Citizens in defense of World Heritage : supporting the Mosque of Cordoba

La Mezquita de Córdoba fue reconocida por Unesco en 1984 como Patrimonio Mundial por constituir la obra cumbre del arte islámico y andalusí en Europa y ser paradigma universal de concordia entre culturas. Construida en el año 785 por Abderramán I, en 1523 Carlos I autoriza edificar en su interior una Catedral renacentista que rompió la infinitud del bosque de columnas al tiempo que precipitó un mestizaje sin precedentes del islam y el cristianismo. Ambas realidades artísticas, históricas y culturales han convivido durante siglos en Córdoba hasta que en 1998, el Cabildo catedralicio, sus actuales gestores, se propusieron borrar la huella andalusí de todos los documentos oficiales de divulgación hasta el punto de eliminar el nombre de Mezquita y suprimir toda alusión a la arquitectura y herencia omeya de un monumento que es conocido en todo el mundo como el edificio andalusí emblemático por excelencia. En un acto de intolerancia y expolio cultural, el Obispado pretendió roclamar la supremacía católica sobre el Islam a costa del sentido común, de la historia, del arte, de la arquitectura y de la memoria de Córdoba y su significado en el mundo. En febrero de 2014, un grupo de ciudadanos cordobeses organizados como “Plataforma Mezquita-Catedral, Patrimonio de Tod@s” lanzó una campaña de denuncia que ha logrado reunir más de 385.000 firmas para reclamar la restitución del nombre y la memoria del universal monumento y exigir una gestión profesional. Entre los firmantes, se encuentran personalidades de la cultura de la talla de Juan Goytisolo, José Manuel Caballero Bonald, Emilio Lledó, Josefina Molina, Antonio Muñoz Molina, Antonio Gala, Rosa Montero, Norman Foster, Eduardo Galeano, Federico Mayor Zaragoza, Manolo Sanlúcar, José Chamizo y muchos otros de reconocido prestigio. La Plataforma ciudadana estima que la actual gestión de la Mezquita-Catedral de Córdoba es profundamente lesiva para la integridad del monumento, desleal con su historia, ofensiva con la memoria de Córdoba y contraria a los valores fundamentales sobre los que la Unesco la reconoció en 1984 como Patrimonio Mundial.The Mosque of Cordoba was recognized by UNESCO as World Heritage in 1984. Not only because of the Islamic and Andalusian masterpiece of art the Mosque represents in Europe, but also for being a universal paradigm of harmony between cultures. Built by Abd ar-Rahman I in 785, in 1523 Charles V authorized to build a Renaissance cathedral inside it, that broke the infinity of the columns’ forest while precipitating an unprecedented mixing of Islam and Christianity. Both artistic realities, historical and cultural, have lived together for centuries in Cordoba until 1998. In that year, the Cathedral Chapter, its current manager, proposed to delete the Andalusian trace from all kind of official documents, as to the point that the name of Mosque was removed and any reference to the Umayyad architecture deleted from the heritage monument, which is known worldwide as the emblematic Andalusian building par excellence. Promoting an act of intolerance and cultural dispossession, the Bishop tried to claim the Catholic supremacy of Islam at the expense of common sense, history, art, architecture and memory of Córdoba and its meaning in the world. In February 2014, a group of citizens organized a civil and civic movement, called Cordoba Mosque-Cathedral, Everyone’s Heritage, and launched a protest campaign that has collected more than 385,000 signatures demanding the return of the name and memory of this universal building, as well as a professional management for the monument. Among many prestigious persons who signed are cultural personalities such as Juan Goytisolo, José Manuel Caballero Bonald, Emilio Lledó, Josefina Molina, Antonio Muñoz Molina, Antonio Gala, Rosa Montero, Norman Foster, Eduardo Galeano, Federico Mayor Zaragoza, Manolo Sanlúcar, José Chamizo. This civic movement believes that the current management of the Mosque-Cathedral of Cordoba is deeply damaging the integrity of the monument, being unfair to its history and offensive to the memory of Córdoba, while being contrary to the fundamental values on which UNESCO recognized it as World Heritage in 1984.Depto. de Prehistoria, Historia Antigua y ArqueologíaFac. de Geografía e HistoriaTRUEMinisterio de Economía y Competitividad (MINECO)pu

