Estat de la qüestió sobre la romanització en l'àmbit rural de l'illa de Menorca : revisió crítica de les investigacions

Estat de la qüestió de les investigacions que s'han portat a terme sobre la continuïtat d'ocupació en els poblats talaiòtics durant l'època romana a Menorca. S'estudia la continuïtat en relació al procés de romanització que va patir l'illa

Clinical consequences of switching from olanzapine to risperidone and vice versa in outpatients with schizophrenia: 36-month results from the worldwide schizophrenia outpatients health outcomes (W-SOHO) study

BACKGROUND: With many atypical antipsychotics now available in the market, it has become a common clinical practice to switch between atypical agents as a means of achieving the best clinical outcomes. This study aimed to examine the impact of switching from olanzapine to risperidone and vice versa on clinical status and tolerability outcomes in outpatients with schizophrenia in a naturalistic setting. METHODS: W-SOHO was a 3-year observational study that involved over 17,000 outpatients with schizophrenia from 37 countries worldwide. The present post hoc study focused on the subgroup of patients who started taking olanzapine at baseline and subsequently made the first switch to risperidone (n=162) and vice versa (n=136). Clinical status was assessed at the visit when the first switch was made (i.e. before switching) and after switching. Logistic regression models examined the impact of medication switch on tolerability outcomes, and linear regression models assessed the association between medication switch and change in the Clinical Global Impression-Schizophrenia (CGI-SCH) overall score or change in weight. In addition, Kaplan-Meier survival curves and Cox-proportional hazards models were used to analyze the time to medication switch as well as time to relapse (symptom worsening as assessed by the CGI-SCH scale or hospitalization). RESULTS: 48% and 39% of patients switching to olanzapine and risperidone, respectively, remained on the medication without further switches (p=0.019). Patients switching to olanzapine were significantly less likely to experience relapse (hazard ratio: 3.43, 95% CI: 1.43, 8.26), extrapyramidal symptoms (odds ratio [OR]: 4.02, 95% CI: 1.49, 10.89) and amenorrhea/galactorrhea (OR: 8.99, 95% CI: 2.30, 35.13). No significant difference in weight change was, however, found between the two groups. While the CGI-SCH overall score improved in both groups after switching, there was a significantly greater change in those who switched to olanzapine (difference of 0.29 points, p=0.013). CONCLUSION: Our study showed that patients who switched from risperidone to olanzapine were likely to experience a more favorable treatment course than those who switched from olanzapine to risperidone. Given the nature of observational study design and small sample size, additional studies are warranted.

Health-related quality of life in the Cambridge City over-75s Cohort (CC75C): development of a dementia-specific scale and descriptive analyses.

BACKGROUND: The assessment of Health Related Quality of Life (HRQL) is important in people with dementia as it could influence their care and support plan. Many studies on dementia do not specifically set out to measure dementia-specific HRQL but do include related items. The aim of this study is to explore the distribution of HRQL by functional and socio-demographic variables in a population-based setting. METHODS: Domains of DEMQOL's conceptual framework were mapped in the Cambridge City over 75's Cohort (CC75C) Study. HRQL was estimated in 110 participants aged 80+ years with a confirmed diagnosis of dementia with mild/moderate severity. Acceptability (missing values and normality of the total score), internal consistency (Cronbach's alpha), convergent, discriminant and known group differences validity (Spearman correlations, Wilcoxon Mann-Whitney and Kruskal-Wallis tests) were assessed. The distribution of HRQL by socio-demographic and functional descriptors was explored. RESULTS: The HRQL score ranged from 0 to 16 and showed an internal consistency Alpha of 0.74. Validity of the instrument was found to be acceptable. Men had higher HRQL than women. Marital status had a greater effect on HRQL for men than it did for women. The HRQL of those with good self-reported health was higher than those with fair/poor self-reported health. HRQL was not associated with dementia severity. CONCLUSIONS: To our knowledge this is the first study to examine the distribution of dementia-specific HRQL in a population sample of the very old. We have mapped an existing conceptual framework of dementia specific HRQL onto an existing study and demonstrated the feasibility of this approach. Findings in this study suggest that whereas there is big emphasis in dementia severity, characteristics such as gender should be taken into account when assessing and implementing programmes to improve HRQL.

