La obra de arte como objeto de intercambio : procesos y estructuras del mercado del arte

Publicación financiada por la AECI

Akong : su reglamento de juego

Vocablos usuales en el juego de Akon

Proyecto ecoturístico integrado en la Reserva Natural El Tisey - La Estanzuela

El presente proyecto realizado en la Reserva Natural El Tisey-La Estanzuela en la República de Nicaragua pretende mejorar la situación de dicha Reserva como destino ecoturístico. Mediante una descripción exhaustiva del área y una valoración de los recursos y servicios turísticos, se ha planteado la problemática para el desarrollo del ecoturismo. Según la OMT, el ecoturismo es un tipo de turismo sostenible que se realiza en espacios naturales protegidos para conocer la flora y fauna características. Debe satisfacer las necesidades de los turistas y de los autóctonos, al mismo tiempo que protege y mejora las oportunidades de futuro y se respeta la integridad cultural, los procesos ecológicos, la diversidad biológica y los sistemas de apoyo a la vida. En base a ésto y a los resultados obtenidos tanto de la valoración de los servicios y recursos como del análisis DAFO, se han propuesto un conjunto de mejoras y se ha realizado un plan de actuación, que se trata de la elaboración de cuatro itinerarios así como de trípticos informativos, que de llevarse a cabo, mejorarían las condiciones turísticas y de seguro que aumentaría la afluencia de turistas.El present projecte realitzat en la Reserva Natural El Tisey-La Estanzuela a la República de Nicaragua pretén millorar la situació d'aquesta Reserva com a destí ecoturístic. Mitjançant una descripció exhaustiva de l'àrea y una valoració dels recursos i serveis turístics, s'ha plantejat la problemàtica per al desenvolupament de l'ecoturisme. Segons la OMT, l'ecoturisme és un tipus de turisme sostenible que es realitza en espais naturals protegits per a conèixer la flora i la fauna característiques. Ha de satisfer les necessitats dels turistes i dels autòctons, alhora que protegeix i millora les oportunitats de futur i es respecta la integritat cultural, els processos ecològics, la diversitat biològica i els sistemes de suport a la vida. En base a això i als resultats obtinguts tant de la valoració dels serveis i recursos com de l'anàlisi DAFO, s'han proposat un conjunt de millores i s'ha realitzat un pla d'actuació, que es tracte de l'elaboració de quatre itineraris així com de tríptics informatius, que si es duguessin a terme, millorarien les condicions turístiques i augmentarien l'afluència de turistes.The present project realized in the Natural Reserve El Tisey-La Estanzuela in the Republic of Nicaragua tries to improve the situation of the Reserve as an ecoturistic destination. Through an exhaustive description of the area and a valuation of the resources and tourist services the problematic of the development of the ecotourism has been described. According to the OMT, ecotourism is a type of sustainable tourism that is realized in natural protected areas to know the typical flora and fauna. It must satisfy the needs of the tourists and of the autochthonous ones, at the same time as it protects and improves the opportunities of future and it respects the cultural integrity, the ecological processes, the biological diversity and the systems of support to the life. On the basis of this and of the results obtained with the valuation of the services and resources, as of the analysis DAFO, it has been proposed a set of improvements and it has been realized an action plan, which treats itself about the elaboration of four itineraries as well as of informative triptychs, that if they were carried out, they would improve the tourist conditions, so the tourists' abundance would increase too

High Resolution Esophageal Manometry in Patients with Chagas Disease : A Cross-Sectional Evaluation

