Insomnia in hospitalised patients with advanced disease: prevalence and related factors

Objectiu: Avaluar prevalença i factors associats a l’insomni en pacients ingressats a una unitat de cures pal•liatives. Mètode: Entrevista estructurada a pacients consecutivament ingressats avaluant l’insomni a través de l’escala Sleep Disturbance Scale, i els factors físics, psicològics i ambientals potencialment associats. Resultats principals: El 47% presentà insomni moderat a sever. Els factors potencialment associats més prevalents foren dolor, distrés psicològic, rumiacions nocturnes i factors ambientals. En l’anàlisi multivariada, rumiacions nocturnes i somnolència diürna (relació inversa) es relacionaren amb insomni moderat a sever. Conclusions: L’insomni és un símptoma prevalent relacionat amb rumiacions nocturnes i absència de somnolència diürna.

Construction of a scale to evaluate the diurnal impact of insomnia

The objective of this study was to develop and validate a scale to assess the diurnal impact of insomnia. The Insomnia Diurnal Impact Scale (IDIS) comprises six items designed to evaluate the daytime effects of insomnia. The sychometric properties of the original scale were analysed in a sample of 172 students, while its ability to differentiate insomniacs and non-insomniacs (according to the International Classification of Diseases (ICD)-10 criteria) was examined in a sample of 79 psychiatric patients and 82 individuals from the community. The psychometric properties of the English version were then analysed in a sample of 44 Englishspeaking participants. The results showed the internal consistency coefficient to be very good (0.86), with testretest reliability at 1 month being 0.79. A single factor explained almost 60% of the variance. Correlation of the IDIS with other scales varied between moderate and high values. Sensitivity was 78% and specificity 57% in the community sample, while the corresponding figures for the psychiatric population were 83% and 63%. Cronbach's ¿ coefficient for the English version reached a value of 0.93. These results indicate that the IDIS shows adequate reliability and validity with both general and psychiatric populations, and also that it can discriminate between the presence and absence of insomnia. The English version presents good preliminary results regarding item-corrected total correlation and internal consistency. In conclusion, the IDIS appears to be a useful tool in the primary care and mental health contexts for assessing insomnia-related diurnal dysfunction.

A Spanish version of the athens insomnia scale

Objectives To develop and validate a Spanish version of the Athens Insomnia Scale (AIS). Methods The AIS is designed to assess sleep difficulty and comprises eight items: the first five refer to the sleep disturbance and the last three to the daytime consequences. Either the full eight-item scale (AIS-8) or the brief form (AIS-5) can be administered. The adaptation used a backtranslation design. The validation process was based on a sample of 323 participants (undergraduates, community sample and psychiatric outpatients), which completed the AIS and other questionnaires: anxiety (BAI), depression (BDI) and psychological well-being (GHQ-12) scales. Results The internal consistency coefficients for both versions were above 0.80. The study of dimensionality revealed a single factor with high loadings and a percentage of explained variance above 50% in both versions. Test-retest reliability was above 0.70 (AIS-5) and over 0.80 (AIS-8) at a one-month interval. The correlation between the AIS and the previously mentioned scales was for both the AIS-5 and the AIS-8 above 0.40 and 0.50, respectively.

Les Variacions Goldberg

L’Ària amb diverses variacions BWV 988, quarta part dels Clavier-übung, de Johann Sebastian Bach, és una obra que ha estat objecte de molts estudis. La seva extrema bellesa, el sobrenom amb què avui la coneixem, Variacions Goldberg -a partir de la llegenda que explica Forkel sobre un comte que patia insomni i el seu clavecinista Goldberg- i la seva estructura interna tan perfectament calculada, alhora que generadora de grans preguntes complexes de respondre, fan d’aquesta obra un mite indiscutible de la literatura per a teclat que, des de fa més 250 anys, ens continua fascinant i la fa immortal. Aquest treball és una humil aproximació a aquests aspectes, que ens faran acostar-nos al món interior d’aquesta obra.

