Catalan Society Research Articles

"Verdaguer ha mort, visca Verdaguer!". Dol, memòria i política en el funeral d’un referent cultural de la Catalunya contemporània

This article situates itself in the field of historiographic studies that deal with memory, the politics of death, and the commemorative cult of public figures. More specifically, it aligns with approaches that conceive funerals as significant ritual expressions within the repertoire of collective action and in the forging of communities. The funeral of Jacint Verdaguer (1845–1902) is considered here the first great posthumous homage to the deceased and a notable moment in the construction of his afterlives. Various aspects of this episode are analysed, from the factors that lent it an extraordinary character, the forms of expressing grief, the role played by the press, the relationship between the event and memory, as well as the plural meanings attributed to the figure of Verdaguer and early evidence of the contested appropriations of his legacy. As will be shown, the event was powerfully shaped by politics, giving it the character of what we might call, following Fureix, a contestatory or opposition burial. Careful study of this rite of passage ultimately demonstrates that Verdaguer was a common reference point through which Catalan society was able to negotiate, if not resolve, consensus and dissensus.

Guimerà: la persistència d’un mite popular i els debats al voltant del cinquantenari de la seva mort (1909–1974)

Few authors are able to represent and exemplify in life the continuity between national literary canon and territorial identity as well as Àngel Guimerà i Jorge (1845–1924). This article sets out to trace the continuities and permanence in Catalan culture of the figure of Guimerà, but at the same to highlight the contrasting or contradictory elements that have characterized public evaluations of his legacy. Beginning with brief consideration of the monumentalization of Guimerà in the early 20th century and immediately following his death in 1924, we will go on to focus on debates around his significance towards the end of the Franco dictatorship, as it was then that new generations of intellectuals and artists who had not directly experienced the civil war would consider the continuing relevance or validity of his writings. This process culminated in 1974 on the occasion of the fiftieth anniversary of his death: when there was open debate in the press about the place of Guimerà in Catalan culture, and, more specifically, on the Catalan stage. Here we aim to contextualise these debates, elucidating both the challenges presented by different aspects of his figure and work for recovery in the Catalan society of the period and the light they shed on the ways in which literary figures are resignified over time.

Reclassification of CADILLAC risk score with lung ultrasound at admission in patients with STEMI in a one-year follow-up

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): JC-M received Original Research Projects Grant from the Catalan Society of Cardiology and LR-S received Scholarship for Training and Research from the Association of Ischemic Heart Disease and Cardiological Critical Care of the Spanish Society of Cardiology. Introduction Lung ultrasound (LUS) has emerged as a valuable diagnostic and prognostic tool in heart failure (HF) and shows promise in risk stratification for ST-segment elevation myocardial infarction (STEMI) during the acute phase. Current risk stratification scales for STEMI primarily rely on the Killip scale to assess the severity of heart failure (HF) upon admission. However, these scales were developed before the widespread use of LUS, and as a result, LUS findings have not been incorporated into any existing risk stratification scales for STEMI. Purpose To assess the potential improvement in prognostic predictive value achieved by incorporating LUS findings into a current risk score for STEMI. Methods In a prospective multicenter cohort study, an independent operator conducted LUS, and offline B-line counting was performed upon admission. Patients were categorized as having wet lung (at least one site with ≥3 B-lines) or dry lung based on LUS results. The CADILLAC score was calculated, and patients were classified as either low risk (≤2 points) or medium/high risk (>2 points). We evaluated the Net Reclassification Index (NRI) and conducted a Receiver Operating Characteristics (ROC) comparison based on the prediction of a composite endpoint which included death, hospitalization for HF, acute coronary syndrome, or stroke within one year following revascularization. Results The CADILLAC score was computed for 353 patients after excluding those admitted with Killip IV. Among these, 216 (61.2%) had a low-risk score (≤2), and 137 (38.8%) had a medium-high score. LUS significantly reclassified CADILLAC results, resulting in an absolute NRI of 12.4%. ROC comparison of models comprising CADILLAC and CADILLAC + LUS demonstrated that the addition of LUS significantly improved the accuracy of predicted risk (0.722 vs. 0.770, p=0.05). Conclusion The inclusion of LUS findings in the CADILLAC score enhances its prognostic capacity.Figure 1

