Franceses en la Valencia del siglo XVI: apuntes acerca de la idea de integración y trayectoria ejemplar del mercader Joan Augier.

la presencia francesa en lo que fuera el reino de valencia es una temática que cuenta con un número de trabajos no desdeñable aunque dedicados mayormente a los siglos xvII y xvIII. Este estudio representa una aproximación a esa cuestión para el siglo xvI destacando aquellas fuentes útiles a tal análisis a la vez que introduce alguna reflexión acerca de las condiciones de establecimiento y proceso de integración de unos individuos procedentes de la vecina Francia en un siglo ciertamente agitado a nivel cultural y religioso. El mercader joan Augier ofrece un ejemplo brillante y exitoso de asentamiento

The Valencian Merchant Joan Augier’s Accounts Book: Year 1604

Merchants are essential figures in the economy of the modern centuries, and getting to know their activity allows for a better understanding of their environment. The accounts book therefore represents a valuable and also a scarce type of document, at least in xvi century Spain. The issue that made the following work possible spans years 1597-1613, and belonged to the Valencian merchant Joan Augier. The analysis of year 1604 reveals diversified economic and financial activity, among which we highlight import and export with Marseilles and Genoa, and tax renting or bond purchasing. The pages show a complex network of interprofessional relationships together with information concerning a range of items and service prices, thereby permitting an approach to the commercial, fiscal and financial life in Valencia at that time.La figura del mercader es clave en la economía de los siglos modernos y llegar a conocer el detalle de sus actividades permite aprehender mejor el entorno en el que se desenvolvía. Para ello, el libro de cuentas constituye un tipo documental destacado a la vez que escaso, al menos para el siglo xvi español. El ejemplar que ha permitido el siguiente trabajo abarca los años 1597-1613 y perteneció al mercader valenciano Joan Augier. El análisis del año 1604 pone de manifiesto una actividad económica y financiera diversificada en el que destacan; la importación y exportación con Marsella y Génova, el arriendo de tributos o la compra de deuda. Sus páginas revelan una compleja red de relaciones interprofesionales, pero también información sobre los precios de una gran variedad de productos y servicios, permitiendo una aproximación a la vida comercial, fiscal y financiera de la Valencia de la época

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

Trends in the epidemiology of catheter-related bloodstream infections; towards a paradigm shift, Spain, 2007 to 2019

Altres ajuts: Departament de Salut. Generalitat de Catalunya ("Pla estratègic de recerca i innovació en salut (PERIS) 2019-2021"); Ministerio de Asuntos Económicos y Transformación Digital; Red Española de Investigación en Patología Infecciosa (REIPI).Background: Catheter-related bloodstream infections (CRBSI) are frequent healthcare-associated infections and an important cause of death. Aim: To analyse changes in CRBSI epidemiology observed by the Infection Control Catalan Programme (VINCat). Methods: A cohort study including all hospital-acquired CRBSI episodes diagnosed at 55 hospitals (2007-2019) in Catalonia, Spain, was prospectively conducted. CRBSI incidence rates were adjusted per 1,000patientdays. To assess the CRBSI rate trend per year, negative binomial models were used, with the number of events as the dependent variable, and the year as the main independent variable. From each model, the annual rate of CRBSI diagnosed per 1,000patientdays and the incidence rate ratio (IRR) with its 95% confidence intervals (CI) were reported. Results: During the study, 9,290 CRBSI episodes were diagnosed (mean annual incidence rate:0.20episodes/1,000patientdays). Patients' median age was 64.1years; 36.6% (3,403/9,290) were female. In total, 73.7% (n=6,845) of CRBSI occurred in non-intensive care unit (ICU) wards, 62.7% (n=5,822) were related to central venous catheter (CVC), 24.1% (n=2,236) to peripheral venous catheters (PVC) and 13.3% (n=1,232) to peripherally-inserted central venous catheters (PICVC). Incidence rate fell over the study period (IRR:0.94;95%CI:0.93-0.96), especially in the ICU (IRR:0.88;95%CI:0.87-0.89). As a whole, while episodes of CVC CRBSI fell significantly (IRR:0.88;95%CI:0.87-0.91), peripherally-inserted catheter CRBSI (PVC and PICVC) rose, especially in medical wards (IRR PICVC:1.08;95%CI:1.05-1.11; IRR PVC: 1.03; 95% 1.00-1.05). Conclusions: Over the study, CRBSIs associated with CVC and diagnosed in ICUs decreased while episodes in conventional wards involving peripherally-inserted catheters increased. Hospitals should implement preventive measures in conventional wards