Efectividad de la intervención psicosocial en pacientes con enfermedad avanzada y final de vida

Objetivos: Demostrar la efectividad de la intervención psicosocial en la atención integral a personas con enfermedades avanzadas. Método: Se ha evaluado la presencia y evolución de parámetros psicológicos y espirituales de 8.964 pacientes, visitados por 117 profesionales de 29 equipos en un estudio de diseño cuasi-experimental, prospectivo, multcéntrico de un solo grupo pre-test post-test. Resultados: Los resultados muestran mejoras significativas en parámetros como ansiedad (RL 657,64; p<0,001), malestar emociona (RL 757,44; p<0,001), sentido de la vida (RL 248,30; p<0,001) y sentimientos de paz y perdón (RL 190,94; p<0,001). Conclusiones: El efecto positivo de la intervención psicosocial en la reducción de los parámetros psicológicos y espirituales evaluados sugiere que esta es eficaz en el contexto de la atención a personas con enfermedades avanzadas.

Classification models for neurocognitive impairment in HIV infection based on demographic and clinical variables

Objective: We used demographic and clinical data to design practical classification models for prediction of neurocognitive impairment (NCI) in people with HIV infection. Methods: The study population comprised 331 HIV-infected patients with available demographic, clinical, and neurocognitive data collected using a comprehensive battery of neuropsychological tests. Classification and regression trees (CART) were developed to btain detailed and reliable models to predict NCI. Following a practical clinical approach, NCI was considered the main variable for study outcomes, and analyses were performed separately in treatment-naïve and treatment-experienced patients. Results: The study sample comprised 52 treatment-naïve and 279 experienced patients. In the first group, the variables identified as better predictors of NCI were CD4 cell count and age (correct classification [CC]: 79.6%, 3 final nodes). In treatment-experienced patients, the variables most closely related to NCI were years of education, nadir CD4 cell count, central nervous system penetration-effectiveness score, age, employment status, and confounding comorbidities (CC: 82.1%, 7 final nodes). In patients with an undetectable viral load and no comorbidities, we obtained a fairly accurate model in which the main variables were nadir CD4 cell count, current CD4 cell count, time on current treatment, and past highest viral load (CC: 88%, 6 final nodes). Conclusion: Practical classification models to predict NCI in HIV infection can be obtained using demographic and clinical variables. An approach based on CART analyses may facilitate screening for HIV-associated neurocognitive disorders and complement clinical information about risk and protective factors for NCI in HIV-infected patients.

Randomized, crossover, double-blind, placebo-controlled trial to assess the lipid lowering effect of co-formulated TDF/FTC

Abstract INTRODUCTION: Previous studies have described improvements on lipid parameters when switching from other antiretroviral drugs to tenofovir (TDF) and impairments in lipid profile when discontinuing TDF. [1-3] It is unknown, however, if TDF has an intrinsic lipid-lowering effect or such findings are due to the addition or removal of other offending agents or other reasons. MATERIALS AND METHODS: RESULTS: 46 subjects with a median age of 43 (40-48) years were enrolled in the study: 70% were male, 56% received DRV/r and 44% LPV/r. One subject withdrew the study voluntarily at week 4 and another one interrupted due to diarrhoea at week 24. Treatment with TDF/FTC decreased total, LDL and HDL-cholesterol from 235.9 to 204.9 (p<0.001), 154.7 to 127.6 (p<0.001) and 50.3 to 44.5 mg/dL (p<0.001), respectively. In comparison, total, LDL and HDL-cholesterol levels remained stable during placebo exposure. Week 12 total cholesterol (p<0.001), LDL-cholesterol (p<0.001) and HDL-cholesterol (p=0.011) levels were significantly lower in TDF/FTC versus placebo. Treatment with TDF/FTC reduced the fraction of subjects with abnormal fasting total-cholesterol (≥200 mg/dL) from 86.7% to 56.8% (p=0.001) and LDL-cholesterol (≥130 mg/dL) from 87.8% to 43.9% (p<0.001), which was not observed with placebo. There were no virological failures, and CD4 and triglyceride levels remained stable regardless of exposure. CONCLUSION: Coformulated TDF/FTC has an intrinsic lipid-lowering effect, likely attributable to TDF.

L’erotisme a les Cartes a les Senyores dels Àngels i de Jerusalem, de Francesc Fontanella = Eroticism in Cartes a les Senyores dels Àngels i de Jerusalem, of Francesc Fontanella

This article focuses on the study of the treatment of eroticism in some of the poetic compositions from Francesc Fontanella (1622-1682/3). The paper studies fiften literary epistles whisch Fontanella dedicated to the nuns of the convent of Els Àngels and Jerusalem of Barcelona during the 1640s. It is divided into two parts; to first, the compositions under study are identified and presented briefly, and some issues related to the transmission of these textes are clarified. The second part discusses in detail all erotic references present in text. This analysis, on one hand, allows to present an interpretation of the meaning of the whole story contained in the letters. Moreover, it allows to present a characterization of the erotic vision of Fontanella. This is done by comparing this vision with the usual one at the time of baroque, as well as by analyzing the rhetorical strategies and the representation strategies that the author uses in the treatment of eroticism