Prognostic evaluation of ST-segment elevation acute myocardial infarction according to lung ultrasound in the acute phase

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): JC-M received an Original Research Projects Grant from the Catalan Society of Cardiology and LR-S received Scholarship for Training and Research from the Association of Ischemic Heart Disease and Cardiological Critical Care of the Spanish Society of Cardiology. Introduction Lung ultrasound (LUS) has emerged as a useful diagnostic and prognostic tool in heart failure (HF) and has shown promise in risk stratification for ST-segment elevation myocardial infarction (STEMI) in the acute phase. These studies consistently indicate that the degree of pulmonary congestion, assessed by the number of B-lines on LUS, is significantly associated with a worse prgnosis during hospitalization and short-term follow-up in STEMI patients. However, this prognostic value has mainly been evaluated during hospital admission or a few days after discharge without a long-term follow-up. Purpose To assess the prognostic value of LUS at one year in patients admitted for STEMI. Methods In a prospective multicenter cohort study involving STEMI patients, an independent operator performed LUS during the first 24 hours after revascularization and offline B-line counting was conducted. LUS results were assessed both as a categorical [wet (at least one site with ³3 B-lines)/dry lung] and continuous variable (total number of B-lines). The primary endpoint was a composite of death or hospitalization for HF, acute coronary syndrome, or stroke within one year. Results A total of 173 patients were included. The composite endpoint occurred in 13.7% of the patients over a median follow-up of 368 days. LUS was able to predict the composite outcome with hazard ratios (HR) of adjusted hazard ratios of 4.85 (95% CI 2.79-8.43) for having a wet lung and 1.13 (95% CI 1.09-1.18) for each B-line. After and adjustment for sex, age, chronic kidney disease, previous atrial fibrillation, Killip class and left ventricular ejection fraction HR was 1.72 (95% CI 0.91-3.28) for having a wet lung and 1.06 (95% CI 1.00-1.11) for each B-line. Conclusion Detecting B-lines on LUS predicts adverse events at one year in STEMI patients.Kaplan-Meier curves

Образы средневековой "независимости" и "государственности" в современной каталоно-испанской мемориальной конфронтации

Introduction. The author in the presented article analyses the forms and features of the development of historical politics in modern Catalonia through the prism of the representation of medievalist concepts in the memorial culture of the regional society. The purpose of the study is to analyse medievalist rhetoric in modern wars of memory and those memorial cultures that arise and develop in Catalan society. Methods. Methodologically, the article is based on the principles of interdisciplinary historiography proposed for the analysis of memorial culture, which makes it possible to analyse medieval images as a form of historical policy aimed at instrumentalizing history. Results. The author analyses the role and place of regional intellectual communities and political elites as the main participants in historical politics, defined as forms of development of nationalism and the Catalan nationalist imagination. The novelty of the research lies in the study of the current (modern) stage in the development of the historical politics of the regional Catalan society through the prism of the actualization of medievalist rhetoric. The article shows that the intellectual community in modern Catalonia is a systemic segment of modern historical politics and the development of a nationalist version of memorial culture. The author believes that the range of memorial practices of regional intellectuals of Catalonia is limited primarily by their participation in strengthening civic identity through the prism of actualization and visualization in public and political discourse of the concepts of “statehood” and “independence” localized in the medievalist coordinate system through the active use of medieval images of the historical experience of Catalonia. Conclusions. The author concludes that medievalist rhetoric actually became a form of nationalization of history, promoting the integration of historical imagination and memorial culture into the discourse of Catalan political nationalism. It is assumed that the participation of regional intellectuals in memory wars actualizes the situation of politicization and ideologization of history, its instrumentalization within the framework of medievalist rhetoric, emphasizing the political, ideological and ethnic heterogeneity of society.

