Search

La producción iconográfica de las ciudades constituye una documentación imprescindible para los estudios de historia urbana pero, a la vez, son elementos con un gran valor interpretativo de los procesos de control urbanístico y, por tanto, de las estrategias de intervención asociadas a intereses de tipo económico, social y cultural. Estas producciones, en forma de vistas y cartografía urbana, son todavía más apreciables cuando son el resultado de la correlación entre los momentos álgidos de la planificación urbanística, el desarrollo urbano real y la creación de un relato de apropiación de la ciudad. La representación iconográfica posee una capacidad comunicativa más efectiva que la derivada del planeamiento, por lo que elabora una construcción simbólica de una realidad urbana con fuerte persistencia en el imaginario cultural. El caso de la ciudad de Barcelona y la cartografía turística de principios de siglo XX es un ejemplo intenso e interesante de esta relación., The iconographic production of cities comprises a corpus of documentation essential for studies of urban history but, at the same time, it is composed of items of great value for the interpretation of urban development control processes and, therefore, of the intervention strategies associated with interests of an economic, social and cultural nature. Such productions, in the form of urban cartography and views, are even more valuable when they are the result of correlation between peak periods in urban planning, real urban development and the creation of an account of appropriation of the city. Iconographic representation possesses a more effective communicative capacity than that derived from urban planning, hence it produces a symbolic construction of an urban reality with a powerful persistence in the cultural imaginary. The case of the city of Barcelona and its tourist cartography of the early 20th century is an intense and interesting example of this relationship.

Having access to parenting interventions in the early years is key to improve the developmental outcomes of children with neurodevelopmental problems. The Incredible Years® (IY) Parent Program is a group intervention that has demonstrated efficacy in terms of reducing stress in parents, as well as improving behavioral, emotional, and social outcomes in children. The program has been recently adapted for families of children with autism or language delays (IY-ASLD®). This intervention has not yet been implemented in the Spanish Public Health System, where there is a scarcity of evidence-based interventions being offered to families with young children presenting neurodevelopmental problems. The main aims of this study are to determine the feasibility of implementing the IY-ASLD® program within Spanish Child Mental Health Services and to examine parents' acceptability and satisfaction with the intervention. As a secondary objective, we aim to evaluate its preliminary effectiveness in terms of reducing parental stress and behavioral difficulties in their children. The FIRST STEPS study is a multicenter, pilot randomized controlled trial comparing the IY-ASLD® program with a treatment-as-usual (TAU) condition. Approximately 70 families of children with autism spectrum disorder (ASD) and preterm children with communication and/or socialization difficulties (aged 2-5 years) will be recruited. Families will be assessed prior to randomization and after the intervention. Due to the COVID-19 pandemic, the intervention will consist of 22 weekly online sessions (approximately 6 months). The FIRST STEPS pilot trial will demonstrate the feasibility and acceptability of reliably implementing the IY-ASLD® program within the Spanish Public Health System. The results of this study could represent the first step to inform policymakers in Spain when designing evidence-based healthcare pathways for families of children presenting ASD symptoms or neurodevelopmental difficulties at early stages. TRIAL REGISTRATION: ClinicalTrials.gov NCT04358484 . Registered on 04 April 2020.

Sarcopenia (loss of muscle mass and function) implies a worse prognosis. However, its diagnosis is complex and is not made in routine clinical care. A biomarker has been proposed as a surrogate estimator of skeletal muscle mass, the so-called sarcopenia index ([serum creatinine/cystatine C] x100) which is associated with prognostic features in various diseases including patients with stable chronic obstructive pulmonary disease (COPD). The aim of our study was to prospectively evaluate the potential clinical and prognostic information of this biomarker in COPD exacerbation. This is a one-year prospective study of consecutive patients admitted for COPD exacerbation. A total of 89 patients. 70 men (79%) and 19 women (21%) were included. Those with lower values of the sarcopenia index had a higher level of dyspnoea and a longer hospitalization. In the correlation analysis, the index had statistically significant values with FEV1 (r = 0.23), PaCO2 (r = -0.30), bicarbonate (r = -0.31), dyspnoea (r = -0.25) and length of admission (r = -0.30). In patients admitted for COPD exacerbation, the sarcopenia index was related to prognostic characteristics, so that lower values were associated with longer duration of hospital admission, more dyspnoea and greater functional impairment. As this is an index associated with muscle mass, its determination may identify patients who could be the subject of a differentiated therapeutic plan.

