L'organització territorial de la Regió II

Aquest article presenta les pautes espacials en l'àmbit de la Regió II arran de l'elaboració de l’ estudi sobre l'estructura territorial del Bisbat de Girona realitzat per la Unitat Geogràfica de la Universitat de Girona

Diagnostic accuracy of the Eurotest for dementia: a naturalistic, multicenter phase II study

BACKGROUND Available screening tests for dementia are of limited usefulness because they are influenced by the patient's culture and educational level. The Eurotest, an instrument based on the knowledge and handling of money, was designed to overcome these limitations. The objective of this study was to evaluate the diagnostic accuracy of the Eurotest in identifying dementia in customary clinical practice. METHODS A cross-sectional, multi-center, naturalistic phase II study was conducted. The Eurotest was administered to consecutive patients, older than 60 years, in general neurology clinics. The patients' condition was classified as dementia or no dementia according to DSM-IV diagnostic criteria. We calculated sensitivity (Sn), specificity (Sp) and area under the ROC curves (aROC) with 95% confidence intervals. The influence of social and educational factors on scores was evaluated with multiple linear regression analysis, and the influence of these factors on diagnostic accuracy was evaluated with logistic regression. RESULTS Sixteen neurologists recruited a total of 516 participants: 101 with dementia, 380 without dementia, and 35 who were excluded. Of the 481 participants who took the Eurotest, 38.7% were totally or functionally illiterate and 45.5% had received no formal education. Mean time needed to administer the test was 8.2+/-2.0 minutes. The best cut-off point was 20/21, with Sn = 0.91 (0.84-0.96), Sp = 0.82 (0.77-0.85), and aROC = 0.93 (0.91-0.95). Neither the scores on the Eurotest nor its diagnostic accuracy were influenced by social or educational factors. CONCLUSION This naturalistic and pragmatic study shows that the Eurotest is a rapid, simple and useful screening instrument, which is free from educational influences, and has appropriate internal and external validity.

Use of palliative radiotherapy in brain and bone metastases (VARA II study).

INTRODUCTION Metastases are detected in 20% of patients with solid tumours at diagnosis and a further 30% after diagnosis. Radiation therapy (RT) has proven effective in bone (BM) and brain (BrM) metastases. The objective of this study was to analyze the variability of RT utilization rates in clinical practice and the accessibility to medical technology in our region. PATIENTS AND METHODS We reviewed the clinical records and RT treatment sheets of all patients undergoing RT for BM and/or BrM during 2007 in the 12 public hospitals in an autonomous region of Spain. Data were gathered on hospital type, patient type and RT treatment characteristics. Calculation of the rate of RT use was based on the cancer incidence and the number of RT treatments for BM, BrM and all cancer sites. RESULTS Out of the 9319 patients undergoing RT during 2007 for cancer at any site, 1242 (13.3%; inter-hospital range, 26.3%) received RT for BM (n = 744) or BrM (n = 498). These 1242 patients represented 79% of all RT treatments with palliative intent, and the most frequent primary tumours were in lung, breast, prostate or digestive system. No significant difference between BM and BrM groups were observed in: mean age (62 vs. 59 yrs, respectively); gender (approximately 64% male and 36% female in both); performance status (ECOG 0-1 in 70 vs. 71%); or mean distance from hospital (36 vs. 28.6 km) or time from consultation to RT treatment (13 vs. 14.3 days). RT regimens differed among hospitals and between patient groups: 10 × 300 cGy, 5 × 400 cGy and 1x800cGy were applied in 32, 27 and 25%, respectively, of BM patients, whereas 10 × 300cGy was used in 49% of BrM patients. CONCLUSIONS Palliative RT use in BM and BrM is high and close to the expected rate, unlike the global rate of RT application for all cancers in our setting. Differences in RT schedules among hospitals may reflect variability in clinical practice among the medical teams.

Impact of the gut microbiota on the development of obesity and type 2 diabetes mellitus.

