Médecine de l'adolescence. La Guglera: une réponse nouvelle et originale aux adolescents gravement obèses et sans travail [Adolescent medicine in Guglera: a novel approach for unemployed, severely obese adolescents]

The Center "la Guglera", located in the canton of Fribourg (Switzerland) provides a novel approach to the care of severely obese adolescents who are currently unemployed. These young people, whose BMI is usually higher than 35 to 40 kg/m2 spend a 6 to 12 months long stay in an in-patient institution which also takes care of other unemployed non obese adolescents on an outpatient basis. Besides a nutritional education which is part of the everyday life of the institution, the program includes a generous amount of hours of physical activities and sports. The adolescents also participate in a rehabilitation training program which fosters the future integration in a professional milieu, such as an apprenticeship. The short term results of la Guglera seem very promising. The program is financially co-supported by the Swiss and cantonal administrations, the insurance companies and the parents.

From controlling to letting go : what are the psychosocial needs of parents of adolescents with a chronic illness?

While one of the main objectives of adolescence is to achieve autonomy, for the specific population of adolescents with a chronic illness (CI), the struggle for autonomy is accentuated by the limits implied by their illness. However, little is known concerning the way their parents manage and cope with their children's autonomy acquisition. Our aim was to identify the needs and preoccupations of parents of adolescents with CI in coping with their children's autonomy acquisition and to determine whether mothers and fathers coped differently. Using a qualitative approach, 30 parents of adolescents with CI participated in five focus groups. Recruitment took place in five specialized pediatric clinics from our university hospital. Thematic analysis was conducted. Transcript analyses suggested four major categories of preoccupations, those regarding autonomy acquisition, giving or taking on autonomy, shared management of treatment and child's future. Some aspects implied differences between mothers' and fathers' viewpoints and ways of experiencing this period of life. Letting go can be hard for the father, mother, adolescent or all three. Helping one or the other can in turn improve family functioning as a whole. Reported findings may help health professionals better assist parents in managing their child's acquisition of autonomy.

Girona entre l'Islam i Carlemany: una ciutat de frontera (759-801)

Tradicionalment s'ha considerat l'ocupació de Girona pels francs (any 785) com el moment "fundacional" de la ciutat medieval, en paral·lel a la consideració que ha merescut l'època de Carlemany (final del segle VIII i principi del IX) com una època formativa en la història de Catalunya. Però tenim raons per pensar que aquells moments no significaren un gran terrabastall enuna ciutat que, des de començament del segle VIII, jugava un paper polític i militar significatiu en els esdeveniments de l'anomenada Marca Superior, el territori musulmà proper a les terres del regne franc. Més endavant, un cop incorporada a l'imperi carolingi, Girona mantingué la seva condició de ciutat capital de frontera o marca, fins a la conquesta de Barcelona l'any 801. Volem historiar, en la mesura del possible, aquesta etapa d'uns quaranta anys -entre 759 i 801- quan la ciutat visqué en primera línia i, també, protagonitzà les vicissituds de l'enfrontament entre dos dels grans estats d'aquell moment: la monarquia franca dels carolingis i l'emirat omeia A'al-Andalús. Els moviments d'anada i tomada dels seus exèrcits van situar Girona en primera línia de combat en aquells anys, fins a la definitiva consolidació del poder franc a principis del segle IX

El Camí de Sant Jaume en la provincia de Girona

En primer lugar se identifican las distintas rutas del Camí de Sant Jaume en la provincia de Girona con el objetivo de determinar cuáles han sido las principales rutas que los peregrinos han utilizado para su peregrinación hacia Santiago de Compostela dentro de la provincia de Girona. En segundo lugar se establecen los elementos que determinan que un itinerario concreto esté comprendido en el Camino de Santiago para lo cual se analizan las rutas y se buscan los componentes que tienen una relación directa con la peregrinación a Santiago de Compostela, bien por ser elementos descriptivos del Santo, bien por ser elementos que a lo largo de la historia se han atribuido a los peregrinos que peregrina a Santiago de Compostela. En tercer lugar se analiza el recorrido del Camí de Sant Jaume elegido por la Generalitat de Catalunya, se examinan los servicios que ofrece y las carencias o insuficiencias que posee. Finalmente se establece la confección de propuestas de mejora y las acciones pertinentes para corregir las debilidades que en su caso puedan tener estos itinerarios

Substrate metabolism, nutrient balance and obesity development in children and adolescents: a target for intervention?