Introduction: Organ tropism of SARS-CoV-2 to the respiratory tract could potentially aggravate asthma. The susceptibility of patients with asthma to develop an exacerbation when they are infected with SARS-CoV-2 is unknown. We aimed to investigate the symptoms presented in patients with asthma who became infected with SARS-CoV-2. Methods and results: All patients over 14 years of age who tested positive for SARS-CoV-2 (by RT-PCR) were included (n = 2995). In patients with asthma (n = 77, 2.6%; 44 females), symptoms, therapy and phenotype were recorded. Seventeen (22%) patients had mild asthma, 55 (71%) moderate and five severe (6%). Twenty-six patients with asthma (34%) were asymptomatic, 34 (44%) developed symptoms but did not require hospital admission, and 17 (22%) were hospitalised. One patient was admitted because of asthma exacerbation without pneumonia or other symptoms. Ten patients (13%) had wheezes (six with pneumonia). Comparison of wheezing between patients with non-T2 asthma and the rest of the patients was statistically significant, (p < 0.001). Conclusions: SARS-CoV-2 infection is not a significant cause of asthma exacerbation, although some patients may present wheezing, especially in cases of pneumonia. The severity of asthma does not seem to be associated with symptoms of the disease.

Background: Efforts have been made to search for parameters that facilitate the prediction of the 3-month survival for clinical decisions in patients with malignant pleural effusion (MPE). We sought to evaluate whether the platelet-to-lymphocyte ratio (PLR) may be a useful marker of 3-month survival in a series of consecutive patients with MPE. Methods: A total of 81 patients with MPE were included, 46 (57%) of whom were female. Twenty-six patients (32%) died during the first 3 months according to thoracentesis data. Results: The area under the receiver operating characteristics curve was 0.73 for PLR. Using a cutoff point of 158, patients with higher PLR values experienced higher mortality at 3 months (p = 0.001). Conclusions: PLR was able to successfully differentiate patients with different survival at 3 months. Outcomes of the PLR (a fast and inexpensive test) could be included among the prognostic factors able to guide the personalized management of MPE.

Introduction: The prevalence of asthma in patients hospitalized with SARS-CoV-2 has been studied and varies widely in the different series. However, the prevalence in SARS-infected patients not requiring hospitalization is not known. The objective of this study was to analyze the presence of asthma in a consecutive series of patients who tested positive in the RT-PCR assay for SARS-CoV-2 and did not require hospital admission. Methods and results: A total of 218 patients (58% of those who tested positive) did not require hospitalization; they had a median age of 45 years (IQR 34-57) and 57% were female. Six patients (2.8%) had a previous diagnosis of asthma. Only one patient developed a mild aggravation of asthma symptoms associated with SARS-CoV-2 infection. Conclusions: Few patients with asthma were infected by SARS-CoV-2, and this infection was not a significant cause of asthma exacerbation.

Increased levels of lactic acid have been described in patients treated for asthma exacerbation. However, the frequency and clinical significance of hyperlactatemia in real-world practice is unknown. The objective of the study was to evaluate the characteristics associated with hyperlactatemia in blood gas analysis of patients with asthma exacerbation hospitalized in a pulmonary department. This is a retrospective 3-year study (2015 to 2017) of patients discharged from the pulmonary department. The level of lactic acid in the blood gas test and the possible relationship with clinical, laboratory, therapy, spirometric values, hospitalization length and use of critical care resources were analyzed. A total of 112 patients with 182 admissions were included in the study. Thirty-two (29%) patients had hyperlactatemia in at least one blood gas analysis. Elevated lactic acid was observed in 42 of 182 admissions (23%), which had larger length hospital stay (median, 6 vs. 5 days, p = 0.013). Hyperlactatemia was present in 8 of 10 admissions in the critical care units, mainly after receiving bronchodilator therapy. There was a significant correlation between lactate level and bicarbonate level (r = -0.417, p = 0.003) and between lactate level and base excess (r = -0.484, p < 0.001) in cases with hiperlactatemia. Hyperlactatemia is a relatively frequent finding in blood gas analysis of patients hospitalized because of asthma (23% of admissions). These admissions with hiperlactatemia are associated with larger hospital length of stay.