Gastrointestinal involvement affects 30-40% of the patients with chronic Chagas disease. Esophageal symptoms appear once the structural damage is established. Little is known about the usefulness of high resolution manometry to early identification of esophageal involvement. We performed a cross-sectional study at the Vall d'Hebron University Hospital (Barcelona, Spain) between May 2011 and April 2012. Consecutive patients diagnosed with Chagas disease in the chronic phase were offered to participate. All patients underwent a structured questionnaire about digestive symptoms, a barium esophagogram (Rezende classification) and an esophageal high resolution manometry (HRM). A control group of patients with heartburn who underwent an esophageal HRM in our hospital was selected. 62 out of 73 patients that were included in the study fulfilled the study protocol. The median age of the Chagas disease group (CG) was 37 (IQR 32-45) years, and 42 (67.7%) patients were female. Twenty-seven (43.5%) patients had esophageal symptoms, heartburn being the most frequent. Esophagogram was abnormal in 5 (8.77%). The esophageal HRM in the CG showed a pathological motility pattern in 14 patients (22.6%). All of them had minor disorders of the peristalsis (13 with ineffective esophageal motility and 1 with fragmented peristalsis). Hypotonic lower esophageal sphincter was found more frequently in the CG than in the control group (21% vs 3.3%; p<0.01). Upper esophageal sphincter was hypertonic in 22 (35.5%) and hypotonic in 1 patient. When comparing specific manometric parameters or patterns in the CG according to the presence of symptoms or esophagogram no statistically significant association were seen, except for distal latency. The esophageal involvement measured by HRM in patients with chronic Chagas disease in our cohort is 22.6%. All the patients with esophageal alterations had minor disorders of the peristalsis. Symptoms and esophagogram results did not correlate with the HRM results. Chagas disease is a parasitic disease mainly transmitted to humans by blood-sucking insects. The disease was endemic in Latin America, but it is now a global disease due to migratory movements. The disease can affect the heart and the digestive system (mainly esophagus and colon). Classically, esophageal assessment in Chagas disease is performed by X-ray and self-reported symptoms. However, they lack accuracy and detect only advanced stage of the disease. Recently, new tools, such as esophageal high resolution manometry, provide more detailed information about the motility disorders of the esophagus. We assessed the esophageal involvement in patients with Chagas disease by means of high resolution manometry and compared the findings with the X-ray and self-reported symptoms. We found a low rate of mild severity motility disorders. We did not find an association between X-ray assessment and symptoms with the high resolution manometry findings. The assessment of esophageal involvement in patients with Chagas disease may benefit from early diagnosis by high resolution manometry, although more research is needed

Situación epidemiológica de las encefalopatías espongiformes transmisibles humanas en España

[ES] Las Encefalopatías Espongiformes Transmisibles Humanas (EETH) son enfermedades de declaración obligatoria, de baja incidencia, provocadas por depósitos de proteína priónica que cursan en general con demencia rápidamente progresiva. El Registro Nacional de EETH (RNEETH) recoge datos de los casos españoles desde 1995. En este informe se presentan las características de los casos de EETH de España. Los datos proceden de las notificaciones hechas por las unidades de vigilancia epidemiológica de las comunidades autónomas al RNEETH hasta el 1 de julio de 2016. La forma más común es la Enfermedad de Creutzfeldt-Jakob esporádica (ECJe, se desconoce la causa) cuya incidencia anual en España es de 1,1 casos por millón de habitantes y año. El grupo de edad con mayores tasas de ECJe es el de 70 a 79 años. El 55% de todos los casos son mujeres. En los años 2005, 2007 y 2008 se recogen cinco casos de variante de ECJ (vECJ), dos de ellos en una mujer y su hijo, única agrupación familiar descrita. En el RNEETH constan también siete casos de ECJ transmitida accidentalmente por implantes de duramadre y 152 casos genéticos: 68 en forma de Insomnio Familiar Letal (IFL), 81 de ECJ familiar (ECJf) y 3 de síndrome de Gerstmann-SträusslerScheinker (SGSS). El País Vasco presenta una incidencia de formas familiares por encima de las demás comunidades autónomas. Los datos que constan en el Registro Nacional de EETH reflejan una situación epidemiológica similar a la descrita en otros países de nuestro entorno salvo para las formas genéticas.[EN] Human Transmissible Spongiform Encephalopathies (HTSE) are notifiable diseases with lowincidence caused by prion protein (PrP) deposits. HTSE are generally characterized by rapidly progressive dementia. The National Registry of HTSE (NRHTSE) collects data from Spanish cases since 1995. This report summarizes the characteristics of the cases of HTSE in Spain. Data come from notifications made by the Epidemiological Surveillance Units of the Autonomous Regions to the NRHTSE until 1 July 2016. The most common form is sporadic Creutzfeldt-Jakob Disease (sCJD) whose annual incidence in Spain is 1.1 cases per million inhabitants per year. The age group with the highest CJD rates is 70 to 79 years. 55% are women. In 2005, 2007 and 2008, 5 cases of variant CJD (vCJD) were recorded, two of them in a woman and her son, the only family group described. In the NRHTSE there are 7 cases of CJD accidentally transmitted by dura mater implants and 152 genetic cases: 68 of Familial Insomnia (FFI), 81 of familial CJD (fCJD) and 3 of Gerstmann-Straüssler-Scheinker syndrome (GSSS). The Basque country has an incidence of family forms above the other Autonomous Regions. The data of the NRHTSE reflect an epidemiological situation similar to other countries of our environment except for genetic forms.N