"Independence" and "statehood" narratives in the modern Catalan-Spanish memorial confrontation

The author in this article analyses the features of the development of historical policy in modern Catalonia through the prism of the representation of the concepts of “independence” and “statehood” in the memorial culture of the regional society. The purpose of the study is to analyze the perception of the concepts of “statehood” and “independence” in modern Catalan memorial culture and historical memory. The author analyses the role and place of regional intellectual communities and political elites as the main participants in historical politics, defined as forms of development of Catalan nationalist imagination. The novelty of the study lies in the study of the current (modern) stage in the development of the historical politics of the regional Catalan society through the prism of development of of the concepts of “statehood” and “independence” in memorial culture, which stimulates a negative response from Castilian (Spanish) nationalists as opponents of the Catalan political project. It is shown that 1) the intellectual community in Catalonia is a systemic segment of modern nationalist political memorial culture, 2) the spectrum of memorial practices of regional intellectuals in Catalonia is limited mainly by their involvement in the development of civic identity through the prism of updating and visualizing the concepts of "statehood" and "independence" in public and political discourses, 3) "statehood" and "independence"concepts in historical imagination and memorial culture of modern Catalan nationalism are used to legitimize the political program of independence. It is assumed that the participation of regional intellectuals in memory wars actualizes the political, ideological and ethnic heterogeneity of society.

Precarious lives, invisible deaths. A history of community funeral management among Moroccans in Catalonia

ABSTRACT Moroccan economic migration to Catalonia began in the mid-1960s and was consolidated in the early 1990s. The history of migration is usually reconstructed on the basis of associative, cultural and religious initiatives, as an expression of a collective identity. But this history is also the result of interaction with the receiving society. This article analyses the process of community funeral management among Moroccans in Catalonia, which represented one of the first expressions of their community configuration, but which at the same time reveals the negative consideration that their presence would arouse in Catalan society. The study of the archives of the Moroccan Consulate in Barcelona allows us to reconstruct the first funerary initiatives, but also some of the situations of early racism that were already occurring throughout the 1970s and 1980s.

Position paper of the Catalan Society of Gastroenterology about hepatic elastography 2022

Position paper of the Catalan Society of Gastroenterology about hepatic elastography 2022

Stepwise application of ECG and electrogram based criteria to ensure left bundle branch pacing

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): MPL received the Catalan Society of Cardiology Research Grant in 2019 and 2020 (Catalonia, Spain); the Josep Font Grant (2019-2022) from Hospital Clínic Barcelona (Catalonia, Spain). Background Left bundle branch pacing (LBBP) has emerged as an alternative to biventricular pacing. However, lack of a systematic stepwise application of the left bundle branch (LBB) capture criteria complicates implantation. Objective To define a stepwise application of LBBP capture criteria that will simplify implantation and ensure LBB capture. Methods A cohort of 24 patients from the LEVEL-AT trial who received LBBP and had electrocardiographic imaging (ECGI) at 45 days post-implant were included. The usefulness of ECG and electrogram based criteria to predict accurate LBB capture were analyzed. A two-step approach was developed to ensure LBB capture. The gold standard used to confirm LBB capture was the change in ventricular activation pattern and shortening in left ventricular activation time, assessed by ECGI. Results Twenty-two (91.6%) patients showed LBBP capture on ECGI. All patients fulfilled pre-screwing requisites: lead in septal position in left-oblique projection and W paced morphology in V1. In the first step, presence of either right bundle branch conduction delay pattern (qR or rSR in V1) or left bundle branch capture Plus (QRS ≤120ms) resulted in 95% sensitivity and 100% specificity to predict LBB capture, with an accuracy of 95.8%. In the second step, the presence of selective capture (100% specificity, only 41% sensitivity) or a spike-R<80ms (100% specificity, sensitivity 46%) ensured 100% accuracy to predict LBBP capture. Conclusions Stepwise application of ECG and electrogram criteria ensured an accurate assessment of left conduction system capture.