Obesity and its associated disorders are a major public health concern. Although obesity has been mainly related with perturbations of the balance between food intake and energy expenditure, other factors must nevertheless be considered. Recent insight suggests that an altered composition and diversity of gut microbiota could play an important role in the development of metabolic disorders. This review discusses research aimed at understanding the role of gut microbiota in the pathogenesis of obesity and type 2 diabetes mellitus (TDM2). The establishment of gut microbiota is dependent on the type of birth. With effect from this point, gut microbiota remain quite stable, although changes take place between birth and adulthood due to external influences, such as diet, disease and environment. Understand these changes is important to predict diseases and develop therapies. A new theory suggests that gut microbiota contribute to the regulation of energy homeostasis, provoking the development of an impairment in energy homeostasis and causing metabolic diseases, such as insulin resistance or TDM2. The metabolic endotoxemia, modifications in the secretion of incretins and butyrate production might explain the influence of the microbiota in these diseases.

II Cumbre UE-ALC: un encuentro sin estrategia

El proceso de asociación estratégica birregional entre la Unión Europea y América Latina y el Caribe es un ejemplo claro de un intento de cooperación encuadrado en la óptica del neoliberalismo institucional, tanto en su forma –el establecimiento de un mecanismo de acercamiento entre dos regiones del mundo- como en su contenido, manifiesto en el amplio y variado temario plasmado en los acuerdos del Compromiso de Madrid. Sin embargo, si se abordan los resultados del encuentro desde esta misma óptica encontramos que en la Cumbre se desaprovechó una oportunidad de afianzar las relaciones entre ambas regiones, poniendo en riesgo el soft power que ejerce la UE respecto a ALC, a raíz de la decepción de las administraciones latinoamericanas en función de la satisfacción de sus demandas, que ha sido baja.

A combination of ascorbic acid and α-tocopherol to test the effectiveness and safety in the fragile X syndrome: study protocol for a phase II, randomized, placebo-controlled trial.

BACKGROUND Fragile X syndrome (FXS) is an inherited neurodevelopmental condition characterised by behavioural, learning disabilities, physical and neurological symptoms. In addition, an important degree of comorbidity with autism is also present. Considered a rare disorder affecting both genders, it first becomes apparent during childhood with displays of language delay and behavioural symptoms.Main aim: To show whether the combination of 10 mg/kg/day of ascorbic acid (vitamin C) and 10 mg/kg/day of α-tocopherol (vitamin E) reduces FXS symptoms among male patients ages 6 to 18 years compared to placebo treatment, as measured on the standardized rating scales at baseline, and after 12 and 24 weeks of treatment.Secondary aims: To assess the safety of the treatment. To describe behavioural and cognitive changes revealed by the Developmental Behaviour Checklist Short Form (DBC-P24) and the Wechsler Intelligence Scale for Children-Revised. To describe metabolic changes revealed by blood analysis. To measure treatment impact at home and in an academic environment. METHODS/DESIGN A phase II randomized, double-blind pilot clinical trial. SCOPE male children and adolescents diagnosed with FXS, in accordance with a standardized molecular biology test, who met all the inclusion criteria and none of the exclusion criteria. INSTRUMENTATION clinical data, blood analysis, Wechsler Intelligence Scale for Children-Revised, Conners parent and teacher rating scale scores and the DBC-P24 results will be obtained at the baseline (t0). Follow up examinations will take place at 12 weeks (t1) and 24 weeks (t2) of treatment. DISCUSSION A limited number of clinical trials have been carried out on children with FXS, but more are necessary as current treatment possibilities are insufficient and often provoke side effects. In the present study, we sought to overcome possible methodological problems by conducting a phase II pilot study in order to calculate the relevant statistical parameters and determine the safety of the proposed treatment. The results will provide evidence to improve hyperactivity control and reduce behavioural and learning problems using ascorbic acid (vitamin C) and α-tocopherol (vitamin E). The study protocol was approved by the Regional Government Committee for Clinical Trials in Andalusia and the Spanish agency for drugs and health products. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01329770 (29 March 2011).