Creative Industries: a Preliminary Insight to their Location Determinants

This paper is about location decisions of Creative Industries and the role played by existent spatial distribution and agglomeration economies of these kinds of activities in order to analyse their location determinants. Our main statistical source is the REIC (Catalan Manufacturing Establishments Register), which has plant-level microdata on location of new plants. Using Count Data Models, our main results show that location determinants are quite similar between both industries and also both non-creative and creative firms are positively influenced by the specialisation level in Creative Industries of municipalities. Moreover, our results provide evidence that the unobserved ‘creative milieu’ has a limited impact on attracting firms. Keywords: creative industries, creative milieu, count data models, industrial location, agglomeration economies

An overview of the proposal for a new Package Travel Directive

After an endless wait, a proposal for a new Package Travel Directive repealing Directive 90/314/EEC1 was presented on 9 July 2013 (hereafter, the Proposal).This article is aimed at providing an overall view of the Proposal. I will address the following issues: The concept of traveller; online package holidays and assisted travel arrangements; information requirements; a new particular right of withdrawal for package travel; other changes to the contract before the start of the package; performance of the Package; and insolvency protection. Some early concluding remarks are made as to when a future Package Travel Directive might take place at some future date

Multimorbidity patterns in a national representative sample of the Spanish adult population.

BACKGROUND: In the context of population aging, multimorbidity has emerged as a growing concern in public health. However, little is known about multimorbidity patterns and other issues surrounding chronic diseases. The aim of our study was to examine multimorbidity patterns, the relationship between physical and mental conditions and the distribution of multimorbidity in the Spanish adult population. METHODS: Data from this cross-sectional study was collected from the COURAGE study. A total of 4,583 participants from Spain were included, 3,625 aged over 50. An exploratory factor analysis was conducted to detect multimorbidity patterns in the population over 50 years of age. Crude and adjusted binary logistic regressions were performed to identify individual associations between physical and mental conditions. RESULTS: THREE MULTIMORBIDITY PATTERNS ROSE: 'cardio-respiratory' (angina, asthma, chronic lung disease), 'mental-arthritis' (arthritis, depression, anxiety) and the 'aggregated pattern' (angina, hypertension, stroke, diabetes, cataracts, edentulism, arthritis). After adjusting for covariates, asthma, chronic lung disease, arthritis and the number of physical conditions were associated with depression. Angina and the number of physical conditions were associated with a higher risk of anxiety. With regard to multimorbidity distribution, women over 65 years suffered from the highest rate of multimorbidity (67.3%). CONCLUSION: Multimorbidity prevalence occurs in a high percentage of the Spanish population, especially in the elderly. There are specific multimorbidity patterns and individual associations between physical and mental conditions, which bring new insights into the complexity of chronic patients. There is need to implement patient-centered care which involves these interactions rather than merely paying attention to individual diseases.

Predictors and consequences of adherence to the treatment of pediatric patients with attention-deficit/hyperactivity disorder in Central Europe and East Asia.

PURPOSE: To assess baseline predictors and consequences of medication non-adherence in the treatment of pediatric patients with attention-deficit/hyperactivity disorder (ADHD) from Central Europe and East Asia. PATIENTS AND METHODS: Data for this post-hoc analysis were taken from a 1-year prospective, observational study that included a total of 1,068 newly-diagnosed pediatric patients with ADHD symptoms from Central Europe and East Asia. Medication adherence during the week prior to each visit was assessed by treating physicians using a 5-point Likert scale, and then dichotomized into either adherent or non-adherent. Clinical severity was measured by the Clinical Global Impressions-ADHD-Severity (CGI-ADHD) scale and the Child Symptom Inventory-4 (CSI-4) Checklist. Health-Related Quality of Life (HRQoL) was measured using the Child Health and Illness Profile-Child Edition (CHIP-CE). Regression analyses were used to assess baseline predictors of overall adherence during follow-up, and the impact of time-varying adherence on subsequent outcomes: response (defined as a decrease of at least 1 point in CGI), changes in CGI-ADHD, CSI-4, and the five dimensions of CHIP-CE. RESULTS: Of the 860 patients analyzed, 64.5% (71.6% in Central Europe and 55.5% in East Asia) were rated as adherent and 35.5% as non-adherent during follow-up. Being from East Asia was found to be a strong predictor of non-adherence. In East Asia, a family history of ADHD and parental emotional distress were associated with non-adherence, while having no other children living at home was associated with non-adherence in Central Europe as well as in the overall sample. Non-adherence was associated with poorer response and less improvement on CGI-ADHD and CSI-4, but not on CHIP-CE. CONCLUSION: Non-adherence to medication is common in the treatment of ADHD, particularly in East Asia. Non-adherence was associated with poorer response and less improvement in clinical severity. A limitation of this study is that medication adherence was assessed by the treating clinician using a single item question.

