Influence of socioeconomic factors on delays, management and boutcome amongst patients with acute myocardial infarction undergoing primary percutaneous coronary intervention

Background¦The outcome after primary percutaneous coronary intervention (pPCI) for STElevation¦Myocardial Infarction (STEMI) is strongly affected by time delays. In thepresent study, we sought to identify the impact of specific socioeconomic factors on time delays, subsequent STEMI management and outcomes in STEMI patients from a well-defined region of the French part of Switzerland.¦Method¦A total of 402 consecutive patients undergoing pPCI for STEMI in a large tertiary hospital were retrospectively studied. Symptom-to-first-medical-contact time was analyzed for the following socioeconomic factors: level of education, gender, origin and marital status. Main exclusion criteria were: time delay beyond 12 hours, previous treatment by fibrinolysis or patients immediately referred for CABG.¦Therefore, 352 patients were finally included.¦Results¦At one year, there was no difference in mortality amongst the different socioeconomic groups. Furthermore, there was no difference in management characteristics between them. Symptom-to-first-medical-contact time was significantly higher for patients with a low level of education, Swiss citizens and non-married patients with median differences of 40 minutes, 48 minutes, and 60 minutes, respectively (p<0.05).¦Nevertheless, no difference was found regarding in-hospital management and clinical outcome.¦Conclusion¦This study demonstrates that symptom-to-first-medical-contact time is higher amongst people with a lower educational level, Swiss-citizens, and non-married people. Because of the low mortality rate in general, these differences in time delays did not affect clinical outcomes. Still, primary prevention measures should particularly focus on these vulnerable populations.

Internal and External Determinants of Radical and incremental Innovation in SMEs: the case of Catalonia

There is a major concern in economic literature about innovation, which is the interaction between internal and external factors.. In this paper those activities are hypothesized as being determined by some territorial characteristics like labour skills, technological infrastructure, educational facilities, agglomeration economies and industrial structure. This assumption allows understanding why those innovative activities are not spread across space and are located into specific areas. We use a detailed survey containing microdata for 497 SMEs located in Catalonia.

Control of urinary schistosomiasis on Zanzibar (Unguja Island): a pilot evaluation of the educational impact of the Juma na Kichocho health booklet within primary schools

To improve health education within primary schools, the health education booklet Juma na kichocho was evaluated during a study within 5 schools using key-informant questionnaires that recorded children's knowledge and attitude (KA) towards schistosomiasis before and after daily structured-use of booklets. A total of 229 schoolchildren (114 boys : 115 girls) of between 11 and 15 years of age were interviewed and re-assessed after a working school week. Existing and putative booklet-induced changes in KA scores for schistosomiasis were compared directly against equivalent KA scores for malaria. In total 47.4% of children were already aware that schistosomiasis was a water-borne disease while only 10.5% knew of its exact aetiology; after booklet intervention these levels increased to 54.6 and 15.7%, respectively. The majority of children still failed, however, to realise that re-infection could take place soon after treatment. While a positive increase was observed for children's total KA questionnaire scores for both malaria and schistosomiasis after booklet intervention, these were not statistically significant. In the context of control, further educational efforts are needed to promote and guide behavioural change, especially in relation to reduction of environmental water contact.

La evaluación de la reducción de amenazas en el Parque Natural de la Zona Volcánica de la Garrotxa (Girona)

En este artículo se presenta la metodología y los resultados derivados de la aplicación de una adaptación del denominado modelo de evaluación de reducción de amenazas (Threat Reduction Assesment) en el Parque Natural de la Zona Volcánica de la Garrotxa (PNZVG). Endefinitiva, se pretende valorar la efectividad de la gestión a partir del grado de reducción de amenazas en el PNZVG. El estudio se realizó a partir de la elaboración de una evaluación externa e independiente, que ha contado a la vez con una estrecha colaboración de los órganos gestores y rectores del Parque, así como con una activa participación de distintos agentes sociales clave. Se concluye que, después de veinticinco años de existencia del Parque, muchas de las amenazas iniciales sólo se han reducido de forma modesta e incluso a partir del índice adaptado, considerado un enfoque más realista; con lo cual se llega a la preocupante conclusión de que algunas de las amenazas más importantes se han incrementado