Obesity results from the organism's inability to maintain energy balance over a long term. Childhood obesity and its related factors and pathological consequences tend to persist into adulthood. A cluster of factors, including high energy density in the diet (high fat intake), low energy expenditure, and disturbed substrate oxidation, favour the increase in fat mass. Oxidation of three major macronutrients and their roles in the regulation of energy balance, particularly in children and adolescents, are discussed. Total glucose oxidation is not different between obese and lean children; exogenous glucose utilization is higher whereas endogenous glucose utilization is lower in obese compared with lean children. Carbohydrate composition of the diet determines carbohydrate oxidation regardless of fat content of the diet. Both exogenous and endogenous fat oxidation are higher in obese than in lean subjects. The influence of high fat intake on accumulation of fat mass is operative rather over a long term. Several future directions are addressed, such that a combination of increased physical activity and modification in diet composition, in terms of energy density and glycemic index, is recommended for children and adolescents.

Moderate to vigorous physical activity and sedentary time and cardiometabolic risk factors in children and adolescents.

CONTEXT: Sparse data exist on the combined associations between physical activity and sedentary time with cardiometabolic risk factors in healthy children. OBJECTIVE: To examine the independent and combined associations between objectively measured time in moderate- to vigorous-intensity physical activity (MVPA) and sedentary time with cardiometabolic risk factors. DESIGN, SETTING, AND PARTICIPANTS: Pooled data from 14 studies between 1998 and 2009 comprising 20 871 children (aged 4-18 years) from the International Children's Accelerometry Database. Time spent in MVPA and sedentary time were measured using accelerometry after reanalyzing raw data. The independent associations between time in MVPA and sedentary time, with outcomes, were examined using meta-analysis. Participants were stratified by tertiles of MVPA and sedentary time. MAIN OUTCOME MEASURES: Waist circumference, systolic blood pressure, fasting triglycerides, high-density lipoprotein cholesterol, and insulin. RESULTS: Times (mean [SD] min/d) accumulated by children in MVPA and being sedentary were 30 (21) and 354 (96), respectively. Time in MVPA was significantly associated with all cardiometabolic outcomes independent of sex, age, monitor wear time, time spent sedentary, and waist circumference (when not the outcome). Sedentary time was not associated with any outcome independent of time in MVPA. In the combined analyses, higher levels of MVPA were associated with better cardiometabolic risk factors across tertiles of sedentary time. The differences in outcomes between higher and lower MVPA were greater with lower sedentary time. Mean differences in waist circumference between the bottom and top tertiles of MVPA were 5.6 cm (95% CI, 4.8-6.4 cm) for high sedentary time and 3.6 cm (95% CI, 2.8-4.3 cm) for low sedentary time. Mean differences in systolic blood pressure for high and low sedentary time were 0.7 mm Hg (95% CI, -0.07 to 1.6) and 2.5 mm Hg (95% CI, 1.7-3.3), and for high-density lipoprotein cholesterol, differences were -2.6 mg/dL (95% CI, -1.4 to -3.9) and -4.5 mg/dL (95% CI, -3.3 to -5.6), respectively. Geometric mean differences for insulin and triglycerides showed similar variation. Those in the top tertile of MVPA accumulated more than 35 minutes per day in this intensity level compared with fewer than 18 minutes per day for those in the bottom tertile. In prospective analyses (N = 6413 at 2.1 years' follow-up), MVPA and sedentary time were not associated with waist circumference at follow-up, but a higher waist circumference at baseline was associated with higher amounts of sedentary time at follow-up. CONCLUSION: Higher MVPA time by children and adolescents was associated with better cardiometabolic risk factors regardless of the amount of sedentary time.

