Antipsychotic polypharmacy in a regional health service: a population-based study

Background To analyse the extent and profile of outpatient regular dispensation of antipsychotics, both in combination and monotherapy, in the Barcelona Health Region (Spain), focusing on the use of clozapine and long-acting injections (LAI). Methods Antipsychotic drugs dispensed for people older than 18 and processed by the Catalan Health Service during 2007 were retrospectively reviewed. First and second generation antipsychotic drugs (FGA and SGA) from the Anatomical Therapeutic Chemical classification (ATC) code N05A (except lithium) were included. A patient selection algorithm was designed to identify prescriptions regularly dispensed. Variables included were age, gender, antipsychotic type, route of administration and number of packages dispensed. Results A total of 117,811 patients were given any antipsychotic, of whom 71,004 regularly received such drugs. Among the latter, 9,855 (13.9%) corresponded to an antipsychotic combination, 47,386 (66.7%) to monotherapy and 13,763 (19.4%) to unspecified combinations. Of the patients given antipsychotics in association, 58% were men. Olanzapine (37.1%) and oral risperidone (36.4%) were the most common dispensations. Analysis of the patients dispensed two antipsychotics (57.8%) revealed 198 different combinations, the most frequent being the association of FGA and SGA (62.0%). Clozapine was dispensed to 2.3% of patients. Of those who were receiving antipsychotics in combination, 6.6% were given clozapine, being clozapine plus amisulpride the most frequent association (22.8%). A total of 3.800 patients (5.4%) were given LAI antipsychotics, and 2.662 of these (70.1%) were in combination. Risperidone was the most widely used LAI. Conclusions The scant evidence available regarding the efficacy of combining different antipsychotics contrasts with the high number and variety of combinations prescribed to outpatients, as well as with the limited use of clozapine. Background To analyse the extent and profile of outpatient regular dispensation of antipsychotics, both in combination and monotherapy, in the Barcelona Health Region (Spain), focusing on the use of clozapine and long-acting injections (LAI). Methods Antipsychotic drugs dispensed for people older than 18 and processed by the Catalan Health Service during 2007 were retrospectively reviewed. First and second generation antipsychotic drugs (FGA and SGA) from the Anatomical Therapeutic Chemical classification (ATC) code N05A (except lithium) were included. A patient selection algorithm was designed to identify prescriptions regularly dispensed. Variables included were age, gender, antipsychotic type, route of administration and number of packages dispensed. Results A total of 117,811 patients were given any antipsychotic, of whom 71,004 regularly received such drugs. Among the latter, 9,855 (13.9%) corresponded to an antipsychotic combination, 47,386 (66.7%) to monotherapy and 13,763 (19.4%) to unspecified combinations. Of the patients given antipsychotics in association, 58% were men. Olanzapine (37.1%) and oral risperidone (36.4%) were the most common dispensations. Analysis of the patients dispensed two antipsychotics (57.8%) revealed 198 different combinations, the most frequent being the association of FGA and SGA (62.0%). Clozapine was dispensed to 2.3% of patients. Of those who were receiving antipsychotics in combination, 6.6% were given clozapine, being clozapine plus amisulpride the most frequent association (22.8%). A total of 3.800 patients (5.4%) were given LAI antipsychotics, and 2.662 of these (70.1%) were in combination. Risperidone was the most widely used LAI. Conclusions The scant evidence available regarding the efficacy of combining different antipsychotics contrasts with the high number and variety of combinations prescribed to outpatients, as well as with the limited use of clozapine.

El Museo Regional del Rif (Marruecos). Proyecto científico y cultural sobre la constitución de un museo de sociedad del Rif.

The end of this paper is to offer a Planning Project aimed to the prospective museum of the Rif society. The authors, unaware of the actual purpose of both political and cultural institutions, which eventually will decide about the museum and its location, just want to attract the attention of those responsible for some aspects and the chronological periods that the Planning Project must take into account to assure the success of this new Riffian cultural institution.

La oportunidad de Turquía de posicionarse como líder regional ante la UE : la Primavera Árabe

Las revueltas en el Maghreb y Mashrek entre otras consecuencias han promovido la diversificación de actores en el área mediterránea, de manera que la UE ya no es el único vecino con intereses en la región. Turquía, el eterno candidato a la adhesión, ha sido designada por académicos y políticos como un modelo de Estado secular y multipartidista donde la separación entre la religión y la política representa uno de sus pilares constitucionales. Además, el Primer Ministro Recep Tayyip Erdogan se ha erigido como un líder en la región Mediterránea debido al viraje de la política turca de asuntos exteriores. En otros términos, Turquía ya no es un país completamente aliado del mundo occidental para los árabes, sino que ha asumido su responsabilidad en la escena global. Sin embargo, dicha determinación se ha alcanzado a través de actuar como un poder blando asumiendo como propio la máxima aportación europea a las relaciones internacionales.