Correction of dyssynchrony by conduction system pacing: results of LEVEL-AT trial

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Catalan Society of Cardiology; Asociación del Ritmo Cardiaco (Spanish Society of Cardiology). Background Correction of dyssynchrony measured with echo strain, in conduction system pacing (CSP) vs biventricular pacing (BIVP) has not been reported. Objectives Our purpose was to compare echocardiographic dyssynchrony correction and strain improvement during follow-up between CSP and BIVP. Methods A treatment received analysis was performed in patients (n=29 CSP; BIVP 40). Patients were evaluated at baseline (ON and OFF programming) and at 6 and 12 months. All echocardiograms were completed by operators blinded to the type of device implanted. Intraventricular (septal flash), interventricular (difference between left and right ventricular outflow times), and auriculoventricular (diastolic filling time) dyssynchrony, as well as strain parameters (septal rebound, global longitudinal strain (GLS), and Risum pattern (typical left bundle branch block contraction pattern)) were analyzed. Results 32% (22/69) were women; baseline LVEF was 27.5% (7% SD) and left ventricular end-systolic volume (LVESV) 138ml (77ml SD) without differences between groups. At the 12-month follow-up, there were no differences in CSP vs. BIVP in LVEF (45.8% (10% SD) vs. 42.7% (12% SD), p=0.25) and LVESV (81.5 ml (41 ml SD) vs. 101.7 ml (56 ml SD), p=0.08). Longitudinal analyses showed that the improvement of all echocardiographic dyssynchrony parameters over time was similar between groups (p<0.001) (Table 1 and Fig 1A). GLS acute correction significantly correlated with LVEF and LVESV at the 12-month follow-up (Fig 1B). Conclusions CSP and BIVP provided a similar dyssynchrony and strain correction over time. Acute strain correction predicted ventricular remodeling at 12 months follow-up.

Prognostic value of subclinical congestion assessed by lung ultrasound in STEMI patients in a short-term follow-up

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): This project received a Scholarship for Training and Research from the Association of Ischemic Heart Disease and Cardiological Critical Care of the Spanish Society of Cardiology and an Original Research Projects Grant from the Catalan Society of Cardiology. Background Heart failure (HF) is an important prognostic factor in ST-segment elevation myocardial infarction (STEMI). Although most STEMI patients are Killip-Kimball class I (KK-I) at admission, there is a risk of developing HF during hospitalization and follow-up. Lung ultrasound (LUS) is an easy, fast, and accurate technique that allows pulmonary congestion to be diagnosed even in pre-clinical stages. Several risk scores have been developed to identify low-risk STEMI patients, nonetheless any of these scores include LUS assessment. Purpose We evaluated the prognostic value of subclinical congestion assessed by LUS at hospital admission in patients with KK-I STEMI. Primary endpoint was a composite of readmission for HF or new acute coronary syndrome or death during 30-day follow-up. Methods This was a multicenter study prospectively enrolling 300 patients admitted for KK-I STEMI. LUS was performed during the first 24 hours after revascularization by and independent operator and B-lines were counted off-line differentiating between patients with wet lung (≥ 3 B-lines in at least one lung field) or dry lung. To assess whether LUS could improve the predictive capacity of current risk scales, a model with categorical result of LUS (dry/wet lung) and categorical result of Zwolle score (low/higher risk) was compared to the isolated result of Zwolle score and net reclassification index (NRI) was calculated. Results Wet lung patients had a higher risk of developing the follow-up composite endpoint (hazard ratio [HR] 10.8, 95% CI 2.6-45.2, p=0.001). After adjusting by a propensity score including age, sex, hypertension, chronic kidney disease (glomerular filtration rate <60ml/min/1,73m2), previous atrial fibrillation/flutter, anterior STEMI, and LVEF, a LUS finding of wet lung remained an independent risk factor for the composite endpoint (adjusted HR 5.4, 95% CI 1.0-28.7, p=0.049). LUS was able to predict de composite endpoint with 62.5% sensitivity, 86.8% specificity, 11.1% positive predictive value and 98.9% negative predictive value. LUS improved the predictive capacity of the Zwolle score (net reclassification improvement = 0.99, 95% CI 0.29-1.69, p=0.006) to predict the composite endpoint. CONCLUSIONS Early subclinical pulmonary congestion identified by LUS in KK-I STEMI patients at hospital admission is a strong predictor of adverse outcomes at 30-day follow-up. Patients without subclinical congestion have a very low risk of adverse outcomes and can potentially benefit from an early discharge. LUS improves the predictive ability of the Zwolle risk score, allowing a more accurate identification of low-risk patients.

