La atenuación en conversaciones coloquiales argentinas y españolas: un estudio contrastivo

El objetivo de este artículo es presentar el resultado de un análisis contrastivo realizado entre las manifestaciones de atenuación en conversaciones coloquiales argentinas y españolas. La atenuación, como fenómeno pragmático que reduce la fuerza ilocutiva de los actos comunicativos, en el que intervienen la imagen y las responsabilidades de los hablantes respecto a sus mensajes (Caffi 1999, 2007; Thaler; Albelda 2016), ha sido ampliamente estudiada para el español, a partir de la década de los 90, desde la perspectiva de los estudios de cortesía (Haverkate; Briz 1995, 2007), la pragmática (Schneider) o la sociolingüística (Samper Hernández; Cestero). Sin embargo, son escasos los trabajos que abordan la comparación entre sus variedades diatópicas (Briz 2007; Albelda 2008). Este trabajo analiza cuantitativa y cualitativamente los recursos atenuantes utilizados en conversaciones coloquiales entre hablantes de 20 a 34 años, de nivel sociocultural medio y alto, de las ciudades de Tucumán (Argentina) y Valencia (España), a partir de una ficha metodológica de análisis (Albelda/ otros), con el propósito de determinar cuáles son las principales semejanzas y diferencias entre ambos países.This paper reports the results of a contrastive analysis of the instances of attenuation occurring in a set of Argentine and Spanish colloquial conversations. Attenuation –understood as a pragmatic phenomenon reducing the illocutionary force of communicative acts, which involves face and the speakers’ responsibilities for their messages (Caffi 1999, 2007; Thaler; Albelda 2016)– has been studied to a significant extent in the Spanish language, beginning in the 1990s, from the perspective of politeness studies (Haverkate; Briz 1995, 2007), pragmatics (Schneider) and sociolinguistics (Samper Hernández; Cestero). However, studies concentrating on the comparison between its diatopic varieties are scarce (Briz 2007; Albelda 2008). This study quantitatively and qualitatively analyses the attenuation resources utilized in colloquial conversations between speakers aged 20-34 at the higher and middle social strata in the cities of Tucumán (Argentina) and Valencia (Spain). The analysis was based on a methodological data sheet (Albelda/ others) with the aim of finding the main similarities and differences between both diatopic varieties

Outcomes of off-label drug uses in hospitals: a multicentric prospective study

Purpose: The study aims to assess the clinical evidence, outcome and cost of off-label use of medicines in the hospital setting. Methods: A multicentric prospective cohort study of patients treated with off-label medicines was carried out in five tertiary hospitals from May 2011 to May 2012. Information on clinical characteristics of patients, drugs, outcomes and costs was collected. Patients were followed up to 6 months, and information was assessed by reviewing clinical records and interviewing physicians. Results: A total of 226 patients were included. The median (interquartile range (IQR)) age of patients was 46 (3362) years; 59 % were women. Patients had received a median of three previous treatments, and a lack of response (or suboptimal) was the main reason for off-label use (72.1 %). A total of 232 off-label medicines were administered for 102 different indications. The most frequent medicines were rituximab (49; 21.1 %), botulinum toxin (25; 10.7 %) and omalizumab (14; 6.0 %). In 117 (51.8 %) cases, the level of clinical evidence for their use was low. A partial clinical response was observed in 82 patients (36.3 %), complete response in 71 (31.4 %) and stabilization in 11 (4.9 %). A total of 58 (26.5 %) patients had adverse effects, which in 11 (4.9 %) were severe. The median (IQR) cost per patient was 2,943.07 (541.95,872.54). Conclusions: There was a high variability of off-label medicines and indications. Although the clinical evidence of off-label medicines was often low, clinical response was observed in many patients with previous multiple treatment failure, but at the expense of some adverse effects and a high cost. Registers of patients would be helpful for clinical decisions, although clinical trials are needed