El territorio y la ciudad de Tarraco

This paper presents a brief description of the archaeological research in the territory and in the city of Tarraco, the ancient capital of provincia Hispania Tarraconensis and one of the main centres for the spread of Hispanic Christianity. Althoug Tarraco was the last capital under imperial control and the firs Hispanic metropolitan see, the city had only a secondary role by comparison with other Hispanic cities during late antiquity. This evolution shaped the development of Tarraco during the 7th century, but archaeologists identify an important architectural vitality still in the 6th century at the same time as other episcopal cities were evolving. During this period, the final Christianization of the symbolic spaces of ancient paganism took place, establishing the ideological basis of medieval urbanism that is still preserved today. The paper also interprets the sites through raising key questions as well as describing rural settlements, where archaeological knowledge is not so far advanced, due in part to the difficult nature of archaeological research, and in part to the need to study new construcitve models, as well as to the systematic collection of the relevant material culture.

Redrawing Tarraco

The city of Tarragona houses an important architectural heritage mainly from its past as ‘Tarraco’, capital of the Roman province of Hispania Citerior, but also from its medieval and late 19th century history. The archaeological ensemble of Tarraco was inscribed as a UNESCO World Heritage Site in 2000, but although many efforts have been devoted by archaeologists and historians to unveil and understand the history and aspect of the Roman city, many aspects remain unknown. This is largely caused by the absence of a coherent body of historiographical material, which is todays cattered across several institutions and, specially, the lack of precise and useful graphical representations of the remains and of the existing city that allows in-depth analysis and interpretations of future findings. In recent years, researchers from the Catalan Institute of Classical Archaeology (ICAC) and the Architecture School of the URV (ETSA) have teamed up to produce comprehensive, detailed graphic materials, including a new set of plans and sections of the old city, of the grandiose areas of representation of the Provincial capital, and of the hidden structures beneath the city’s surface. These have been executed with the latest technologies (fotogrammetry, laser scanning) but also with traditional methods (measurement, topography), on t op of a mixture of existing materials (hand-drafted cartography from municipal master plans) and of historical and archaeological documentation.

Excavacions arqueològiques a la Catedral de Tarragona (2000-2002)

La catedral de Tarragona es el edificio más importante de la Edad Media en la ciudad. Se asienta en una zona arqueológica de primera magnitud como es la parte alta de Tarragona, en medio de la gran plaza del recinto de culto imperial de Tarraco, lugar en el cual después se erigió la sede visigoda de la ciudad. La ejecución del Plan Director de la Catedral de Tarragona, proyecto de los arquitectos Joan Figuerola y Joan Gavaldà, conlleva la realización de una serie de importantes actuaciones arqueológicas tanto en el subsuelo como en arqueología vertical. Con esta comunicación presentamos un primer avance de los trabajos realizados entre los años 2000 y 2002, con la siguiente evolución: época flavia (construcción del recinto sagrado imperial, con restos conservados de nueve metros de alto); antigüedad tardía (desmontaje del recinto de culto y construcción de nuevas estancias posiblemente relacionables con la ocupación habitada de la zona -¿episcopio?-); edad media (construcción de la canóniga cardenalicia y templo sobr el antiguo emplazamiento cultural romano. Estructura monástica adaptada a los precedentes romanos. Apertura de capillas en el claustro); época moderna y contemporánea (reformas y transformaciones de la catedral).