Increased levels of lactic acid have been described in patients treated for asthma exacerbation. However, the frequency and clinical significance of hyperlactatemia in real-world practice is unknown. The objective of the study was to evaluate the characteristics associated with hyperlactatemia in blood gas analysis of patients with asthma exacerbation hospitalized in a pulmonary department. This is a retrospective 3-year study (2015 to 2017) of patients discharged from the pulmonary department. The level of lactic acid in the blood gas test and the possible relationship with clinical, laboratory, therapy, spirometric values, hospitalization length and use of critical care resources were analyzed. A total of 112 patients with 182 admissions were included in the study. Thirty-two (29%) patients had hyperlactatemia in at least one blood gas analysis. Elevated lactic acid was observed in 42 of 182 admissions (23%), which had larger length hospital stay (median, 6 vs. 5 days, p = 0.013). Hyperlactatemia was present in 8 of 10 admissions in the critical care units, mainly after receiving bronchodilator therapy. There was a significant correlation between lactate level and bicarbonate level (r = -0.417, p = 0.003) and between lactate level and base excess (r = -0.484, p < 0.001) in cases with hiperlactatemia. Hyperlactatemia is a relatively frequent finding in blood gas analysis of patients hospitalized because of asthma (23% of admissions). These admissions with hiperlactatemia are associated with larger hospital length of stay.

En aquest article s'analitzen els criteris que estableix el legislador català per a l'atribució de la guarda dels fills en cas de ruptura de la convivència dels seus progenitors, tenint especialment present l'opinió del menor. Com a conclusió es proposa la participació efectiva del menor en el procés civil., This article reviews the criteria established by the Catalan legislator concerning the attribution of the custody of children in the case of the divorce of their parents, especially bearing in mind the views of the minor. In conclusion, we propose the effective participation of the minor in the civil process.

Maspalomas-Costa Canaria y Costa Brava son actualmente dos destinos maduros en la órbita del turismo internacional que han contribuido decisivamente a la consolidación del modelo del turismo vacacional de sol y playa en España. Si bien partieron de una situación completamente distinta en la etapa inicial de la actividad turística a finales del siglo XIX, de acuerdo con contextos geográficos y socioeconómicos diferenciales, convergieron en el momento de eclosión del turismo de masas a partir de la década de los 60, por lo que sus respectivos desarrollos comparten muchos elementos comunes en relación a los procesos económicos, las formas de ocupación del territorio, la expansión urbanística y su articulación con grandes infraestructuras de transporte, así como las tipologías arquitectónicas creadas masivamente para el tiempo de ocio. A pesar de la tendencia seguida en ambos casos en la elaboración de un producto estandarizado y reconocible a nivel mundial, Canarias y Costa Brava han preservado valores singulares y contrastados dentro del modelo de sol y playa, y ello se ha convertido en un potencial de regeneración y valoración de la identidad de sus territorios costeros en un momento en el que la emergencia de una conciencia de estancamiento económico, a la par con la degradación irreversible de los paisajes, protagoniza el debate sobre las zonas turísticas. El análisis comparativo que aquí se presenta aborda con mayor complejidad aspectos esenciales del ciclo de vida del fenómeno turístico en los dos casos de estudio y pretende aportar claves para su proyección ante estrategias futuras de intervención.