Outcomes of off-label drug uses in hospitals : a multicentric prospective study

Altres ajuts: We would to thank the Spanish Ministry of Health, Social Affairs and Equality for their financial support given though a grant from the scholarship EC-206 in the public call for the promotion of independent clinical research (SAS/2370/2010 order of September 27)The study aims to assess the clinical evidence, outcome and cost of off-label use of medicines in the hospital setting. A multicentric prospective cohort study of patients treated with off-label medicines was carried out in five tertiary hospitals from May 2011 to May 2012. Information on clinical characteristics of patients, drugs, outcomes and costs was collected. Patients were followed up to 6 months, and information was assessed by reviewing clinical records and interviewing physicians. A total of 226 patients were included. The median (interquartile range (IQR)) age of patients was 46 (33-62) years; 59 % were women. Patients had received a median of three previous treatments, and a lack of response (or suboptimal) was the main reason for off-label use (72.1 %). A total of 232 off-label medicines were administered for 102 different indications. The most frequent medicines were rituximab (49; 21.1 %), botulinum toxin (25; 10.7 %) and omalizumab (14; 6.0 %). In 117 (51.8 %) cases, the level of clinical evidence for their use was low. A partial clinical response was observed in 82 patients (36.3 %), complete response in 71 (31.4 %) and stabilization in 11 (4.9 %). A total of 58 (26.5 %) patients had adverse effects, which in 11 (4.9 %) were severe. The median (IQR) cost per patient was €2,943.07 (541.9-5,872.54). There was a high variability of off-label medicines and indications. Although the clinical evidence of off-label medicines was often low, clinical response was observed in many patients with previous multiple treatment failure, but at the expense of some adverse effects and a high cost. Registers of patients would be helpful for clinical decisions, although clinical trials are needed. The online version of this article (doi:10.1007/s00228-014-1746-2) contains supplementary material, which is available to authorized users

Government-Opposition Dynamics in Spain under the Pressure of Economic Collapse and the Debt Crisis

Government - opposition relations in Spain have been long characterised by a high level of consensus and cooperation. The question analysed here is whether the economic crisis initiated in 2008 has created unprecedented levels of conflict in the political system or whether opposition parties have maintained a cooperative strategy oriented to influence far-reaching policy decisions. Results illustrate that patterns of consensus have decreased significantly since the outbreak of the crisis, and this is partly explained by the rising amount of legislation with socio-economic content, variations in the government's popularity, and the type of government. The analysis also shows that the crisis has increased the incentives of opposition parliamentary groups to oppose European Union legislation, especially among left parties

La atenuación en conversaciones coloquiales argentinas y españolas: un estudio contrastivo

El objetivo de este artículo es presentar el resultado de un análisis contrastivo realizado entre las manifestaciones de atenuación en conversaciones coloquiales argentinas y españolas. La atenuación, como fenómeno pragmático que reduce la fuerza ilocutiva de los actos comunicativos, en el que intervienen la imagen y las responsabilidades de los hablantes respecto a sus mensajes (Caffi 1999, 2007; Thaler; Albelda 2016), ha sido ampliamente estudiada para el español, a partir de la década de los 90, desde la perspectiva de los estudios de cortesía (Haverkate; Briz 1995, 2007), la pragmática (Schneider) o la sociolingüística (Samper Hernández; Cestero). Sin embargo, son escasos los trabajos que abordan la comparación entre sus variedades diatópicas (Briz 2007; Albelda 2008). Este trabajo analiza cuantitativa y cualitativamente los recursos atenuantes utilizados en conversaciones coloquiales entre hablantes de 20 a 34 años, de nivel sociocultural medio y alto, de las ciudades de Tucumán (Argentina) y Valencia (España), a partir de una ficha metodológica de análisis (Albelda/ otros), con el propósito de determinar cuáles son las principales semejanzas y diferencias entre ambos países.This paper reports the results of a contrastive analysis of the instances of attenuation occurring in a set of Argentine and Spanish colloquial conversations. Attenuation –understood as a pragmatic phenomenon reducing the illocutionary force of communicative acts, which involves face and the speakers’ responsibilities for their messages (Caffi 1999, 2007; Thaler; Albelda 2016)– has been studied to a significant extent in the Spanish language, beginning in the 1990s, from the perspective of politeness studies (Haverkate; Briz 1995, 2007), pragmatics (Schneider) and sociolinguistics (Samper Hernández; Cestero). However, studies concentrating on the comparison between its diatopic varieties are scarce (Briz 2007; Albelda 2008). This study quantitatively and qualitatively analyses the attenuation resources utilized in colloquial conversations between speakers aged 20-34 at the higher and middle social strata in the cities of Tucumán (Argentina) and Valencia (Spain). The analysis was based on a methodological data sheet (Albelda/ others) with the aim of finding the main similarities and differences between both diatopic varieties