Regional determinants of firm entry in a developing country

We analyse the determinants of firm entry in developing countries using Argentina as an illustrative case. Our main finding is that although most of the regional determinants used in previous studies analysing developed countries are also relevant here, there is a need for additional explanatory variables that proxy for the specificities of developing economies (e.g., poverty, informal economy and idle capacity).We also find evidence of a core-periphery pattern in the spatial structure of entry that seems to be mostly driven by differences in agglomeration economies. Since regional policies aiming to attract new firms are largely based on evidence from developed countries, our results raise doubts about the usefulness of such policies when applied to developing economies. JEL classification: R12, R30, C33. Key words: Firm entry, Argentina, count data models.

Reconstruction of the Regional GDP of Portugal, 1890 – 1980

[cat] Aquest article metodològic ofereix estimacions del PIB per càpita regional de les regions portugueses, entre 1890 i 1980. Aquestes estimacions s’han obtingut seguint la metodologia proposada per (Geary and Stark, 2002) per a la industria, i considerant estimacions de producció directa per la resta de sectors.

Reconstruction of the Regional GDP of Portugal, 1890 – 1980

[cat] Aquest article metodològic ofereix estimacions del PIB per càpita regional de les regions portugueses, entre 1890 i 1980. Aquestes estimacions s’han obtingut seguint la metodologia proposada per (Geary and Stark, 2002) per a la industria, i considerant estimacions de producció directa per la resta de sectors.

Una aproximación a la evolución de la ciencia regional en España a través de las contribuciones a las Reuniones de Estudios Regionales (1973-2004)

This paper presents a bibliometric analysis of the contributions that have been presented to the 30 Spanish Regional Studies Meetings which have been hold since 1973. Firstly, the paper displays rankings of the authors and institutions that have participated more actively in the Meetings. Secondly, the paper analyses the main changes in the objectives, topics and research techniques of the contributions, as well as in the scientific specialisation of their authors. This analysis allows drawing some conclusions on the evolution of Regional Science in Spain throughout the last 30 years.

Evaluating the Performance of a Regional-Scale Photochemical Modelling System: Part I Ozone Predictions

We present a detailed evaluation of the seasonal performance of the Community Multiscale Air Quality (CMAQ) modelling system and the PSU/NCAR meteorological model coupled to a new Numerical Emission Model for Air Quality (MNEQA). The combined system simulates air quality at a fine resolution (3 km as horizontal resolution and 1 h as temporal resolution) in north-eastern Spain, where problems of ozone pollution are frequent. An extensive database compiled over two periods, from May to September 2009 and 2010, is used to evaluate meteorological simulations and chemical outputs. Our results indicate that the model accurately reproduces hourly and 1-h and 8-h maximum ozone surface concentrations measured at the air quality stations, as statistical values fall within the EPA and EU recommendations. However, to further improve forecast accuracy, three simple bias-adjustment techniques mean subtraction (MS), ratio adjustment (RA), and hybrid forecast (HF) based on 10 days of available comparisons are applied. The results show that the MS technique performed better than RA or HF, although all the bias-adjustment techniques significantly reduce the systematic errors in ozone forecasts.

Variación regional del coeficiente de atenuación de las ondas Rayleigh en el escudo europeo

A partir del análisis del modo fundamental de las ondas Rayleigh generadas por tres terremotos situados en las Azores, Sicilia y el Mar Negro se obtiene la variación regional del coeficiente de atenuación en el escudo europeo para un intervalo de periodos de 15-80 s. El método de análisis ha consistido en comparar los espectros de amplitudes observados con los calculados teóricamente. Para el calculo de estos últimos se ha utilizado un nuevo método consistente en calcular la función global de la fuente a partir de un proceso de mínimos cuadrados. Los resultados son los siguientes.