Projecte d'una passarel·la metàl·lica per a vianants amb tauler de fusta sobre el riu Onyar de Girona

Girona és famosa entre d’altres coses pels seus ponts sobre el riu Onyar.El nou pont que es vol projectar es vol situar entre el carrer del Carme i el carrer Emili Grahit de Girona al principi on la llera del riu Onyar comença a ser transitable. El projecte té com a objectiu la projecció (disseny, càlcul i construcció) d’unapassarel•la d’acer sobre el riu Onyar a Girona al seu començament de la zonatransitable a la llera del riu, que permeti el pas de vianants i vehicles rodats nomotoritzats, incloent cadires de rodes, bicicletes, carros de la compra i cotxets d’uncostat a l’altre del riu. Per aconseguir un disseny òptim sense necessitar d’utilitzar mésmaterial del necessari es decideix realitzar una passarel•la amb forma corba i un estudide la biga principal aplicant el mètode dels elements finits a través d’un programacomercial.L’abast del projecte és la de projectar una passarel•la metàl•lica de uns 50 metres dellarg i 4 metres d’amplada. Amb una estructura el mes apurada possible per tal de noutilitzar més material del compte i així poder abaratir costos. El material també ha deser un material bo i resistent a les inclemències meteorològiques per tal de tenir elmenor manteniment possible. A més ha de complir totes les normatives vigents deseguretat

La Desamortització a Girona: mite, realitat i anècdota

Article sobre la desamortització a les comarques gironines

HGI, l' herbari de la Universitat de Girona

Descripció de l'herbari de la Universitat de Girona, fundat l'any 1976 pel Dr. Lluís Polo

Physical activity is inversely associated with high blood pressure independently of overweight in Brazilian adolescents.

The purpose of this study was to assess the relationship between blood pressure (BP) levels and physical activity (PA) domains accounting for overweight/obesity. Adolescents aged 10 to 17 years old were recruited (n = 1021). International Obesity Task Force (IOTF) criteria were used to define overweight and obesity. High BP was defined using the Center of Disease Control and Prevention criteria. Different domains of PA (school activities, sport out of school, and leisure time PA) were assessed using a validated questionnaire. The prevalence of overweight/obesity was 21.9% for boys and 14.8% for girls. Some 13.4% of boys and 10.2% of girls, respectively, had high blood pressure (HBP). A strong and positive association was found between overweight and HBP. After adjustment for body mass index (BMI), total PA was inversely associated with BP. When all PA domains were entered simultaneously in a regression model, and after adjustment for BMI, only sport out of school was significantly and inversely associated with systolic BP [β: -0.82 (-1.50; -0.13)]. These findings open avenue for the early prevention of HBP by the prevention of obesity and promotion of PA.

La construcció de l'església de Sant Feliu de Girona

La construcció de l' església de Sant Feliu de Girona des dels seus orígens (s.IV) fins al segle XVIII

Proves de càrrega al claustre de la catedral de Girona

El projecte tracta de la realització de proves de càrrega al Claustre de la Catedral de Girona per tal de conèixer la càrrega que suporten les columnes de pedra del claustre. Un cop coneguda aquesta càrrega, es podrà decidir si son aptes o no per al canvi d’ús previst a la planta superior i es podrà aportar una resposta definitiva a una de les dues hipòtesis plantejades: si es forma o no arc de descàrrega a les columnes del Claustre. D’altre banda, es realitzarà una proposta de tractament de les columnes del Claustre que consistirà a escollir les que hauran de ser reparades i les que hauran de ser substituïdes, en base a una sèrie de càlculs numèrics