El patronatge de les noves oligarquies urbanes a l'art català dels segles XVI i XVII

Al llarg del segle XVI es produí de manera lenta i heterogènia la progressiva introducció al Principat de les formes artístiques del Renaixement italià. Tradicionalment, a Catalunya, igual que a la resta del territori europeu, havia estat la noblesa, com a estament més proper al poder reial, la principal protagonista en el procés de comitència de les obres de més envergadura, moltes d"elles plantejades amb un sentit àulic que pretenia manifestar el predomini polític i econòmic de què havia gaudit d"antuvi aquest segment de la societat. Tanmateix, amb l"arribada a casa nostra dels nous corrents artístics renaixentistes es produí una certa inflexió en aquesta tendència, i hom pot observar com, a la fi del segle XVI i, sobretot, al llarg del segle XVII, aparegueren en l"escena del mercat artístic alts funcionaris reials, magistrats i juristes que, adherits al modern corrent de pensament humanista, dugueren a terme un important exercici de promoció i finançament d"empreses arquitectòniques, escultòriques i pictòriques seguidores dels preceptes renaixentistes. El present estudi analitza en quins termes es produí aquest relleu de patrocini artístic i repassa alguns casos ben emblemàtics.

El primer plor

«Ja el nàixer és un gran plor», ens canta Raimon. Hi ha dos moments crucials que fiten tota vida humana: el naixement i la mort.

Machiavelli translated into Catalan: textuals and editorials choices

This article provides an appraisal of all published and unpublished, complete and excerpted translations into Catalan of Machiavelli's works, and reconstructs the cultural circumstances around their completion as a means to determine from which editions the various translators worked. It also explains how the translators confronted and resolved issues of language and syntax in The Prince .

Pragmática de la puntuación y nuevas tecnologías

La puntuación ha evolucionado a lo largo de la historia, no solo en cuanto al número de signos, sino también con respecto a su función de guía en la (re)presentación y el procesamiento del texto. El objetivo del presente artículo es discutir la pragmática de la puntuación en los principales modos de comunicación mediada por ordenador. Mi propuesta consiste en considerar que las nuevas formas escritas de interacción mediada por ordenador situadas en el polo de la inmediatez comunicativa han dado lugar a un particular sistema de puntuación metarrepresentativa que compite con los códigos de puntuación tanto retórico como gramatical.

Searching for consensus in ahp-group decision making. A bayesian perspective

This paper sets out to identify the initial positions of the different decisionmakers who intervene in a group decision making process with a reducednumber of actors, and to establish possible consensus paths between theseactors. As a methodological support, it employs one of the most widely-knownmulticriteria decision techniques, namely, the Analytic Hierarchy Process(AHP). Assuming that the judgements elicited by the decision makers follow theso-called multiplicative model (Crawford and Williams, 1985; Altuzarra et al.,1997; Laininen and Hämäläinen, 2003) with log-normal errors and unknownvariance, a Bayesian approach is used in the estimation of the relative prioritiesof the alternatives being compared. These priorities, estimated by way of themedian of the posterior distribution and normalised in a distributive manner(priorities add up to one), are a clear example of compositional data that will beused in the search for consensus between the actors involved in the resolution ofthe problem through the use of Multidimensional Scaling tools

Compositional data analysis of vote shares in the 2001 Australian Federal election

First application of compositional data analysis techniques to Australian election data

Group preference structures in AHP–group decision making

This paper presents a procedure that allows us to determine the preference structures(PS) associated to each of the different groups of actors that can be identified in a groupdecision making problem with a large number of individuals. To that end, it makesuse of the Analytic Hierarchy Process (AHP) (Saaty, 1980) as the technique to solvediscrete multicriteria decision making problems. This technique permits the resolutionof multicriteria, multienvironment and multiactor problems in which subjective aspectsand uncertainty have been incorporated into the model, constructing ratio scales correspondingto the priorities relative to the elements being compared, normalised in adistributive manner (wi = 1). On the basis of the individuals’ priorities we identifydifferent clusters for the decision makers and, for each of these, the associated preferencestructure using, to that end, tools analogous to those of Multidimensional Scaling.The resulting PS will be employed to extract knowledge for the subsequent negotiationprocesses and, should it be necessary, to determine the relative importance of thealternatives being compared using anyone of the existing procedures

Regression analysis of compositional data when both the dependent variable and independent variable are components

It is well known that regression analyses involving compositional data need special attention because the data are not of full rank. For a regression analysis where both the dependent and independent variable are components we propose a transformation of the components emphasizing their role as dependent and independent variables. A simple linear regression can be performed on the transformed components. The regression line can be depicted in a ternary diagram facilitating the interpretation of the analysis in terms of components. An exemple with time-budgets illustrates the method and the graphical features

A vueltas con la Crónica del rey don Rodrigo

The paper discusses the problem of the literary genre of the Crónica sarracina from a peninsular and european points of view. It is considerer through the prism of a new kind of fiction, related to history and an incipient realism, which grows up along the 15th century. Moreover, it reveals new fragments inspired by Pedro de Corral from the catalan version of Seneca’s tragedies and from the Libro de los doce sabios