Clinician’s attitude towards clozapine prescription

IntroductionCurrent clinical guidelines recommend the use of clozapine for the treatment of refractory schizophrenia, present in up to a third of patients with this disease. Despite the evidence, the data point to low prescription, underdosing, and delayed initiation.ObjectivesThe objective of the study is to elucidate which factors may interfere in clozpine prescription.MethodsThis is a cross-sectional observational study, carried out using a survey designed specifically for it.It was answered online by seventy psychiatrists affiliated with the Catalan Society of Psychiatry.ResultsMore than half admitted having prescribed two or more antipsychotics without having previously ruled out pseudorefractoriness through depot treatment. 70% recognized the need for monitoring as the main prescription barrier, while the main reason for withdrawal was its adverse effects. The most alarming was considered agranulocytosis, with drooling, drowsiness and weight gain being the most reported.Statistically significant differences (p=0.031) were found in relation to the years of experience and the device where clozapine was preferred to be started: <10 years in hospital, 10-20 years in partial hospitalization and >20 years outpatient office.Statistically significant differences were observed in the preference of the device for its initiation depending on the usual work device: hospitalization (p<0.000) and partial hospitalization (p=0.046) preferred to schedule it from their respective devices, without any preference in consultations.The level of experience and the most reported side effect were statistically significant: for the newest psychiatrists it was weight gain (p=0.031), without presenting differences in the rest of the groups.ConclusionsClozapine is the psychoactive drug of choice in refractory schizophrenia, so efforts should be devoted to reducing prescription barriers, offering training on its management and innovating forms of monitoring to promote its use.Disclosure of InterestNone Declared

Primary and Community Care Transformation in Post-COVID Era: Nationwide General Practitioner Survey.

The health emergency caused by COVID-19 has led to substantial changes in the usual working system of primary healthcare centers and in relations with users. The Catalan Society of Family and Community Medicine designed a survey that aimed to collect the opinions and facilitate the participation of its partners on what the future work model of general practitioners (GPs) should look like post-COVID-19. Online survey of Family and Community Medicine members consisting of filiation data, 22 Likert-type multiple-choice questions grouped in five thematic axes, and a free text question. The number of respondents to the questionnaire was 1051 (22.6% of all members): 83.2% said they spent excessive time on bureaucratic tasks; 91.8% were against call center systems; 66% believed that home care is the responsibility of every family doctor; 77.5% supported continuity of care as a fundamental value of patient-centered care; and >90% defended the contracting of complementary tests and first hospital visits from primary healthcare (PHC). The survey responses describe a strong consensus on the identity and competencies of the GP and on the needs of and the threats to the PHC system. The demand for an increase in health resources, greater professional leadership, elimination of bureaucracy, an increase in the number of health professionals, and greater management autonomy, are the axes towards which a new era in PHC should be directed.

Carga administrativa, motivación y bienestar entre médicos de atención primaria. Comparación entre modelos de gestión

ObjectiveTo analyze the relationship between administrative burden and intrinsic motivation and between administrative burden and professional well-being among family and community medicine physicians. To analyze the extent to which attention to three basic needs (autonomy, sense of competence and relationship capacity) that one of the main motivation theories identifies as a generator of intrinsic motivation compensates for the negative effect of the administrative burden. To compare management models. MethodData from a survey (542 valid questionnaires) carried out through the Catalan Society of Family and Community Medicine are used. Data analysis is based on multiple regression and ANOVA techniques. ResultsThe perception of administrative burden and “red tape” are clearly demotivating and reduce job satisfaction. On the contrary, individual autonomy, networking opportunities between professionals and performance feedback are motivating and feed the perception of professional well-being. The EBA (Association Based Entity) model presents results above the ICS (Catalan Health Institute) and OSI (Integrated Health Organizations) models both in controlling the negative effect of administrative burden and in the management of basic psychological needs. ConclusionsThe motivation and professional well-being of primary care physicians would benefit from reforms that limit the administrative burden of some procedures and red tape. At the primary health center level, greater attention to individual autonomy, improving relatedness between professionals and the sense of competence based on better information on individual performance can offset the negative effects of the administrative burden.