L'estructura territorial al Bisbat de Girona

Article que analitza l' estructura i els models bàsics d'organització territorial al Bisbat de Girona i que planteja una proposta de divisió territorial per a cada nivell d' organització espacial

Sobre la crítica d'art a la Girona franquista

Article que analitza la crítica d'art a la Girona franquista

Sobre l´elecció de bisbes durant el franquisme: els casos de Narcís Jubany (1964) i Jaume Camprodon (1973) per a la seu de Girona

L'objectiu d'aquest article és presentar les circumstàncies i algunes de les actuacions que es produïren a l'hora de fer els dos nomenaments que afectaren la diòcesi de Girona. El primer, per causa de la mort del bisbe Cartañà, enregistrada el 1963; i el segon, motivat pel trasllat del bisbe Jubany a Barcelona, el 1971

Sobre la Girona Constitucional (1820-1823)

Sobre la Girona Constitucional del trienni 1820-1823, en base la documentació existent a l'Arxiu Municipal i a l'Arxiu Diocesà

Josep Pallach, vist des del Govern Civil de Girona (1967-1976)

Fa dotze anys l'autor d'aquest article va donar a conèixer la documentació dels anys 1944-1946 que, procedent dels arxius governatius i de les presons gironines, feia referència a la vida clandestina i de represaliat del polític i professor Josep Pallach (Figueres 1920-l’Hospitalet de Llobregat 1977), antic militant del Bloc Obrer i Camperol i del Partit Obrer d’Unificació Marxista (POUM). Aquest article del 2005 complementa aquella recerca amb la recuperació d’una documentació similar, relativa al temps final del franquisme i al període inicial de la transició, els quals es corresponen també amb els darrers anys del periple vital del protagonista d’aquestes pàgines

Promoting secure attachment: evaluation of the effectiveness of an early intervention pilot programme with mother-infant dyads in Santiago, Chile.

BackgroundResearch indicates that the early attachment patterns of babies could influence their socio-emotional development and prevent the emergence of problematic behaviours in the child later in life. Many studies in the field of early attachment interventions have promoted a secure attachment bond between mother and infant. The purpose of this study was to evaluate the effectiveness of an early pilot intervention programme designed to promote a secure attachment bond in mother-infant dyads belonging to a population seeking regular treatment at urban health centres in Santiago, Chile.MethodsPrimipara mothers were randomly assigned to two intervention conditions: a secure attachment promotion programme (experimental group = 43) or an educational talk (control group = 29). The Strange Situation Assessment was used to collect data on the attachment patterns of babies.ResultsThe results show that after the intervention, there were more babies with secure attachment in the experimental group than in the control group.ConclusionsThese findings represent a preliminary step towards evaluating interventions aimed at promoting secure attachment in Chilean mother-child dyads. While the effect of the intervention is not significant, the effect size obtained is respectable and consistent with other meta-analytic findings.

El Pla de Girona en època tardoantiga

Estudi sobre 2 viles romanes trobades a finals dels anys 80 al límit occidental del Pla de Girona, una a Montfullà i l’altra a Vilablareix, tot fixant-se en el cas de l’Església de Sant Cugat de Salt. Un dels trets més destacables d’ambdós jaciments és la relació topogràfica amb les esglésies de Sant Pere de Montfullà i Sant Menna de Vilablareix, respectivament

Algunes notes a l'entorn de la vil·la del Pla de l'Horta a Sarrià de Dalt (Girona)

Es presenten notes sobre el jaciment arqueològic de la vil·la del Pla d'Horta a Sarrià de Dalt, com ara, la descripció de la situació i planta de l’edifici, els resultats de sondejos de les habitacions i la cronologia del jaciment i les fases d’ocupació