Task Trade and its determinants in Spain: a national and regional analysis

Globalisation and technological advances have made possible to offshore specific productive tasks (that do not require physical proximity to the actual location of the work unit) to foreign countries where these are usually performed at lower costs. We analyse the effect of task trade (i.e. task offshorability) on Spanish regional and national employment levels correlating a newly built index of task-delocalisation index to key variables such as the region’s wealth, the worker’s age and level of education, the importance of the service sector and the technological level of the economic activities undertaken in that particular geographical area. We conclude that approximately 25 per cent of Spanish occupations are potentially affected by task trade / offshoring and that this is likely to benefit Spanish economy (and the performance of specific regions, categories of workers and sectors) being Spain a potential recipient of tasks offshored from abroad. Also we obtain that Spain’s trade in tasks correlates strongly with the above variables, presenting significant regional differences.

3,4-Methylenedioxy-methamphetamine induces in vivo regional up-regulation of central nicotinic receptors in rats and potentiates the regulatory effects of nicotine on these receptors

Nicotine (NIC), the main psychostimulant compound of smoked tobacco, exerts its effects through activation of central nicotinic acetylcholine receptors (nAChR), which become up-regulated after chronic administration. Recent work has demonstrated that the recreational drug 3,4-methylenedioxymethamphetamine (MDMA) has affinity for nAChR and also induces up-regulation of nAChR in PC 12 cells. Tobacco and MDMA are often consumed together. In the present work we studied the in vivo effect of a classic chronic dosing schedule of MDMA in rats, alone or combined with a chronic schedule of NIC, on the density of nAChR and on serotonin reuptake transporters. MDMA induced significant decreases in [3H]paroxetine binding in the cortex and hippocampus measured 24 h after the last dose and these decreases were not modified by the association with NIC. In the prefrontal cortex, NIC and MDMA each induced significant increases in [3H]epibatidine binding (29.5 and 34.6%, respectively) with respect to saline-treated rats, and these increases were significantly potentiated (up to 72.1%) when the two drugs were associated. Also in this area, [3H]methyllycaconitine binding was increased a 42.1% with NIC + MDMA but not when they were given alone. In the hippocampus, MDMA potentiated the a7 regulatory effects of NIC (raising a 25.5% increase to 52.5%) but alone was devoid of effect. MDMA had no effect on heteromeric nAChR in striatum and a coronal section of the midbrain containing superior colliculi, geniculate nuclei, substantia nigra and ventral tegmental area. Specific immunoprecipitation of solubilised receptors suggests that the up-regulated heteromeric nAChRs contain a4 and b2 subunits. Western blots with specific a4 and a7 antibodies showed no significant differences between the groups, indicating that, as reported for nicotine, up-regulation caused by MDMA is due to post-translational events rather than increased receptor synthesis.

The Spatial Distribution of Human Capital: Can It Really Be Explained by Regional Differences in Market Access?

This paper tests the robustness of estimates of market access impact on regional variability in human capital, as previously derived in the NEG literature. Our hypothesis is that these estimates of the coefficient of market access, in fact, capture the effects of regional differences in the industrial mix and the spatial dependence in the distribution of human capital. Results for the Spanish provinces indicate that the estimated impact of market access vanishes and becomes non-significant once these two elements are included in the empirical analysis.

Geography of talent and regional differences in Spain

Tentative empirical evidence suggests that the agglomeration of talent contributes to regional development. However, given that talented people are not evenly distributed across regions, this paper seeks to determine how the concentration of talent affects patterns of regional development. Here, we empirically evaluate the effects of the distribution of talent on regional differences by means of a detailed analysis of the 17 Autonomous Communities of Spain between 1996 and 2004. We hypothesise that regions specialising in strategic sectors that are creative and which can be assumed to enjoy rapid growth in productivity will experience faster rates of development and, in turn, that this concentration of talent will have a positive impact on the region’s economic performance. Thus, we believe that this mechanism can explain the marked regional imbalances in Spain. Our findings confirm that regional differences, measured in terms of GDP per capita and by, - industrial and service- oriented production, are influenced by the Communities’ talent bases as determined by, educational attainment and employment in assumed to be strategic for regional development, inasmuch as these sectors provide economic specialization.

Young people and youth policies in Spain in times of austerity: between juggling and the trapeze

The aim of this article is to present and discuss the situation regarding young people and youth policy in Spain via the parameters of the magic triangle linking policy, research and action: (1) the situation of young people in Spain today -some indicators are highlighted regarding the main challenges and opportunities for young people, with references to the so-called"Ni-Nis" (neither studying nor working)- and the movement of the"outraged" youth that occupied the streets of Spain"s major cities in May 2011; (2) the current approaches adopted by public youth policies in Spain and limitations and difficulties encountered by the government in attempting to meet the demands of young people; (3) social work with young people and professionals involved in youth policies. In the last section, we conclude with some open questions and proposals for the immediate future