Els fongs de Catalunya occidental segons les prospeccions recents. II

This paper contains the conclusion of a mycological survey of western Catalonia. The first part of the results was published in Acta Bot. Barc. 45 (Homenatge a Oriol de Bolòs): 57-89. The present part covers the last two groups of Basidiomycota: the agarics (326 species) and the gasteromycetes (44 species). The data regarding the surveyed area, collection localities, abbreviations used in the information on ecology, collectors and identifiers are found in the mentioned first part, which contains records of 37 species of Myxomycota, 5 of Zygomycota, 101 of mitosporic fungi, 8 of Teliomycetes, 1 of Ustomycetes, 16 of Phragmobasidiomycetes and 92 of Aphyllophorales. Together with the first part, the results of our survey are a useful contribution to an improved understanding of the fungal component of plant communities of the dry, warm lowlands of the western Mediterranean region, and highlight the remarkable reproductive activity of the fungi observed during late Autumn and Winter, in the studied area.

Histopathological evaluation of root canal filling materials for primary teeth

This study aimed to assess the response of apical and periapical tissues of dogs¿ teeth after root canal filling with different materials. Forty roots from dogs¿ premolars were prepared biomechanically and assigned to 4 groups filled with: Group I: commercial calcium hydroxide and polyethylene glycol-based paste (Calen®) thickened with zinc oxide; Group II: paste composed of iodoform, Rifocort® and camphorated amonochlorophenol; Group III: zinc oxide-eugenol cement; Group IV: sterile saline. After 30 days, the samples were subjected to histological processing. The histopathological findings revealed that in Groups I and IV the apical and periapical regions exhibited normal appearance, with large number of fibers and cells and no resorption of mineralized tissues. In Group II, mild inflammatory infiltrate and mild edema were observed, with discrete fibrogenesis and bone resorption. Group III showed altered periapical region and thickened periodontal ligament with presence of inflammatory cells and edema. It may be concluded that the Calen paste thickened with zinc oxide yielded the best tissue response, being the most indicated material for root canal filling of primary teeth with pulp vitality.

Comparação de dados dos satélites Ikonos-II e Landsat/ETM+ no estudo de áreas cafeeiras

O objetivo deste trabalho foi avaliar o impacto do aumento da resolução espacial e radiométrica da imagem pancromática do Ikonos-II na identificação de plantios de café (Coffea arabica), em comparação com as imagens do Landsat/ETM+. A área de estudo está localizada no Município de Pedregulho, SP, onde foram selecionados 50 talhões com plantios de café, e foram levantados dados referentes à altura, idade, espaçamento e variedade de cada talhão. As imagens permitiram a identificação de talhões com características diferentes em campo, tendo-se destacado a imagem do Ikonos-II, que apresentou melhor desempenho. Para os talhões com características iguais em campo, as imagens analisadas não se mostraram eficientes, independentemente do satélite utilizado. As correções atmosféricas e radiométricas, na imagem do Ikonos-II, não proporcionaram ganho efetivo nas análises realizadas. A maioria dos talhões identificados na imagem do Ikonos-II pode ser localizada na imagem do Landsat/ETM+ (68%). A correlação significativa entre a banda 4 do Landsat/ETM+ e o canal pancromático do Ikonos-II indica uma forma de ligação entre as imagens dos dois satélites.

L'empresa xarxa a Catalunya : TIC, productivitat, competitivitat, salaris i rendiment a les empreses de Catalunya. Informe final de recerca (volum II)

El projecte de recerca L'empresa xarxa a Catalunya. TIC, productivitat, competitivitat, salaris i beneficis a l'empresa catalana té com a objectiu principal constatar que la consolidació d'un nou model estratègic, organitzatiu i d'activitat empresarial, vinculat amb la inversió i l'ús de les TIC (o empresa xarxa), modifica substancialment els patrons de comportament dels resultats empresarials, en especial la productivitat, la competitivitat, les retribucions dels treballadors i el benefici. La contrastació empírica de les hipòtesis de treball l'hem feta per mitjà de les dades d'una enquesta a una mostra representativa de 2.038 empreses catalanes. Amb la perspectiva de l'impacte de la inversió i l'ús de les TIC no s'aprecia una relació directa entre els processos d'innovació digital i els resultats de l'activitat de l'empresa catalana. En aquest sentit, hem hagut de segmentar el teixit productiu català per a buscar les organitzacions en què el procés de coinnovació tecnològica digital i organitzativa és més present i en què la intensitat de l'ús del coneixement és un recurs molt freqüent per a poder copsar impactes rellevants en els principals resultats empresarials. Això és així perquè l'economia catalana, avui, presenta una estructura productiva dual.