Gender differences in GPs’ strategies for coping with the stress of the COVID-19 pandemic in Catalonia: A cross-sectional study

Background The Covid-19 pandemic has increased stress levels in GPs, who have resorted to different coping strategies to deal with this crisis. Gender differences in coping styles may be contributing factors in the development of psychological distress. Objectives To identify differences by gender and by stress level in coping strategies of GPs during the Covid-19 pandemic. Methods A cross-sectional, web-based survey conducted with GPs in Catalonia (Spain), in June–July 2021. via the institution’s email distribution list, all GPs members of the Catalan Society of Family and Community Medicine were invited to complete a survey assessing sociodemographic, health and work-related characteristics, experienced stress (Stress scale of the Depression, Anxiety and Stress Scales-DASS 21) and the frequency of use of a range of coping strategies (Brief-COPE) classified as problem-focused, emotion-focused and avoidant strategies, some of which are adaptive and others maladaptive. We compared the scores of each strategy by gender and stress level using Student’s t-test. Results Of 4739 members, 522 GPs participated in the study (response rate 11%; 79.1% women; mean age = 46.9 years, SD = 10.5). Of these, 41.9% reported moderate-severe stress levels. The most common coping strategies were acceptance, active coping, planning, positive reframing and venting. More frequently than men, women resorted to emotional and instrumental support, venting, distraction and self-blame, whereas men used acceptance and humour more commonly than women. Moderate-severe stress levels were associated with non-adaptive coping, with increased use of avoidance strategies, self-blame, religion and venting, and decreased use of positive reframing and acceptance. Conclusion The most common coping strategies were adaptive and differed by gender. However, highly stressful situations caused maladaptive strategies to emerge.

Role of emergency departments and emergency physicians in expanding clinical knowledge on drug-related events.

aEmergency Department, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona bExpert Group on Toxicology of the Catalan Society of Emergency Medicine (SoCMUE-Tox), Barcelona, Catalonia, Spain Received 18 August 2022 Accepted 21 August 2022 Correspondence to Miguel Galicia, MD, Emergency Department, Hospital Clínic, Villarroel 170, 08036 Barcelona, Catalonia, Spain, Tel: +34 932 27 98 33; e-mail: [email protected]

Septal flash correction with His-Purkinje pacing predicts echocardiographic response in resynchronization therapy

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Grant of the Catalan Society of Cardiology, 2019; Research Grant Josep Font 2019, Hospital Clínic de Barcelona His-Purkinje conduction system pacing (HPCSP) has been proposed as an alternative to cardiac resynchronization therapy (CRT); however, no predictors of echocardiographic response have been described. Septal flash (SF) is a marker of intraventricular dyssynchrony. Methods The study aimed to analyze whether HPCSP corrects SF in patients with CRT indication, and if correction of SF predicts echocardiographic response. Prospective observational study (n=30). Left ventricular ejection fraction (LVEF) was measured with echocardiography at baseline and at 6-month follow-up. Echocardiographic response was defined as increase in 5 points LVEF. ECG Imaging was performed in 2 patients to validate ventricular activation shortening and to study the basal and HPCSP activation pattern. Results HPCSP shortened QRS duration by 48±21ms and SF was significantly decreased (baseline 3.6±2.2mm vs HPCSP 1.5±1.5mm p<0.0001) (Fig.1). At 6-months, mean LVEF improvement was 8.6% ± 8.7% and 64% of patients were responders. There was a significant correlation between SF correction and increased LVEF (r=0.61, p=0.004). A correction of >1.5mm had 81% sensitivity and 80% specificity to predict echocardiographic response (area under curve 0.86, p=0.019). Conclusion HPCSP improves intraventricular dyssynchrony and results in 64% echocardiographic responders at 6-month follow-up. Dyssynchrony improvement with SF correction may predict echocardiographic response at 6-month follow-up (Fig.2.).

