualization of intracranial vessels.Few studies have compared the TAMM in TCD and TCDI, and no studies have established a cutoff point for TAMM in TCDI equivalent to the STOP criteria of “normal”, “conditional” and “abnormal”, which could predict a high risk of stroke in children with SCAObjectives: To compare the TAMM velocity obtained by TCDI with the TAMM velocity obtained with TCD in the middle cerebral artery, and to determine a cutoff point for TAMM in TCDI that could predict a high risk of stroke in children with SCAMethods: This study is a cross-sectional study of a diagnostic test. 78 children with sickle cell anemia between 2 to 16 years will be evaluated with both TCD and TCDI in order to determinate the TAMM with the two devices. Velocities obtained with both Doppler techniques will be compared using an intraclass correlation coefficient

Percutaneous access versus standard femoral exposure for endovascular abdominal aortic aneurysm repair: a randomized, controlled trial

The treatment of abdominal aortic aneurysm (AAA) has shifted from the exposure of the aorta artery in an open repair technique to a small groin cut in an endovascular repair. Recently, a percutaneous access for endovascular repair has appeared. This new technique aims to minimize the complications of the common femoral artery exposure, the patient discomfort and the length of hospitalizationObjectives: To compare the proportion of discharged patients within the first 48 postoperative hours of two common femoral artery accesses for endovascular repair of AAA: the open exposure technique and the percutaneous technique. Secondary objectives include to evaluate the total procedure time, the femoral access complications, the need for extra analgesia and the patient satisfaction and groin discomfort of the two techniquesDesign: Randomized controlled trial conducted between 2014 and 2017Participants: Patients diagnosed with abdominal aortic aneurysm with elective endovascular repair indication