[cat] En els 200 anys compresos entre 1761, data del Pla radial de carreteres d’Espanya, i la segona meitat del segle XX es produeix la modernització del sistema de comunicacions terrestres de Catalunya. Es tracta d’un arc temporal prou llarg en el qual les noves infraestructures de transport evolucionen d’acord amb un model caracteritzat per una planificació intensiva de la xarxa de carreteres i uns ritmes irregulars de construcció de vies amb una tendència al retard endèmic en relació als plans d’origen. El contrast entre aquests dos elements principals va condicionar la consecució de la xarxa viària moderna i va establir també unes relacions específiques de concurrència entre els diversos mitjans de transport i la mobilitat que d’aquests es deriva. En l’àmbit català, el reconeixement del model descrit s’adequa perfectament a l’evolució seguida a la regió de Barcelona, i coincideix en gran part amb la divisió administrativa de la província com a marc d’actuació i gestió de la xarxa de carreteres des del segon terç del segle XIX. Les fonts històriques consultades han permès corroborar que la formació de la xarxa viària obeeix a uns cicles distingits pels arguments i criteris que justifiquen l’obertura de vies noves. En un primer moment, la planificació és assimilable a una radiografia de l’activitat econòmica del territori que té en compte l’estructura de la circulació comercial llargament consolidada; sorgeix, així, la xarxa bàsica a escala catalana com a expressió de la primera industrialització, sancionada en el Pla estatal de 1860. La potència dels nous eixos definits pel saber tècnic de l’enginyeria de camins esdevenen els canals d’una nova comunicació que es completa amb un segon moment de planificació provincial, més madura i protagonitzada per la xarxa de carreteres secundàries del darrer terç del segle XIX. La identificació de la interacció entre carreteres i territori porta a reflexionar sobre el paper fonamental de les vies en l’assoliment d’un equilibri territorial que es converteix, en un tercer cicle que té lloc durant les primeres dècades del segle XX, en una veritable acció de govern destinada a estendre la civilització per tota la geografia catalana. Són els camins veïnals com a equipaments del territori que superen amb escreix la magnitud de la planificació I també dels ritmes constructius anteriors. Avui, formen part de la xarxa de carreteres locals de Barcelona i els considerem components essencials del seu patrimonio territorial. Finament, l’arribada de l’automòbil suposa l’entrada de nous paràmetres que es concreten especialment en una visió que incorpora noves escales territorials i supera l’articulació basada en la concurrència i la intermodalitat que s’havia establert entre els carruatges i el ferrocarril. L’hegemonia del nou mitjà de transport s’imposa a partir de 1960, moment que s’instaura un cicle dual de planificació basat en l’acabament de la xarxa viària local i el començament de les vies d’alta capacitat que estructuren la Regió Metropolitana de Barcelona., [eng] In the 200 years between 1761, (Radial Road Plan, Spain), and the second half of the 20th century witnessed the modernization of terrestrial communications system in Catalonia. It constitutes a long enough period of time in which the new transportation infrastructures evolve according with a model characterized by an intensive road network planning and some irregular road construction rhythms, with a certain endemic delay in relation to the original plans. The contrast between these two main elements conditioned the achievement of a modern road network and established some specific relations of coexistence between the diverse transport modalities and their derived mobility. In Catalonia, the described model perfectly matches the evolution of Barcelona region, and coincides largely with the administrative division of the province as an area of performance for the road network since the second third of the 19th century. The historical sources consulted corroborate that the formation that the road-network evolution follows a cycle based on the arguments that justify the new road construction. Firstly, planning becomes a territory x-ray of economic activity that takes into account the consolidated commercial mobility. It led to the Catalan-scaled basic network as a first industrialization expression, sanctioned in the state Plan of 1860. Civil engineering body of knowledge left those strong new axes behind, leading to a new communication system to be completed, in the late 19th century, by provincial planning, focusing on the secondary road network. The identification of road-territory interaction leads to consider the fundamental role of the road network in achieving a territorial balance that results in a third cycle during the early 20th century, as a true governmental action aimed to civilize the Catalan geography. These are the “veïnal” paths that widely exceed those formulated in plans as well as the previous construction rhythms. At present, they form part of Barcelona’s local network and are considered as essential elements of its landscape heritage. Finally, the arrival of the car-based mobility on the scene resulted in a vision that incorporates new territorial scales and overcomes the railway-carriage intermodal reality. Car hegemony, since 1960s, initiates a process of local road network completion and the appearance of a highway network for the Metropolitan Region of Barcelona.