Cost-Utility of Attachment-Based Compassion Therapy (ABCT) and Mindfulness-Based Stress Reduction (MBSR) in the Management of Depressive, Anxious, and Adjustment Disorders in Mental Health Settings: Economic Evaluation Alongside a Randomized Controlled Trial

ObjectivesThe main objective of this paper was to examine the cost-utility of attachment-based compassion therapy (ABCT) compared to Mindfulness-Based Stress Reduction (MBSR) and treatment-as-usual (TAU) on patients with depressive and/or anxious disorder, or adjustment disorder with depressive and/or anxious symptomatology in terms of effects on quality-adjusted life years (QALYs) as well as healthcare costs from a public healthcare system perspective.MethodA 6-month randomized controlled trial was conducted. Ninety Spanish patients with mental disorders (depressive, anxious, or adjustment disorders) received 8 weekly group sessions of TAU + ABCT, TAU + MBSR, or TAU alone. Data collection took place at pre- and 6-month follow-up. Cost-utility of the two treatment groups (ABCT vs MBSR vs TAU) was compared by examining treatment outcomes in terms of QALYs (obtained with the EQ-5D-3L) and healthcare costs (data about service use obtained with the Client Service Receipt Inventory).ResultsBoth MBSR and ABCT were more efficient than TAU alone, although the results did not reach statistical significance. Compared to ABCT, MBSR produced an increase both in terms of costs (euro53.69, 95% CI [- 571.27 to 513.14]) and effects (0.004 QALYs, 95% CI [- 0.031 to 0.049]); ICUR = euro13,422.50/QALY). Both interventions significantly reduced the number of visits to general practice compared to TAU.ConclusionsThis study has contributed to the evidence base of mindfulness- and compassion-based programs and provided promising information about the cost-utility of MBSR for patients with emotional disorders. However, the small sample size and short follow-up period limit the generalizability of the findings.PreregistrationClinicaltrials.gov; NCT03425487

Fifth European Dirofilaria and Angiostrongylus Days (FiEDAD) 2016

Peer reviewe

Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019 : a comprehensive demographic analysis for the Global Burden of Disease Study 2019

Background: Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. Methods: 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10–14 and 50–54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. Findings: The global TFR decreased from 2·72 (95% uncertainty interval [UI] 2·66–2·79) in 2000 to 2·31 (2·17–2·46) in 2019. Global annual livebirths increased from 134·5 million (131·5–137·8) in 2000 to a peak of 139·6 million (133·0–146·9) in 2016. Global livebirths then declined to 135·3 million (127·2–144·1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2·1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27·1% (95% UI 26·4–27·8) of global livebirths. Global life expectancy at birth increased from 67·2 years (95% UI 66·8–67·6) in 2000 to 73·5 years (72·8–74·3) in 2019. The total number of deaths increased from 50·7 million (49·5–51·9) in 2000 to 56·5 million (53·7–59·2) in 2019. Under-5 deaths declined from 9·6 million (9·1–10·3) in 2000 to 5·0 million (4·3–6·0) in 2019. Global population increased by 25·7%, from 6·2 billion (6·0–6·3) in 2000 to 7·7 billion (7·5–8·0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58·6 years (56·1–60·8) in 2000 to 63·5 years (60·8–66·1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019

Marguerite de Habsbourg

Dans ce volume dédié à notre très chère collègue italianiste Théa Picquet, nous avons voulu consacrer un article à une femme parmi les plus puissantes de la Renaissance. Une femme qui joua un rôle de première importance dans les vicissitudes politiques européennes de la première partie du XVIe siècle. Il s’agit de Marguerite de Habsbourg, la tante de Charles Quint, connue aussi sous les noms de Marguerite d’Autriche ou Marguerite de Savoie, fille de l’empereur Maximilien Ier de la famille des Habsbourg et de Marie de Bourgogne, fille de Charles dit le Téméraire. Sa vie est un exemple du rôle réservé aux femmes de la haute noblesse européenne de cette époque, rôle dicté par l’obéissance et la soumission aux politiques matrimoniales dynastiques, mais elle donne aussi à voir un modèle de femme de lettres, de poétesse et de protectrice des arts qui trouva le moyen de s’affirmer dans un monde dominé par le pouvoir patriarcal

L’Arétin, poète et polémiste au service de la rhétorique impériale

L’article de Juan Carlos D’Amico analyse les rapports entre l’Arétin, appelé par ses admirateurs le fléau des princes, et Charles Quint. L’écrivain avait fait de l’éloge et de la célébration des puissants de la terre la source de son indépendance matérielle. On peut être choqué par son adulation et ses tirades dithyrambiques adressées à l’empereur et roi d’Espagne. Cependant, il faut y voir la conséquence logique d’une stratégie originale pour éviter les servitudes d’une vie courtisane. À cela, nous pouvons ajouter que Charles Quint avait besoin d’une voix amie à Venise pour y défendre sa politique et y trouver l’appui nécessaire à la poursuite de sa lutte contre François Ier.<br>El artículo de Juan Carlos D’Amico analiza el vínculo entre Aretino, llamado por sus admiradores el flagelo de los príncipes, y Carlos V. El escritor había hecho de la alabanza y de la celebración de los poderosos de la tierra la fuente de su independencia material. Si bien uno podría encontrar chocante su adulación y su encomio poco mesurado del emperador y rey de España, es preciso considerlo como la consecuencia lógica de una estrategia original para evitar la servidumbre de una existencia cortesana. Además, Carlos V necesitaba una voz amiga en Venecia para defender su política y prolongar su lucha contra Francisco I

Gattinara et la « monarchie impériale » de Charles Quint. Entre millénarisme, translatio imperii et droits du Saint-Empire

Spreading the universal monarchy myth in the early 16th century was closely linked to the magnitude of the territories controlled by Charles V. For the imperial chancellor Mercurino Gattinara, universal and messianic ideas, which were integrated into the symbolism of the Empire, were to legitimate a policy that aimed at giving a more rational structure to Charles’ territories and at securing a prominent influence for the Habsburg family in the whole of Europe. Gattinara imagined a kind of supranational monarchy, organised in accordance with the mythical model of the Roman Empire, which would be able to guarantee peace under the aegis of Christianity

Écrivains et pouvoir à la Renaissance. Les écrivains italiens, le pouvoir de Charles Quint et l’idéologie impériale

Cet article étudie les rapports, au cours de la première moitié du XVIe siècle, entre le pouvoir politique de Charles Quint et les hommes de culture italiens. Le plus souvent, les écrivains entretenaient eux-mêmes des rapports directs avec le pouvoir impérial. Certains dédiaient leurs œuvres à l’empereur, d’autres attendaient d’être sollicités par son entourage. Mais aussi, de nombreuses productions littéraires, élogieuses à l’égard de l’empereur, naissaient suite à un événement comme une alliance entre princes, une défaite militaire et ses conséquences politiques, l’arrivée de nouveaux alliés dans le camp impérial, ou étaient le moyen de prétendre à une pension. Les exemples analysés ici illustrent la contribution de plusieurs écrivains italiens comme l’Arioste, l’Arétin, le Trissin ou Paul Jove à la définition de l’idéologie à la base du programme politique impérial en Europe et la contribution de chacun à la création d’une nouvelle image iconographique et littéraire de Charles Quint en Italie

Medios de comunicación y difusión de las reivindicaciones en Nápoles durante la rebelión de 1547

En efecto, cuando el soberano está presente, ve nacer los desórdenes y los remedia al instante; pero estando ausente, muchas veces no los conoce hasta que son tan grandes que ya no puede remediarlos. N. Maquiavelo, El Príncipe, III, 13. En los últimos años, numerosos trabajos críticos se han centrado en analizar en profundidad, mediante nuevos métodos, aspectos peculiares en torno a las formas más violentas de oposición política. Entre los diversos elementos tomados en consideración, se ha id..