The Role of the Civil Society in the Catalan Political Process (2012–2021)

The purpose of this paper is to understand the role of the civil society during the Catalan political process (2012–2021). In a context of a huge political polarization of the Catalan society, we would like to focus on the influence and role of the organized civil society in the political decisions during this period. The methodology used in this paper is based on a qualitative research using in-depth interviews with Catalan spin-doctors, participant observation, and study cases. In the paper, we can prove that the role of the organized Catalan civil society was fundamental to understand some of the decisions taken by the Catalan government, such as the consultation of ninth of November 2014; the referendum of first of October 2017; the proclaim of the Catalan Republic; the demonstrations against de verdict of the Spanish Supreme Court; the pressure of the civil society to boost pro-independence Catalan political parties to continue with a separatist agenda after the 2021 elections; and the following negotiation process with the Spanish government. As far as the findings is concerned, it is important to underline how the Catalan civil society have used different ways to organize themselves and mobilize their followers. We will comment the effectiveness of social networks; how these groups have converted themselves in actors of the political digital conversation; and how they have been able to modify the political agenda and have impacted in the media agenda setting. This paper contributes to understand more effectively the important role of the organized civil society in the Catalan political process and emphasizes its political role and influence. So do, we are able to suggest future political scenarios that could have an important impact on the political polarization that currently affects Catalonia.

Chronic pancreatitis for the clinician: complications and special forms of the disease. Interdisciplinary position paper of the Catalan Society of Digestology (SCD) and the Catalan Pancreatic Society (SCPanc).

Chronic pancreatitis tends to develop a number of complications that may constitute the form of presentation of the disease. Some societies have issued guidelines for diagnosis and treatment of chronic pancreatitis complications, but the level of evidence for any topic is usually low and recommendations tend to be weak. We aimed to provide defined position statements for the clinician based on updated review of published literature and on multidisciplinary expert agreement. The goal was to propose defined terminology and rational diagnostic/therapeutic circuits based on current knowledge. To this end 14 sections related to complications and special forms of chronic pancreatitis (early chronic, groove and autoimmune pancreatitis) were reviewed by 21 specialists from 6 different fields to generate 32 statements. Featured statements assert common bile duct stenosis does not require invasive treatment (endoscopic or surgical) unless cholestasis, cholangitis, lithiasis or other symptoms develop. Pancreatic duct strictures and calculi should be approached (after ruling out malignancy) if causing pain, pancreatitis, pseudocysts or other complications. Treatment of symptomatic pseudocysts must be individualized, considering associated main duct stenosis, vascular and pericystic complications. Higher risk conditions for pancreatic cancer are advance age, smoking, genetic background, recent diagnosis of chronic pancreatitis or diabetes, and appearance of new symptoms. Groove pancreatitis can initially be treated with conservative measures. Both prednisolone or rituximab can induce remission and maintenance of autoimmune pancreatitis. Internal fistula, vascular complications, bacterial overgrowth, osteoporosis and renal lithiasis require specific therapeutic approaches.

Tension in translation: Spain’s and Catalonia’s discourse on independence

ABSTRACT In the aftermath of the 2010 legal and political crisis surrounding the status of Catalonia within Spain, the Catalan pro-independence civil society undertook an extensive campaign during which they produced, translated and distributed many documents in favor of independence. The aim of this campaign was to make the international community, especially the European Union, aware of the Catalan independence cause and ultimately to garner support from outside Catalonia and Spain. Our study aims to understand the way pro-independence discourse in translation depicts the crisis at large, and more specifically the relationship between Catalonia and Spain in the early stages of the crisis. To this end, we conducted a critical discourse analysis using Chilton and Schäffner’s strategic functions, drawing on three books produced, translated and distributed between 2010 and 2014 and that deal primarily with the independence of this autonomous community of Spain.