Projecte d’una nau d’emmagatzematge i comercialització de productes hortofructícoles d’una capacitat de 300.000 kg/any, situada al terme municipal de Gualta, al Baix Empordà (Girona)

L’objectiu del projecte és la construcció d’una nau industrial al terme municipal de Gualta,Baix Empordà (Girona), amb la finalitat de conservar i comercialitzar fruita dolça ( poma i pera). La nau disposarà de tres cambres d’atmosfera controlada, la capacitat de les quals serà de tres-centes tones de fruita l’any. L’edifici, de 1.000 m2, s’utilitzarà per emmagatzemar, manipular i comercialitzar la fruita però també hi haurà una part important de l’edifici destinat a ser utilitzat com a magatzem de les eines del camp i de diferents productes fitosanitaris i adobs

"The 3/3 strategy": a successful multifaceted hospital wide hand hygiene intervention based on WHO and continuous quality improvement methodology.

BACKGROUND Only multifaceted hospital wide interventions have been successful in achieving sustained improvements in hand hygiene (HH) compliance. METHODOLOGY/PRINCIPAL FINDINGS Pre-post intervention study of HH performance at baseline (October 2007-December 2009) and during intervention, which included two phases. Phase 1 (2010) included multimodal WHO approach. Phase 2 (2011) added Continuous Quality Improvement (CQI) tools and was based on: a) Increase of alcohol hand rub (AHR) solution placement (from 0.57 dispensers/bed to 1.56); b) Increase in frequency of audits (three days every three weeks: "3/3 strategy"); c) Implementation of a standardized register form of HH corrective actions; d) Statistical Process Control (SPC) as time series analysis methodology through appropriate control charts. During the intervention period we performed 819 scheduled direct observation audits which provided data from 11,714 HH opportunities. The most remarkable findings were: a) significant improvements in HH compliance with respect to baseline (25% mean increase); b) sustained high level (82%) of HH compliance during intervention; c) significant increase in AHRs consumption over time; c) significant decrease in the rate of healthcare-acquired MRSA; d) small but significant improvements in HH compliance when comparing phase 2 to phase 1 [79.5% (95% CI: 78.2-80.7) vs 84.6% (95% CI:83.8-85.4), p<0.05]; e) successful use of control charts to identify significant negative and positive deviations (special causes) related to the HH compliance process over time ("positive": 90.1% as highest HH compliance coinciding with the "World hygiene day"; and "negative":73.7% as lowest HH compliance coinciding with a statutory lay-off proceeding). CONCLUSIONS/SIGNIFICANCE CQI tools may be a key addition to WHO strategy to maintain a good HH performance over time. In addition, SPC has shown to be a powerful methodology to detect special causes in HH performance (positive and negative) and to help establishing adequate feedback to healthcare workers.

Programa de conservació de la flora vascular de les comarques de Girona : bdesenvolupament per al Parc Natural dels Aiguamolls de l’Empordà i el LIC de les basses de l’Albera

Descripció dels passos a seguir per realitzar un pla de conservació de la flora vascular a Girona, més concretament es tracten les àrees del Parc Natural dels Aiguamolls de l’Empordà i de les basses de l’Albera, i que sigui atribuïble a d’altres indrets de Catalunya per així obtenir una major consolidació i coordinació entre la xarxa d’espais protegits i no protegits.La metodologia seguida ha estat la realització d’una baremació dels tàxons prioritzats segons els espais escollits, l’elaboració de les actuacions de conservació per a les espècies prioritàries, l’establiment de la distribució geogràfica dels tàxons prioritzats dels quals es crearà un cronograma que recollirà totes les actuacions que es realitzaran durant un període de temps determinat, depenent dels impactes que els hi afectin i, per últim, es pressupostarà el cost genèric de les actuacions realitzades durant el programa