Epidemiological and clinical features, response to HAART, and survival in HIV-infected patients diagnosed at the age of 50 or more

BACKGROUND: Over the last years, the mean age of subjects with HIV infection and AIDS is increasing. Moreover, some epidemiological and clinical differences between younger and older HIV-infected individuals have been observed. However, since introduction of HAART therapy, there are controversial results regarding their response to HAART. The aim of the present study is to evaluate epidemiological and clinical features, response to HAART, and survival in elderly HIV-infected patients with regard to younger HIV-infected patients. METHODS: A prospective cohort study (1998–2003) was performed on patients from Sabadell Hospital, in Northeast of Spain. The cohort includes newly attended HIV-infected patients since January 1, 1998. For the purpose of this analysis, data was censured at December 31, 2003. Taking into account age at time of diagnosis, it was considered 36 HIV-positive people aged 50 years or more (Group 1, G1) and 419 HIV-positive people aged 13–40 years (Group 2, G2). Epidemiological, clinical, biological and therapy data are recorded. Statistical analysis was performed using Chi-squared test and Fisher exact test, Mann-Whitney U test, Kaplan-Meier, Log Rank test, and Two-Way ANOVA from random factors. RESULTS: G1 showed higher proportion of men than G2. The most common risk factors in G1 were heterosexual transmission (P = 0.01) and having sex with men or women (P < 0.001). G1 and G2 show parallel profiles through the time regarding immunological response (P = 0.989) and virological response (P = 0.074). However, older people showed lower CD4 cell counts at first clinic visit (P < 0.001) and, eventually, they did not achieve the same counts as G2. G1 presented faster progression to AIDS (P < 0.001) and shorter survival (P < 0.001). CONCLUSION: Older patients have different epidemiological features. Their immunological and virological responses are good. However, older patients do not achieve the same CD4 cell counts likely due to they have lower counts at first clinic visit. Thus, it is essential physicians know older HIV-infected patients features to consider the possibility of HIV infection in these patients with the aim of treatment would not be delayed

Effectiveness of a psycho-educational program for improving quality of life of fibromyalgia patients

<p>Abstract</p> <p>Background</p> <p>Most fibromyalgia patients are seen in primary care (PC). However, the effectiveness of the treatments prescribed by general practitioners is usually minimal. The main objective of the present research is to assess the efficacy of structured psycho-educational intervention, combined with relaxation, developed to improve the quality of life of patients suffering fibromyalgia (FM). The second objective is to assess the cost-effectiveness of this multimodal intervention.</p> <p>Method/Design</p> <p><it>Design</it>. Randomized controlled trial with a 12-month follow-up involving two groups, one of which is the intervention group that includes patients receiving a psychoeducational program and the other the control group consisting of patients treated for FM in the usual way.</p> <p><it>Setting</it>. Three urban PC centers in the province of Barcelona (Spain).</p> <p><it>Sample</it>. The total sample comprises 218 patients (over 18 years of age) suffering FM, selected from a database (Rheumatology service-Viladecans Hospital) of patients with this illness. Only those patients introduced in the database between the years 2005 and 2007 were included in the selection. Selected patients will be asked for written informed consent to participate in the study.</p> <p><it>Intervention</it>. Multi-component program including information about the illness, counselling about physical exercise and training in autogenic relaxation. The intervention consists of nine 2-hour sessions delivered during a two-month period. The pharmacological treatment prescribed by the physician was maintained in both groups.</p> <p><it>Main variables</it>. Sociodemographic characteristics, quality of life, use and cost of healthcare and social services.</p> <p><it>Measures</it>. Quality of life is to be measured with the FIQ and the EuroQol-5D, and the use of healthcare services with an adapted version of the Client Service Receipt Inventory (CSRI). These variables will be measured before the beginning of the program (baseline) and 1, 2, 6 and 12 months later.</p> <p>Discussion</p> <p>This research project is an attempt to demonstrate that a psycho-educational program implemented in the context of PC can produce a significant increase in the quality of life for patients with FM, as well as a decrease in the use of healthcare and social services, compared with usual care.</p> <p>Trial registration</p> <p>NCT00550966</p