Les TIC i les transformacions de l'empresa catalana. Informe de recerca II

El projecte de recerca Les tecnologies de la informació i la comunicació i les transformacions de l'empresa catalana va analitzar la relació entre l'estratègia, l'organització i les pràctiques empresarials i els usos de les tecnologies de la informació i la comunicació a l'empresa catalana. A partir d'una enquesta a una mostra representativa a 2.038 empreses catalanes, segmentada per branques d'activitat i per dimensió, aquesta recerca va obtenir evidència concloent del procés de construcció de l'empresa xarxa a Catalunya, com també de la relació entre la inversió i els usos de la innovació digital i el seu impacte favorable sobre la productivitat, els salaris i la competitivitat internacional de les empreses catalanes.

Registro arqueobotánico de Cataluña occidental durante el II y I milenio a.n.e.

Se presenta una síntesis de los resultados obtenidos en los estudios de semillas y frutos realizados durante los últimos años en la Cataluña Occidental (especialmente en el llamado Llano Occidental Catalán) en yacimientos del II y I milenio a.n.e. Entre las plantas cultivadas destacan claramente los cereales, sobre todo la cebada vestida (Hordeum vulgare) y el trigo común/duro (Triticum aestivum/durum), con escasa presencia de leguminosas, siendo las más representadas la lenteja (Lens culinaris) y el guisante (Pisum sativum). Nuevos cultivos como los mijos (Panicum miliaceum y Setaria italica) o el lino (Linum usitatissimum) se detectan ya desde mediados del II milenio, mientras que otros como la avena (Avena sativa) se introducen en época ibérica. Se han recuperado también testimonios de recolección, como las bellotas (Quercus sp.) o la uva silvestre (Vitis vinifera ssp. sylvestris), así como de la vegetación arvense, principalmente el raygrás (Lolium sp.).

Características hidráulicas y geomorfológicas de ríos de montaña (II)

En el primer artículo, de una serie de tres destinados a una síntesis del estado del conocimiento acerca de la hidráulica y la geomorfología fluvial que se desarrollan en ríos de montaña, se puso de manifiesto el papel absolutamente determinante de las cuencas montanas en los recursos hídricos mundiales. Asimismo, se describieron los rasgos definitorios de las tres categorías de flujo consideradas en cauces de montaña en función de la concentración del sedimento transportado (de baja concentración, hiperconcentrado y lava torrencial). En este segundo artículo se exponen las principales características hidráulicas del flujo de baja concentración de sedimento.

Ética de las organizaciones de Servicios Sociales (parte II)

Este artículo, por su extensión, se dividió en dos partes. La primera, que se editó en el número anterior, se centró en descubrir las características tanto de las organizaciones del bienestar, como de la ética cuando se aplica a la organización. En esta segunda parte, se presenta un esquema para situar y analizar la dimensión ética en las organizaciones de Servicios Sociales así como la postura que, en ellos, correspondería tomar a los profesionales. Con ello se trata de establecer la conveniencia de introducir o profundizar la reflexión ética en las organizaciones de Servicios Sociales y aportar argumentos que demuestren que también incumbe a éstas el plantearse y mantener en todo lo posible un tipo de comportamiento honesto, acorde con la dignidad de todas las personas y posibilitador de una vida buena.

Distribución espacial de las clases altas en la región metropolitana de Madrid 2001-2011

La articulación espacial de elites y clases altas influye en el desarrollo urbano, puede condicionar la viabilidad de los servicios municipales y desencadenar polémicos procesos de gentrificación. Estos patrones de distribución territorial de las clases altas se estudian para la región metropolitana de Madrid mediante tres perspectivas: del análisis multivariable y cartográfico; de la intensidad de la segregación; y de la articulación interna que genera la movilidad obligada entre municipios. Los resultados indican que la CAM presenta cinco grandes conglomerados de municipios especializados socioespacialmente: tres de clase alta y medio-alta situados al norte y oeste de la comunidad, uno de carácter mixto al este (el subsistema entorno a Alcalá de Henares) y uno de clases bajas en el sur. Los datos a nivel de secciones censales muestran una fuerte segregación y un patrón característico de la CAM: centros urbanos con alta presencia de clases bajas. Esta configuración puede asociarse a la histórica preponderancia de Madrid capital