The Mosque of Cordoba: a case of symbolic destruction of heritage

La Mezquita de Córdoba fue incluida en 1984 en la Lista de Patrimonio Mundial UNESCO. La organización internacional fijó cuatro criterios que justificaron su reconocimiento, todos ellos relacionados con su valor como ejemplo excepcional de la arquitectura islámica y andalusí en Occidente. Iniciado en el siglo VIII por Abd alRahman I, el universal monumento fue dedicado al culto católico en el siglo XIII y en el XVI incorporó una Catedral en su interior. En las dos últimas décadas de nuestra centuria, sus actuales administradores han puesto en marcha un modelo de gestión que persigue amputar sus señas de identidad originarias, lo que amenaza el Valor Universal Excepcional declarado por UNESCO, con especial atención a las características incluidas en materia de autenticidad. Este artículo examina lo que entiende como un caso de mutilación simbólica del patrimonio, en cierta manera análogo a la polémica conversión en mezquita de la basílica de Santa Sofía en Estambul impulsada por el presidente turco Recep Tayyip Erdogan.The Mosque of Córdoba was first inscribed on the UNESCO World Heritage List in 1984. The international organization set four criteria that justified its recognition, all of them related to its value as an exceptional example of Islamic and Andalusian architecture in the West. Started to build in the 8th century by Abd al-Rahman I, the universal monument was dedicated to Catholic worship in the 13th century and in the 16th it incorporated a Cathedral inside. During the last two decades of our century, its current administrators have implemented a management model that seeks to amputate its original identity signs, which threatens the Outstanding Universal Value declared by UNESCO, with special attention to the characteristics related to its authenticity. This article examines what it understands as a case of symbolic mutilation of heritage, in a way analogous to the controversial mosque conversion of the Saint Sophia Cathedral in Istanbul promoted by Turkish President Recep Tayyip Erdogan

Disrupted neuroglial metabolic coupling after peripheral surgery

Immune-related events in the periphery can remotely affect brain function, contributing to neurodegenerative processes and cognitive decline. In mice, peripheral surgery induces a systemic inflammatory response associated with changes in hippocampal synaptic plasticity and transient cognitive decline, however, the underlying mechanisms remain unknown. Here we investigated the effect of peripheral surgery on neuronal-glial function within hippocampal neuronal circuits of relevance to cognitive processing in male mice at 6, 24, and72hpostsurgery. At 6hwedetect theproinflammatorycytokineIL-6inthehippocampus, followedupbyalterations in them RNA and protein expression of astrocyticandneuronal proteinsnecessaryfor optimal energysupplytothebrainandfor thereuptakeandrecycling of glutamate in the synapse. Similarly, at 24 h postsurgery the mRNA expression of structural proteins (GFAP and AQP4) was compromised. At this time point, functional analysis in astrocytes revealed a decrease in resting calcium signaling. Examination of neuronal activity by whole-cell patch-clamp shows elevated levels of glutamatergic transmission and changes in AMPA receptor subunit composition at 72 h postsurgery. Finally, lactate, an essential energy substrate produced by astrocytes and critical for memory formation, decreases at 6 and 72 h after surgery. Based on temporal parallels with our previous studies, we propose that the previously reported cognitive decline observed at 72 h postsurgery in mice might be the consequence of temporal hippocampal metabolic, structural, and functional changes in astrocytes that lead to a disruption of the neuroglial metabolic coupling and consequently to a neuronal dysfunction.This work was supported by a “Ramón y Cajal” fellowship (RYC-2014-15792 to A.G.-C.) from Spanish “Ministerio de Economía y Competitividad”, the Swedish Research Council, the confocal microscope used in the study by Knut and Alice Wallenberg Foundation (Grant KAW2008.0149), and NIH/NIA R01AG057525 to N.T

Psychological factors and prognostic communication preferences in advanced cancer: multicentre study