All News is Bad News: Newspaper Coverage of Political Parties in Spain

Spain has a highly partisan media system, with newspapers reaching self-selected partisan audiences and espousing explicitly partisan editorial preferences. Do the newspapers of the left and right differ in how they cover politics in ways that can be predicted by their partisan leanings? We review theories of issue-ownership, journalistic standards, and information scarcity and test hypotheses derived from each. We find that the parties converge substantially in virtually every aspect of their coverage. Few differences emerge when we look at what topics are covered or in the dynamics of which topics gain attention over time. However, we confirm important differences across the papers when they make explicit reference to individual political parties. Journalistic norms result in a surprising focus on the faults of one’s enemies, however, rather than the virtues of one’s allies. Our assessment is based on a comprehensive database of all front-page stories in El País and El Mundo, Spain’s largest daily newspapers, from 1996 through 2011

Antiretroviral treatment switch strategies for lowering the costs of antiretroviral therapy in subjects with suppressed HIV-1 viremia in Spain

Josep M Llibre,1,2 Gloria Cardona,3 Jos&eacute; R Santos,2 Angels Andreu,3 Josep O Estrada,4 Jordi Ara,4 Xavier Bonafont,3 Bonaventura Clotet1,21HIV Unit, University Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; 2Lluita contra la SIDA Foundation, Badalona, Barcelona, Spain; 3Hospital Pharmacy, University Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; 4Hospital Management, University Hospital Germans Trias i Pujol, Badalona, Barcelona, SpainBackground: The current economic recession in European countries has forced governments to design emergency measures to reduce spending on drugs, including antiretroviral therapy (ART). Switching antiretroviral drugs for others that have the same efficacy and safety profile at a lower cost (cost-reduction measures, CRM) could prove to be a valid means of generating savings.Methods: Descriptive study of prospective consensus-based CRM undertaken in 2011 in a Catalonian hospital HIV unit among patients with prolonged plasma HIV-1 RNA <50 copies/mL.Results: During the study period, we made 673 switches (87.5% more than the previous year), of which 378 (56.2%) were CRM (16% of all patients treated), leading to a savings of &euro;87,410/month. Switching tenofovir/emtricitabine for abacavir/lamivudine was the most common CRM (129, 31.3%), followed by simplification to boosted protease inhibitor monotherapy (bPImono, 102, 26%). The CRM that generated the greatest saving were switching to bPImono (38%), withdrawal or replacement of raltegravir (24%), switching tenofovir/emtricitabine for abacavir/lamivudine (13%), and switching to nevirapine (5%). Cost savings with CRM were slightly higher than those achieved with medication paid for by clinical trial sponsors (&euro;80,333/month) or through discount arrangements (&euro;76,389/month).Conclusion: Proactively switching antiretroviral therapy in selected treated patients with sustained virological suppression can generate significant cost savings in pharmacy spending in developed countries. These findings have implications for decision makers in designing safe strategies that maintain HIV-1 suppression at lower costs.Keywords: health economics, cost analysis, antiretroviral agents economics, antiretroviral therapy highly active, protease inhibitor monotherap