Anàlisi. Disseny i implementació d'una utilitat de Workflow aplicat a una web de gestió d'un centre de Reclamacions i Queixes mitjançant J2EE : una solució amb Struts i EJBs

El treball final de carrera està compost de l¿anàlisi, disseny i implementació d'una utilitat de Workflow que dóna servei a una web per gestionar les reclamacions i queixes d'una empresa. La part del Workflow s'ha pensat per ser totalment configurable a les particularitats d'un determinat aplicatiu i per donar servei a tantes aplicacions com faci falta simultàniament.L'anàlisi i el disseny s'han basat en la metodologia UML dins el paradigma de l'Orientació a Objectes juntament amb diversos patrons de disseny com pot ser el MVC que ha permès separar completament la lògica de negoci (Workflow) de la presentació (Web). Per les 2 parts: Workflow i web s¿ha fet ús d'una arquitectura distribuïda.

The donor problem

Donors often rely on local intermediaries to deliver benefits to target beneficiaries. Each selected recipient observes if the intermediary under-delivers to them, so they serve as natural monitors. However, they may withhold complaints when feeling unentitled or grateful to the intermediary for selecting them. Furthermore, the intermediary may distort selection (e.g. by picking richer recipients who feel less entitled) to reduce complaints. We design an experimental game representing the donor s problem. In one treatment, the intermediary selects recipients. In the other, selection is random - as by an uninformed donor. In our data, random selection dominates delegation of the selection task to the intermediary. Selection distortions are similar, but intermediaries embezzle more when they have selection power and (correctly) expect fewer complaints.

Analysis of the association between chondrocalcinosis and osteoarthritis: a community based study

To analyse the association between chondrocalcinosis and osteoarthritis (OA) of the hands and knees in an unselected elderly rural population. METHODS--A community based cross sectional study was performed in individuals randomly selected from a previous epidemiological survey on the prevalence of chondrocalcinosis in people older than 60 years from Osona county, Catalonia, northeastern Spain. Radiological OA (grade 2 or more of Kellgren's classification) was evaluated in 26 individuals with chondrocalcinosis and in 104 controls. A total of 18 articular areas of both knees (medial and lateral tibiofemoral compartments) and hands (first, second and third metacarpophalangeal (MCP), first carpometacarpal, trapezium-scaphoid, radiocarpal and distal radioulnar joints) were studied. RESULTS--Radiological changes of OA in the knees were more common in subjects with chondrocalcinosis than in those without it, with an odds ratio adjusted for age and gender (aOR) of 4.3 (95% confidence interval (CI) 1.6 to 11.8, p = 0.005). OA was also more frequent in almost all areas of the hands in individuals with chondrocalcinosis, though the difference reached statistical significance only in the MCP joints (aOR 3.1; 95% CI 1.1 to 8.8; p = 0.033). However, taking into account the side and the different joint compartments analysed, the association between chondrocalcinosis and OA was significant only in the lateral tibiofemoral compartment and the left MCP joints. CONCLUSIONS--In an elderly population unselected for their rheumatic complaints, there was a real association between OA and chondrocalcinosis. This association was particularly relevant in the lateral tibiofemoral compartment of the knee and in the first three left MCP joints.

Las comunicaciones intestatales ante órganos judiciales o cuasi-judiciales de garantía de los derechos humanos: ¿un mecanismo útil en situaciones de crisis?

[spa] Como expresión de la naturaleza erga omnes de las obligaciones jurídicas relativas a la protección de derechos humanos, muchos tratados de derechos humanos que establecen órganos de expertos permiten a los Estados Parte presentar quejas ante dichos órganos contra otras Partes que no observan las obligaciones convencionales. Tales quejas interestatales son un mecanismo híbrido que busca controlar la aplicación del tratado, solucionar las controversias entre Estados Parte y/o prevenir esas controversias. En la práctica, no obstante, las quejas interestatales se interponen en raras ocasiones, principalmente por causa de su alto componente político, que hace que sean vistas como un acto inamistoso. Pese a este escaso uso, llama la atención que la mayoría de quejas interestatales presentadas hasta la fecha se hayan referido a situaciones excepcionales calificables de"crisis", lo que parece poner de manifiesto que este mecanismo podría ser particularmente útil para hacer frente a las violaciones de derechos humanos cometidas en períodos de excepcionalidad.