Objectives: Communication regarding prognosis to patients with advanced cancer is fundamental for informed medical decision making. Our objective was to analyse (1) the proportion of subjects with advanced cancer who prefer to know their prognosis, (2) the characteristics associated with patients’ preference for prognostic information, (3) the psychological factors that impact the preference to know prognosis and 4) the concordance between preference for prognostic information perceived among physicians and patients. Methods: A prospective, cross-sectional design was adopted. Data were collected from 748 participants with advanced cancer at 15 tertiary hospitals in Spain. Participants completed the following questionnaires: Mental Adjustment to Cancer; Trust in the Physician; Uncertainty in Illness Scale Patient’s Prognostic Preferences. Results: Fifty-two per cent of advanced cancer sufferers preferred to know the prognosis of their disease. Compared with participants who preferred not to know, those who did reported more uncertainty, greater satisfaction with their physician and higher scores on positive attitude (all p=0.001). Thirty-seven per cent of the physicians believed that patients want to know their prognosis, indicating that they underestimate the number of such patients. No significant differences were found regarding preference to know prognosis as a function of sociodemographic and clinical variables. Conclusions: A substantial proportion of individuals with advanced cancer prefer to know the prognosis of their disease. It appears that knowing their prognosis was mainly motivated by a need to maintain a positive attitude, lessen uncertainty and by satisfaction with the physician. It is important to explore patients’ preferences for information to offer more personalised communication

Pla estratègic d’atenció pal·liativa especialitzada de Catalunya: bases del model de futur

Pla estratègic; Atenció pal·liativa; Atenció centrada en la personaPlan estratégico; Atención paliativa; Atención centrada en la personaStrategic plan; Palliative care; Person centered careAquest Pla estratègic aborda la planificació estratègica de l’atenció a les persones amb necessitats pal·liatives per part dels equips i dispositius de cures pal·liatives específics (a partir d’ara, atenció pal·liativa especialitzada), mentre que de forma conjunta amb la direcció estratègica d’atenció primària i comunitària serà necessari el replantejament de l’atenció al final de vida de forma transversal

Pla estratègic d'atenció geriàtrica i pal·liativa especialitzada de Catalunya: línies estratègiques, projectes i actuacions

Pla estratègic; Atenció pal·liativa; Atenció centrada en la personaPlan estratégico; Atención paliativa; Atención centrada en la personaStrategic plan; Palliative care; Person centered careAquest document conté les línies estratègiques, projectes i actuacions del Pla estratègic d'atenció geriàtrica i pal·liativa especialitzada de Catalunya

Nutrición parenteral domiciliaria en España, 2019: informe del Grupo de Nutrición Artificial Domiciliaria y Ambulatoria NADYA

RESUMEN Objetivo: comunicar los datos de nutrición parenteral domiciliaria (NPD) obtenidos del registro del grupo NADYA-SENPE (www.nadyasenpe.com) del año 2019. Material y métodos: análisis descriptivo de los datos recogidos de pacientes adultos y pediátricos con NPD en el registro NADYA-SENPE desde el 1 de enero al 31 de diciembre de 2019. Resultados: se registraron 283 pacientes (51,9 %, mujeres), 31 niños y 252 adultos procedentes de 47 hospitales españoles, lo que representa una tasa de prevalencia de 6,01 pacientes/millón de habitantes/año 2019. El diagnóstico más frecuente en los adultos fue “oncológico paliativo” y “otros” (21,0 %). En los niños fue la enfermedad de Hirschsprung junto a la enterocolitis necrotizante, las alteraciones de la motilidad intestinal y la pseudoobstrucción intestinal crónica, con 4 casos cada uno (12,9 %). El primer motivo de indicación fue el síndrome del intestino corto tanto en los niños (51,6 %) como en los adultos (37,3 %). El tipo de catéter más utilizado fue el tunelizado tanto en los niños (75,9 %) como en los adultos (40,8 %). Finalizaron 68 episodios, todos en adultos: la causa más frecuente fue el fallecimiento (54,4 %). Pasaron a la vía oral el 38,2 %. Conclusiones: el número de centros y profesionales colaboradores con el registro NADYA va incrementándose. Se mantienen estables las principales indicaciones y los motivos de finalización de la NPD

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe